Dizziness, vertigo, light-headedness, rocking or swaying sensations

[ChessieCat]

1 hour ago, Galmond said:

The weird thing is I didn't get it when I CT from cymbalta after six years but got it after stopping pristiq after 1 month go figure.

 

I've had two completely different experiences with two different drugs.  I CTed citalopram and felt great for a few months and then crashed big time with the flu, was bedridden for 2.5 weeks and lost 8kgs because I couldn't eat.  At the time I didn't realise it was withdrawal.  I ended up on Pristiq, and when I tried to reduce from 100mg to 50mg I suffered severe cog fog for two weeks before I found SA and they suggested I updose.

[Nubl]

On 1/22/2015 at 5:52 PM, iquit said:

Hi All!

 

I am still trying to find my way around here, so I haven't posted much.  I think I have the search function and Google function figured out, but am shocked that there aren't more threads discussing the topics in my header!  It seemed on PP there were pages of threads discussing this!  I have found maybe 2-3 threads here.  I am starting to wonder if it's just me.

 

Dizziness, vertigo, and lightheadedness are by FAR my worst w/d symptom.  Honestly, it wasn't for that, I'd be pretty good to go other than the occasional anxiety attack.  I am eight months off Lexapro.  This has actually been an issue for me on and off since I got pregnant with my daughter, and was three months off basically a CT of Paxil.  I attributed it to the pregnancy.  Then, I had her, and my symptoms got WORSE!  They hung around until I started Lexapro.  While in the beginning months of Lexapro, I had my first ever experience with vertigo.  It has kind of been with me ever since on and off.  When I started weaning, it definitely picked up, and off the Lexapro, it hasn't been very fun.

 

My daughter is SEVEN, by the way.  That is a looooong time to be dealing with this.  And, I'd really like it to go away.  Like NOW.  RIGHT NOW.  I had a complete ENT workup after she was born, along with an MRI, and nothing was found.  I haven't really done any other testing since then, because I figure hey, it's been seven years.  If it was something serious, I probably wouldn't be typing this by now.  I have a 12 year history of SSRI use on and off... I am wondering if the long term use could have caused this as well.

 

Any other sufferers out there?  Why are your symptoms and experiences? 

 

Any out there who have had this issue, even for a long time, and have had it get better?

 

To all of you past PPers, feel free to skip or not reply!  I know you have all heard it before!   Still just looking for some answers and relief...

 Hi my name is Nubl

Three years with issues similar to yours. Light headed , blurred vision.  Dizziness. 

Off Paxil 9 months now. 

Keep in touch. 

[deadbrain]

Hi everyone need some advice. I was doing a teaching job for 3 weeks it was sort of overstimulating as all my sensitivities to food and light would come back, plus I was in constant brain fog, burning would come back, severe migraine, IBS like symptoms.All these symptoms of withdrawal I had mainly during the first year and they sort of waxed and waned over time. I continued the job since I was used to these symptoms from year 1 and I really liked this job(and for 3 years in withdrawal I had no proper job). However in the the last 2 days I developed a new symptom something I had not experienced at all in my withdrawal until now and that was dizziness. I just left the job since this symptom.  It's extremely irritating because now my basic things like driving,walking are getting affected.  Does this go away by just resting and not overstimulating myself. 

[Nubl]

I’m still dealing with the same issues. Light-headedness, gait instability, blurred vision. This started three years ago when I was introduced to ssri meds. I off all SSRIs for almost a year. Hell on earth. Hell on earth. All my issues started when I took Zoloft, then Paxil. The SSRIs have changed my life. Again, hell on earth. Please share your experiences with me. 

Nubl

[Blondiee1915]

I still have dizziness 2.2 years acted stopping lexapro (however I am tapering another SSRI now).  It is awful,  unsteady, rocking boat kind of feeling with accompanied weakness and feeling of fainting.  

[direstraits]

I often feel unsteady on my feet almost 5 years after quitting paxil.

I'm afraid people will think I'm drunk.

how can they still be prescribing this junk.

 

hey,I rhymed there...😄

[shespark]

Does this ever go away? And, why does this affect some of us more than others? 😪

[Nubl]

Have been off Paxil for 10 months, am. Stilll light headed. Anyone else feel the same?

