I went to the Mayo Clinic last week to figure out why I am still dizzy 24/7 even though my initial attack of spinning vertigo was over a year ago. I had been previously diagnosed with MAV by the Chicago Dizziness and Hearing Clinic, who prescribed Effexor. I was not sure about that diagnosis because I found it hard to believe that I had a one-year constant migraine. So I drove up to the Mayo Clinic and spent a few days undergoing tests and meeting with Audiologists, ENTs, and Psychiatrists. It is an amazing facility, and the doctors were tremendous. Here is what happened:
The Audiogram and hearing tests were normal.
The full range of dizziness tests (including Rotary Chair, ENG water caloric, posturography) were all normal.
The ENT exam was normal.
The psychological evaluation showed no depression but a tendency toward generalized anxiety.
Blood pressure, pulse, and blood flow to brain were all normal.
Neurological exam normal.
Previous MRI of the brain normal, blood normal, no lyme disease etc.
They gave me a diagnosis of “Chronic Subjective Dizziness.” They describe this as a conditioned response to a real trauma (such as bppv or an ear infection) where the body gets into a habit of constantly adjusting to the trauma even though it has already passed. The brain is overexcited and looking for patterns and moving back and forth to adjust to what it perceives as motion. They claim it is not a psychiatric condition but rather a ‘software glitch’ where the brain is stuck with an inability to adjust back to the reactions that I made pre-trauma. At first I was dubious of this diagnosis, but the longer that I thought about it, the more it made sense. My bppv (or VN) was quite brutal, and I can understand why my brain went into overdrive trying to adjust, and simply couldn’t ratchet back down. They also showed me a study from Germany that tested whether patients with this diagnosis later turned out to have something more ominous (MS, cancer, Parkinson’s, etc) and the answer was that there was no ominous underlying condition, which I found comforting.
Normally they prescribe Effexor, but since I already take Atenolol for migraine, they are suggesting that I start on Celexa at a very low dose. They want me to keep taking Klonopin for a while to temper the Celexa, then to slowly drop it.
I was incredibly impressed with the Mayo Clinic. The facility is amazing, the doctors and staff treat you as someone special, they work as a team and they have all your records in front of them, and when you ask questions they pull studies out of their files and give them to you. The doctors that I saw were all highly published and well-regarded, and more importantly, they treated me with total respect and concern. There were very few patients there; you get the sense that they take a lot of time on each patient. Anyway, I really felt spoiled there, and I felt that it was a cut above even the highly ranked facilities around here (Northwestern, University of Chicago, etc).
So now I cross my fingers and start on the Celexa, or other anti-depressant, and hope for the best.
I know that not everyone has the time, resources, or insurance to go to the Mayo Clinic, so I wanted to post my experience for those of you who also have long-term 24/7 symptoms.