[20F] Experiencing severe dizziness, ear pain, and uncontrolled eye movements

Patient Description

A 20-year-old female is experiencing severe dizziness described as a sensation of the room spinning and eyes moving uncontrollably, which has been persistent for minutes and is worse in the morning and before bed. The patient also reports sharp and clogged ear pain for a week, visual disturbances with the eyes crossing and moving up and down, and extreme nausea with an urge to vomit. The symptoms of lightheadedness and headache started suddenly and have been on and off, with a persistent sense of imbalance. The patient is currently taking Ritalin (10mg twice daily), Amitriptyline (75mg at night), Trazodone (50mg as needed), and Ativan (0.5mg as needed), and has a known allergy to Sulfa. There is no recent history of trauma, and the patient is not aware of any family history of vestibular disorders. No other pre-existing conditions, chronic illnesses, or substance use was reported.

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Arora's Assessment

What might be happening

Based on the information provided, possible conditions include:

  • Vestibular Neuritis: This condition is an inflammation of the inner ear usually caused by a viral infection, resulting in dizziness and loss of balance. The symptoms you described, such as severe dizziness, nausea, and problems with balance, are common in this condition.

    • Treatment usually involves medications to reduce inflammation and to manage symptoms such as nausea and dizziness.
  • Meniere's Disease: This is a disorder of the inner ear that can lead to dizzy spells (vertigo) and hearing loss. In most cases, Meniere's disease affects only one ear.

    • Treatment typically involves a combination of medications, lifestyle changes, and sometimes surgical procedures.
  • Benign Paroxysmal Positional Vertigo (BPPV): This condition causes intense, brief episodes of dizziness or vertigo associated with moving the head, often when rolling in bed or getting up in the morning. BPPV is the most common cause of vertigo.

    • Treatment often involves maneuvers that can be performed in a doctor's office to reposition loose crystals in the inner ear.
  • Labyrinthitis: This is an inner ear disorder. The two vestibular nerves in your inner ear send your brain information about your spatial navigation and balance control. When one of these nerves becomes inflamed, it creates a condition known as labyrinthitis.

    • Treatment involves medications to reduce inflammation and to manage symptoms such as nausea and dizziness.

Please note that these are possibilities based on the symptoms you've described and you should seek medical attention for a proper diagnosis and treatment.

What you can do

  1. Rest and avoid sudden position changes. If you need to stand, do it slowly.
  2. Avoid bright lights, TV, and reading during a vertigo attack. They may make symptoms worse.
  3. Avoid activities such as driving, operating heavy machinery, and climbing while you are having symptoms.
  4. Drink enough fluids, eat a healthy diet, get enough sleep, and avoid stress.

What you should look out for

Seek immediate medical attention if you:

  • Have a new, severe headache
  • Are experiencing fever, double vision, or trouble using your arms or legs
  • Have a loss of consciousness
  • Have symptoms that are new, become more severe or frequent

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for BPPV (Benign Paroxysmal Positional Vertigo)

People Also Ask


What are the common symptoms of vestibular neuritis?

Common symptoms of vestibular neuritis include sudden, severe dizziness (vertigo), balance problems, nausea, and sometimes hearing loss. It is often caused by a viral infection that inflames the inner ear.


How is Meniere's disease typically treated?

Meniere's disease is typically treated with a combination of medications to reduce vertigo and nausea, lifestyle changes such as a low-salt diet, and sometimes surgical procedures if symptoms are severe and persistent.


What causes Benign Paroxysmal Positional Vertigo (BPPV) and how is it treated?

BPPV is caused by small crystals of calcium carbonate that become dislodged in the inner ear. It is treated with specific head maneuvers, such as the Epley maneuver, which can be performed by a healthcare provider to reposition the crystals.


What should I do if I experience severe dizziness and imbalance?

If you experience severe dizziness and imbalance, it is important to rest, avoid sudden movements, and seek medical attention to determine the underlying cause. Avoid activities that require balance and coordination, such as driving, until symptoms improve.


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