 

nubl

[direstraits]

I've been off paxil almost 5 years and still get light-headed and off balance.

[Onmyway]

I just went down from 1.8 to 1.6 mg of citalopram. Tapered from 40/30/20/10/5/0 between September 2018 - Feb 2019. Prior to that had been on 20 mg citalopram for 19 years increased to 40 for a month in the summer during a stressful period. Severe WD - anxiety, akathisia, palpitations in Feb, 1-2 hrs of sleep a night. Used xanax/klonopin to help but it was not tenable and worrying that I would get an addiction went back to 2.5 mg of citalopram within a month and since then slow tapering. Just made a dosage cut from 1.8 to 1.6 (at night) and the next morning had severe nausea/stomach cramps and dizziness. The dizziness has gotten worse today (nausea better) to the point that I had to sit down for a while before leaving the house. It feels like the back of my head is full with fluff and I worry about losing my balance. 

 

I read some place that dizziness is associated with anxiety and while I am not actively anxious (no heart palpitations, mental preoccupation) I wonder if there is a background, almost subconscious anxiety and it manifests as dizziness or if it is really a WD symptom. I had some dizziness after the last cut but much less and it had resolved. The nausea had resolved as well for a couple of weeks. It is just mind boggling to me that 0.2 mg cut when the therapeutic dosage is 20  mg is making such a difference.   

[ShiningLight]

You can be dizzy without necessarily having anxiety.

[JB1234]

I had vertigo for hours and not associated with anxiety 

[lalala]

I was reducing klonopin  and im holding now  but I'm  having  balance issues, had pretty bad dizziness, nausea and  and blurry vision  I was taking the ssri in liquid but messed it up for some time  when down to 4.5mg  of celexa 10%  ...  not sure what is causing what 

[lalala]

On 5/2/2019 at 3:02 AM, JB1234 said:

I had vertigo for hours and not associated with anxiety 

Hi when did it go away or how did you handle it was it from klonopin wd?

 

On 5/2/2019 at 3:02 AM, JB1234 said:

 

 

[papaloapan]

A great doctor that I fully trust in him says that dizziness and vertigo are also caused from a sick and congested liver

[Giulietta]

Has anyone considered whether they may be dehydrated during periods of vertigo?

 

Has anyone taken their blood pressure during times of dizziness when you have not been able to stand/walk?

 

I took mine this morning and found that it was below my normal measurements during theperiod of dizziness:

both on left arm: during period of dizziness: 108/57 sit and 96/61 stand. Feeling much better but still not completely free of dizziness: sit 121/75 and stand 128/82.  The latter are my usual measurements.

 

I take a low dose of lisinopril.

[SOcean]

On 7/12/2011 at 2:53 PM, squirrel said:

Been to see balance specialist today. he says I have uncompensated labyrinthitus. I need vestibular physio.he wants me to take cyclizine to calm it down before I start physio. However this is an antihistamine. according to David Healy many anti-histamines'are serotonin reuptake inhibiting

so you might end up back on an SSRI effectively' so what do I do guys??????????

Hi Squirrel, did you ever compensate? I have a 30% uncompensated loss in my.left ear.  No idea when it happened...I was on prozac at the time and it may have masked it. Now I am 5 months off prozac and I keep more unbalanced and dizzy. Have started rehab so I was wondering how you did with yours? 

[Giulietta]

18 hours ago, SOcean said:

Now I am 5 months off prozac and I keep more unbalanced and dizzy. Have started rehab so I was wondering how you did with yours? 

 

Hello SOcean @SOcean

 

I'm sorry you are continuing to have imbalance and dizziness issues. I have the same (still) and wobbly legs. How much are you impaired now and how frequently do you experience this?

 

I experience this 2-3 times a week now and am chair bound. It my last between 1.5 and more often 3.5 hours. I am truly incapacitated.   Although I experienced this in June/July for the first time - it became worse in September and doesn't go away.

