First acute balance issues:
Number & duration of acute phase(s):
Any suspicious physical event/trauma leading up to dizziness:
No trauma. Very heavy and prolonged head cold a few weeks earlier.
Start of chronic phase:
Age at chronic onset:
Prochlorperazine May-August 2018. Betahistine wef August 2018
Number & type of consultants seen to date:
2 x otolaryngologists
1 x unidentified
Diagnoses received (one I’m “running with” first):
Incomplete compensation following acute labyrinthitis.
Middle ear infection
Non-pharmalogical treatment tried which helped:
VRT in the form of Cawthorne-Cooksey exercises and gaze stabilisation exercises
Non-pharmalogical treatment tried which didn’t seem to help
Brandt-Daroff exercises. Replaced with Cawthorne-Cooksey August 2019
Dietary triggers identified:
Not really sure but caffeine may be a contributor so cut it out in July 2020
Any hearing loss in either ear:
Both ears courtesy of Her Majesty’s Armed Forces
Persistent or intermittent tinnitus and character:
Right ear as above. Constant high pitched “electronic” type sound
Left ear started December 2009 (?). Varies from light wind blowing to roaring fire. Consultant’s diagnosis? Tinnitus!!
Other chronic conditions I’m suffering from:
Medication I’m taking for other conditions:
Any personal history of migraines:
Occasional migraine during teens. Last known attack circa 1971.
Any family history of migraines:
Any history of ear problems:
Substantial bilateral hearing loss
How did friends, family, and doctors react to your symptoms?:
Wife is very supportive.
(Your current state)
What’s Gone: (what symptoms you had but no longer get)
No true vertigo since early 2019. Not much nausea. Betahistine seems to help.
What’s Ongoing: (what symptoms you still get)
Overall condition is no better and no worse than it was in August 2019 when I started Cawthorne-Cooksey and swimming. Specifically:
Varying degrees of dizziness
Tinnitus (pre-existing condition)
Brain fog/ mental confusion
Difficulty in concentrating
Generally feeling unwell
Light sensitivity usually brought on by fluorescent lighting
Noise sensitivity when exposed to extremely noisy environments eg. crowds in a theatre
Supermarket/ tall building syndrome
My Worse Day Now:
Visiting a supermarket or garden centre. Dizziness and tiredness start pretty much right away followed by confusion and irritability. Extreme tiredness follows. Generally takes a few days to recover from a single visit.
- It all began when I awoke early one morning in May 2018 to find the room spinning violently.
- The first thing I did was to go back to sleep thinking it would be better in the morning. It wasn’t. Slightly reduced symptoms persisted for several days so I went to see a doctor. Initial diagnosis was a middle ear infection and Prochlorperazine was prescribed.
- August 2018. The Prochlorperazine may have caused visual disturbances so I was switched to Betahistine. Changed GP at this time.
- October 2018 little change in symptoms so I was referred to a consultant who diagnosed BPPV or an acoustic neuroma and sent me for a scan. Brandt-Daroff exercises recommended.
- March 2019. Scan results (“unremarkable”) presented to me by a new doctor who spent a long time talking about the accuracy of the scanning process eventually confirming the diagnosis (had to ask for it) as BPPV. Hardly any examination, however. Doctor unable to answer questions satisfactorily.
- August 2019. Still dizzy. Given unsatisfactory nature of last consultation I went to see an otolaryngologist privately. Thorough discussion of history followed by loads of tests including Dix-Hallpike. Conclusion: not BPPV but incomplete compensation following acute labyrinthitis/ neuronitis. Cawthorne-Cooksey exercises recommended in place of Brandt-Daroff
- September 2019. Put back into NHS system. Sent for extensive vestibular system tests at local hospital. Result: strong vestibular response. No nerve damage. Light/ noise sensitivity mentioned for the first time. I hadn’t previously identified this as a symptom. It was only over the course of the next days, weeks and months that I realised that strong lighting, especially fluorescent, had actually been a factor in the reaction I got in supermarkets etc.
Start of Journal
- November 2020. Noticed that instructions for gaze stabilisation exercises suggest that they may have limited benefit if undertaken whilst on medication. Similar comments in BMJ article 2017.Spoke to consultant who proposed reducing Betahistine to 2 tablets/ day for a month then reducing to 1.
- December 2020. Been on reduced dose for 3 weeks. No beneficial impact on dizziness noticed but tinnitus is almost unbearable.