 

18 hours ago, SOcean said:

have uncompensated labyrinthitus. I need vestibular physio.he wants me to take cyclizine to calm it down before I start physio

 

Did you see someone for this and get a diagnosis?  I have just been accepting this as a WD symptom and hoping it goes away.  Maybe it is something to investigate. @Gridley do you have any thoughts?

 

 

 

 

[SOcean]

On 12/21/2019 at 4:21 PM, Guilietta said:

 

Hello SOcean @SOcean

 

I'm sorry you are continuing to have imbalance and dizziness issues. I have the same (still) and wobbly legs. How much are you impaired now and how frequently do you experience this?

 

I experience this 2-3 times a week now and am chair bound. It my last between 1.5 and more often 3.5 hours. I am truly incapacitated.   Although I experienced this in June/July for the first time - it became worse in September and doesn't go away.

 

 

Did you see someone for this and get a diagnosis?  I have just been accepting this as a WD symptom and hoping it goes away.  Maybe it is something to investigate. @Gridley do you have any thoughts?

 

 

 

 

I had testing at ENT. I have a 30% vestibular loss in my left ear. Which means that something damaged the nerve. It could have been a virus or it could have been drug toxicity. I do not know how I got it. The prozac probably covered a lot of it up. Now I just keep getting worse and worse. I am incapacitated 24/7. I can barely walk a straight line. My head is like a balloon floating above me. The treatment for this is usually physical therapy and an anti-depressant so now I probably have to get on another one. The doctors want me to try amitriptyline. I don't even know what to say. I suspect withdrawal is playing huge role in my worsening condition. 

[Pens]

Hi everyone, Im a new member. I was reading this and relating to the dizzyness you are mentioning. The more I read about anti-depressant withdrawal here and by googling I am seeing that the stomach and brain connection can have a profound effect on your body. You are all more knowledgable than I in this area but but I would bring this up to see if anyone has heard of this and could this possibly be one factor contributing to being dizzy.

[Giulietta]

https://www.yourhealthremedy.com/health-tips/menieres-disease-vs-labyrinthitis/

 

Nice comparison of menieres and labyrinithitis

[Giulietta]

On 12/24/2019 at 6:20 PM, SOcean said:

I had testing at ENT. I have a 30% vestibular loss in my left ear. Which means that something damaged the nerve. It could have been a virus or it could have been drug toxicity. I do not know how I got it. The prozac probably covered a lot of it up. Now I just keep getting worse and worse. I am incapacitated 24/7. I can barely walk a straight line. My head is like a balloon floating above me. The treatment for this is usually physical therapy and an anti-depressant so now I probably have to get on another one. The doctors want me to try amitriptyline. I don't even know what to say. I suspect withdrawal is playing huge role in my worsening condition. 

 

Hello SOcean

 

Have you improved? What did you end up trying?

 

I can appreciate your situation now at a very personal level. A bad case of tinnitus and ear pain drove me to an ENT in Feb/Mar in  2019. Result: hearing fine - L ear better than right. Incidentally - first question from the ENT - 'are you getting off of ADs'

 

Now - after months of worsening imbalance - started in Sept, skipped Oct, started in Nov with 4 days, hell in Dec and worse hell in Jan, (modified infant walk to make it to chair - you are way ahead of me on the straight line), dizziness, blurred vision and more - really incapacitated - I am back at the ENT. Step 1 was a new audiology exam yesterday. Guess what. Hearing changed and R hear now much better than L ear.  I posted something on Meniere's and also on Labyrinthitis. Do either of these appy to you?

 

Many drugs are ototoxic, including ADs. Antibiotics are another.  These often resolve and I'm sure it varies.

 

Will let you know what I learn and what I might do about this.

 

Hugs,

Giuilietta

[SOcean]

1 hour ago, Guilietta said:

 

Hello SOcean

 

Have you improved? What did you end up trying?

 

I can appreciate your situation now at a very personal level. A bad case of tinnitus and ear pain drove me to an ENT in Feb/Mar in  2019. Result: hearing fine - L ear better than right. Incidentally - first question from the ENT - 'are you getting off of ADs'

 

Now - after months of worsening imbalance - started in Sept, skipped Oct, started in Nov with 4 days, hell in Dec and worse hell in Jan, (modified infant walk to make it to chair - you are way ahead of me on the straight line), dizziness, blurred vision and more - really incapacitated - I am back at the ENT. Step 1 was a new audiology exam yesterday. Guess what. Hearing changed and R hear now much better than L ear.  I posted something on Meniere's and also on Labyrinthitis. Do either of these appy to you?

 

Many drugs are ototoxic, including ADs. Antibiotics are another.  These often resolve and I'm sure it varies.

 

Will let you know what I learn and what I might do about this.

 

Hugs,

Giuilietta

Hi Giulietta, Did you get balance testing/calorics done? I did. It said.my nerve wasn't working right. My balance is completely messed up on one side. My vision is messed up. I have fasciculations. Scared. 

[Giulietta]

2 hours ago, SOcean said:

Did you get balance testing/calorics done?

 

Hi there. I did not. What is it? What type of MD would order this?

 

I got only a hearing test and he said it was OK - and that we would repeat in 6 months. I saw the results and saw a bit of a change - and he said that these things can go up and down int he course of a few months.

 

He indicated I did not have meniere's or Labyrinthitis as I do not have vertigo (i.e., the room is spinning). He also indicated that since my vision is involved - this sounds neurological. His recommendation was to see a balance PT until (or perhaps in addition to) pursuing diagnosis and treatment. 

 

2 hours ago, SOcean said:

My vision is messed up. I have fasciculations.

 

Have you seen an opthalmologist who knows about the effect of meds of vision? Sorry about asking this (dumb?) question since you have a lot of experience with these 'meds.'  Only one out of 5 came out and said that the clonazepam and lamotrine would cause my problems. Lamotrigine can have permanent damage when taken for a prolonged time.

 

I have Myokymia - an involuntary, spontaneous, localized quivering of a few muscles under my R eye - new the past 2 months. It's odd - you can see the muscle contracting. This is self-diagnosed ( - I can't go for every stupid thing I get). I see you have Blepharospasm (do you still?). They don't associate it with ADs.

 

I also have tremors as you do (or did). per your sig.

[SOcean]

It can be the vestibular nerve, like mine. Balance and vision are effected, not vision. They need to do caloric test and VNG. You just go to ENT that does the balance testing.

 

 Probably coming off the AD is making mine worse too. I feel like some if it is central, in my brain. Yes, I still have the spasm and tremors. And I haven't found any good eye doctors. 

[Giulietta]

3 hours ago, SOcean said:

Balance and vision are effected, not vision

 

Hi -

 

Thanks. What do you mean by your comment? I have imbalance - and sometimes with it I have blurry vision (meaing I'm sitting and reading and struggle or can't read anything).

 

Do only some ENTs do these tests you mention?  How do you find one? I expected more form the MD I saw today. I'm grateful for your direction.

 

Re: an eye MD: is there a teaching hospital near you? Or perhaps one with satellites? They may have more 'better qualified' MDs. On the other hand, you may find a greater likelihood to find a good person at one of these places - but living near them - I wouldln't say you find the cream of the  crop there more than 75% of the time.

 

That being said - word of mouth is a decent indicator.

 

I better nix the document I'm sending to theneurologist then now...I don't want there to be discussion about my months' long issue with this....they'll want to fix it with another prescription.😎 I've been trying not to say anything about physical symptoms. She knows the psych.

 

I re-reviewed your sig and I hope some of these symptoms have died done. I noticed your comment about gabapentin. Based on my personal experience with it, and others I know who tried it for p ain management - it's a lot of terrible side effects, hard to taper onto, and doesn't work. It ws developed as an add-on for seizure control. Then the drug company wants to make more money so they decide to sell it in for other problems.....

 

Glad the flexerall provides some help

 

September 2019 Was prescribed Gabapentin for withdrawal symptoms and tremor. Scared to take it due to side effects and worried it will make things worse.

 

Well - goodnight. Have a restful sleep.

[SOcean]

1 hour ago, Guilietta said:

 

Hi -

 

Thanks. What do you mean by your comment? I have imbalance - and sometimes with it I have blurry vision (meaing I'm sitting and reading and struggle or can't read anything).

 

 

Hi, sorry - I meant that vestibular nerve problems effect balance and vision but NOT hearing. I would call around to ENT's  and Audiologists and ask if they do the specific balance tests....Calorics and VNG especially. That will tell you what is going on in your ear, where the problem is and what percentage you are off. These drugs can probably effect the vestibular nerve. Or this issue can also be caused by a virus. Your tests could come out normal too...it may not be with the nerve, but at least you'll know. They can help find what the issue is.

With me, it was the nerve. I am still suffering, we haven't figured things out yet.

 

There is also something called PPPD. Look that up. I have that as well as my nerve problem. 

 

Currently I'm not on any meds. I need to update signature. I keep reacting to everything so I'm only taking advil, vitamins and cbd. I have been to multiple eye doctors and neuropthamologists. I am extremely frustrated. None are taking me seriously. I did get prism glasses for my eye misalignment but they make the visual vertigo worse, so I haven't been wearing them, which causes a ton of pain. I can't win. 😭

[Giulietta]

You poor thing!  What a wringer!

 

7 hours ago, SOcean said:

balance and vision but NOT hearing

 

This is me. Vision may or may not be affected. That may be coincidental since it is some days thing - come to think of it I may have that when my balance is normal.

 

I looked back up on the discussion about your PT and wondered if you pursued (guessing you did) and hoped that alleviated symptoms. I was advised to pursue that while diagnosis and treatment is pursued. 🙄

 

You have done a tremendous amount of research on your vestibular (and ocular?) system. I came across a little information about melanin in the eyes and ears - mostly eyes. As you may or may not know. eyes (particularly?) are loaded with melanin. So, they can soak up drugs like lamotrigine (and not enough resarch on this -  a few studies ) which is toxic to eyes. I don't know where on earth I found it. Other drugs  - GABA drugs? - may be the same.

 

I literally found this when searching for the article mentioned above...https://www.ncbi.nlm.nih.gov/pubmed/28838247

It could lead to a person or solution that can help us.

 

In addition - I looked up since your comments to learn more about our vestibular system- "It is pointed out that melanin is capable of binding ototoxic drugs" and that is is plentiful in the inner ear. I copied/pasted the article below this msg and the link as well. It draws a link to hereditary diseases (and who knows what else). thi sis from pubmed.

 

I mentioned the imbalance, etc. general complaints to the neuro as a follow-up to our visit. She suggested reducing lamotrigine which I don't know is hte problem and not something to mess with unless you are sure to do it. I don't want word to get to psych. I'm not sure this is a lamotrigine issue.  I still think this should be pursued. ENT disappointed yesterday so now I have to respond to neuro in a tactful way. I would like to keep any credibility I may have - as would we all.

 

Did Squirrel have any luck? I don't see that she has been on in a while?

 

Are you and I the only people on the site with this issue? I don't know how to find out.

 

10 hours ago, Guilietta said:

eye MD: is there a teaching hospital

 

I was 'lucky' to find someone (happened to be a teaching hospital satellite) who suggested klonopin and lamotrigine for the vision - this was years ago - but have not spoken with her or anyone else about this exacerbation. I know what the problem is.

 

I'm afraid to go to these people because they may want to give me a script for something. Like you - I want advil and vitamins. Iwould like off the  crestor if I can as well.

 

 

 

8 hours ago, SOcean said:

prism glasses

 

Are these what people are prescribed for people with cross-eyes? I remember so many kids growing up wearing them and it did correct them

 

I use a magnifying glass to read paper with but it has limits like H/As. Otherwise reading is near impossible.

 

take care,

Giulietta

 

https://www.ncbi.nlm.nih.gov/pubmed/3070525

Pigment Cell Res. 1988;1(4):238-49.

Physiology and pathophysiology of inner ear melanin.

Meyer zum Gottesberge AM1.

Author information

Abstract

The presence of melanin in the inner ear was established more than a century ago, but the exact biological function of the pigment in the labyrinth has yet to be determined. In this brief review, the correlation of pigmentation and inner ear function, as well as the presumed role of melanocytes in hereditary diseases are discussed. Special attention was drawn to the composition of melanin and its presumed function as a biological reservoir for divalent ions and as an ion exchanger, as well as an intracellular buffering system for calcium. It is pointed out that melanin is capable of binding ototoxic drugs. Finally, morphological responses of melanocytes to local disturbance of Ca++ homeostasis in the inner ear are described as 1) intracellular movement and intraepithelial deposition of melanosomes; 2) cell motility; 3) neomelanogenesis; and 4) enhanced exocytotoxic/endocytotic activity. The possible consequences of this malfunction of the melanocytes on the inner ear function are discussed.

 

[Giulietta]

On 1/30/2020 at 12:45 AM, SOcean said:

I meant that vestibular nerve problems effect balance

 

Hello SOcean,

 

How are you today.

 

I thought of an idea to find an opthalmologist in my quest to find a specialist in balance disorders. I see that otolaryngolosts are neurologists (when I have searched for balance disorders/vestibular). 

 

I got these ideas for you re: how to find eye specialists - it may take a bit of resarch. I hope it helps. Let me know:

 

• Look at journals (pubmed) and identify names of people who live near you - or a place where you can get to).  Or not nearby. Their locations would be located on the publication. Even if they are not nearby they might be able to give you names of people who are commutable.
• Look at clinical trials on clintrials.gov (if I have that right) and see who is involved in studies. You could try reaching them for recommendations.
• As everything is international - people in India or the UK might know of people connected with someone near you - or someone doing the resarch may be nearby.

Hugs,

Giuilietta

 

[Giulietta]

@Nubl @SOcean @Miko789 @Junglechicken @anona

@IrishMonkey92 @apace41 @direstraits @TortugaHealing @deadbrain @Blondiee1915 @lalala @shespark @JB1234 @Pens @Onmyway @Healing

 

Hello all,

 

Thank you for all of your helpful posts - and to @SOcean

 

I hope you are improving (or are not having the vestibular/sea legs/vertigo other garbage put upon us). 

 

If you are interested - I posted a few questions to see if there any trends/commonalities amongst our group - particularly the sea legs/vestibular/head turns/dizziness issues. I hope this info might be organized in some way.

 

1. Amongst us - who has vestibular/sea legs/vertigo/imbalance symptoms (still or at all)?

2. How long have they/did last (weeks, months, years...)

3. Do they  follow  a consistent pattern of onset or occurence that you can tell? (i.e., multiple throughout the day, occur at one time of day generally, occur throughout the week, a couple of times a month...? time of day?)

4. How long do they last? (15 min, 1 hour, 1 day...etc.) 

5. Do they regularly start at a certain time or the day? Do they have a trigger or just come on?

6. How incapacitating are they for you (physically, mentally, sensory, emotional)  - are you  chair or bed bound? 

7. Do you have other symptoms that occur during the attacks of vertigo (for example, blurry vision, headache, nausea, anxiety, foggy thinking...)

 

This kind of info for people getting off ADs doesn't seem to be available.

 

I'll collate the information from anyone who cares to post their 2 cents. I'll post my feedack to the above questions below.

 

Thanks,

Giulietta

 

[Giulietta]

Just now, Guilietta said:

1. Amongst us - who has vestibular/sea legs/vertigo/imbalance symptoms (still or at all)?

 

Yes I have this.

 

1 minute ago, Guilietta said:

. How long have they/did last (weeks, months, years...)

 

Since June 2019 - 6 mos post near CT (Dec 2018)

 

2 minutes ago, Guilietta said:

Do they  follow  a consistent pattern of onset or occurence that you can tell? (

 

Yes. Frequency 10 times a month (increase since June).

 

Note: I didn't have any in October!  

 

4 minutes ago, Guilietta said:

4. How long do they last? (15 min, 1 hour, 1 day...etc.) 

 

Generally 3-3.5 hours. Rare if 2 hours.

 

5 minutes ago, Guilietta said:

Do they regularly start at a certain time or the day? Do they have a trigger or just come on?

 

Mornings - they start about 30-45 min after my feet hit the floor (7.30 ish). Even if I am holding my body squarely - etc., not moving head....doesn't matter. I can't prevent them from coming on. Don't know what else to try.

 

They occur back to back, every o ther day, or I am happy if I get 4 or 5 good days in a row.

 

7 minutes ago, Guilietta said:

How incapacitating are they for you (physically, mentally, sensory, emotional)  - are you  chair or bed bound? 

 

Chair or bed bound for first 2 hours. Must sit squarely in chair or I will tip over. Glutes weak. Cannot walk unaided. Sea legs. Thighs stiff (this may be one of first indicators of onset). Last hour or so generally stagger like a toddler. Migraine/head ache, worse when moving head, I think I have nystagmus - can't tell be sure, can't focus on words. Trouble with fine motor skills. Ears may pop. Tinnitis - but that is present most of the time. Rest of day I tend to be lightheaded and have some residual dizziness.

 

 

 

 

[Giulietta]

I found this article on screening. Abstract available. Pub in Nov 2019

https://www.ncbi.nlm.nih.gov/pubmed/30995137

 

J Neurophysiol. 2019 Jul 1;122(1):81-92. doi: 10.1152/jn.00819.2018. Epub 2019 Apr 17.

A review on screening tests for vestibular disorders.

Cohen HS1.

Author information

1

Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine , Houston, Texas.

Abstract

Although many studies have reported on tests of the vestibular system a valid and reliable, evidence-based screening battery for easy clinical use remains elusive. Many screening tests attempt to assess the vestibulo-ocular reflex. Therefore, head shaking, the Dix-Hallpike maneuver, the supine roll test, and head impulse tests are discussed. Other tests address the spatial orientation functions of the vestibular system, such as the Bucket Test and the Fukuda Stepping test. Still, other tests are based on the known correlates with balance skills, both static and dynamic, such as tandem walking and the modern variation of the Romberg test, the modified Clinical Test of Sensory Interaction and Balance. This review provides a critical overview of the literature on some of these tests and their value for clinical use and in epidemiological studies.

KEYWORDS:

balance; diagnostic testing; screening

 

Another evaluative/diagnostic article:

https://www.ncbi.nlm.nih.gov/pubmed/24664545

 

Otolaryngol Head Neck Surg. 2014 Jul;151(1):131-6. doi: 10.1177/0194599814527724. Epub 2014 Mar 24.

Utility of Stepping, Walking, and Head Impulses for Screening Patients for Vestibular Impairments.

Cohen HS1, Sangi-Haghpeykar H2, Ricci NA3, Kampangkaew J4, Williamson RA5.

Author information

Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA hcohen@bcm.edu.

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.

Division of Otoneurology, Department of Otolaryngology-Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil.

Baylor College of Medicine, Houston, Texas, USA.

Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.

Abstract

OBJECTIVE:

To determine if some common screening tests predict scores on detailed, objective diagnostic tests of the vestibular system.

 

Edited February 4, 2020 by Guilietta
Adding 2nd article on vestibular diagnosis

[Giulietta]

This article - although cited for anti-epilepsy drugs - includes a number of drugs that members on SA are taking  (gabapentin and lamotrigine are mentioned) - which many are tapering from or currently on to manage AD WD symptoms (for example). The research findings are based on subjects with therapeutic levels.

 

https://www.ncbi.nlm.nih.gov/pubmed/28838247

 

Expert Opin Drug Saf. 2017 Nov;16(11):1281-1294. doi: 10.1080/14740338.2017.1372420. Epub 2017 Aug 29.

The auditory and vestibular toxicities induced by antiepileptic drugs.

Hamed SA1.

Author information

a Department of Neurology and Psychiatry , Assiut University Hospital , Assiut , Egypt.

Abstract

Epilepsy is a chronic medical disease in one third of patients and is associated with comorbid adverse somatic conditions due to epilepsy itself or its long-term treatment with antiepileptic drugs (AEDs). Data from experimental, cross-sectional and prospective studies have evidence for the deleterious effect of some AEDs on the auditory and vestibular systems. These abnormalities may be reversible or irreversible. Areas covered: This article review the evidence that long-term treatment with some antiepileptic drugs (AEDs) [e.g. carbamazepine, phenytoin, valproate, lamotrigine, gabapentin, vigabatrin and oxcarbazepine] (even in therapeutic drug doses) may result in tinnitus, phonophobia, sensorineural hearing loss, dizziness, ataxia, disequilibrium, imbalance, nystagmus, abnormalities in saccadic and pursuit eye movements and delayed conduction within the cochlea, auditory nerve and brainstem auditory pathways evidenced by abnormalities in Brainstem auditory evoked potentials and nystagmography recordings indicating auditory and central and/or peripheral vestibular dysfunctions. Expert opinion: Identification of monitoring of patients at high risk for developing audio-vestibular manifestations is necessary for appropriate preventive and therapeutic measures.

KEYWORDS:

Epilepsy; adverse effects; antiepileptic drugs; carbamazepine; hearing loss; imbalance; nystagmus; ototoxicity; valproate; vestibular toxicity

[Giulietta]

Hello all - I missed my PT eval this afternoon due to an MD visit for a worsening cough.  You can't win. So - until I have the eval, etc., I can't share my exerecises. I did find this in case anyone is interested @SOcean I don't know if it will be helpful for you. I haven't tried anything yet. 

 

Epley maneuver

Also called the “Canalith” repositioning maneuver, the Epley maneuver is the first go-to strategy for many people experiencing vertigo. ResearchTrusted Source indicates that the Epley maneuver is extremely effective for people with BPPV. You can perform the maneuver at home by following this simple procedure:

1. Start by sitting upright on a flat surface, with a pillow behind you and with your legs outstretched.
2. Turn your head 45 degrees to the right.
3. With your head still titled, quickly recline with your head on the pillow. Stay in this position for at least 30 seconds.
4. Slowly turn your head to the left, a full 90 degrees, without lifting your neck.
5. Engage your whole body, turning it to the left so that you are completely on your left side.
6. Slowly return to your original position, looking forward and sitting straight up.

You may also have someone assist you with the Epley maneuver by guiding your head according to the steps outlined above. It can be repeated three times in a row, and you may feel dizzy during each movement.

 

Semont-Toupet maneuver

The Semont-Toupet maneuver is a similar set of movements that you can perform at home to treat vertigo. This maneuver is less well-known, but some studiesTrusted Source claim it is just as effective.Trusted Source The Semont-Toupet maneuver is very similar to the Epley Maneuver, but it requires less neck flexibility.

1. Start by sitting upright on a flat surface, with a pillow behind you and with your legs outstretched.
2. Lie down, turning to your right, and look to your left side, looking upward.
3. Quickly sit up and turn to your left side, keeping your head facing to your left. You will now be looking down toward the ground.
4. Slowly return to your original position, looking forward and sitting straight up.

 

Brandt-Daroff exercise

This exercise is most commonly recommended for people with vertigo to do at home, because it is simple to do it unsupervised. You shouldn’t perform the Brandt-Daroff exercise unless you are in a safe place and won’t be driving for a while, because it might provoke increased dizziness for a short period of time.

1. Start by sitting on a flat surface, with your legs dangling as they would from a chair.
2. Turn your head as far as you can to the left side, then lay your head and torso down on your right side. Your legs should not move. Stay here for at least 30 seconds.
3. Sit up and turn your head back to the center position.
4. Repeat the exercise on the opposite side by turning your head as far as you can to the right side, then laying down on your left side.

You can do this exercise in a set of 5 repetitions and repeat it as often as 3 times a day, twice a week.

 

https://www.healthline.com/health/home-remedies-for-vertigo#brandtdaroff-exercise

 

 

 

[Galmond10]

I have had vertigo now for 2 years this month since I cd off cymbalta. It hit about three or four days after stopping and has still yet to go away. It has improved but still very much a issue not allowing me to drive or go on a boat. If anyone knows why this is or things I can do to help repair whatever is damaged I would love any feedback. And yes I've been to a ENT and neurologist they can't find anything.

[Altostrata]

While vertigo can be a withdrawal symptom, I recently had a bout of vertigo that seems to be due to a common inner ear problem that can come and go, especially in older people.

 

I did these exercises and it went away over about a week.