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Would Slight Vertigo, Hearing Loss, And Left Ear Pain Need Medical Intervention?
Question: My mother is 82 years old. Got up from bed one morning with pain in her left ear. She's had some slight vertigo, hearing loss, sound bothers her so in church she's holding her hand over her ear when the preacher is preaching. She also has some nausea. Has gone to two ENTS, one who did MRI, the other one gave her nausea meds but they are stumped. Nothing is showing up on MRI. Any suggestions?
Brief Answer:
Please see the answer
Detailed Answer:
Hi,
I would like to ask you few questions for better understanding of the patient's situation:
1.Did the complains of ear pain,hearing loss,vertigo ,sound in the ear,and nausea, started at once or patient had earlier complain of hearing loss,sound in ear and mild vertigo and the complain of ear pain started new?
2.Since how long the patient is suffering from these complains?
3.What is the sequence of occurrence of these complains?
4.Is there any history of viral infection like cold after which all the symptoms or some of the symptoms occurred?
5.Does the symptoms of hearing loss,sound in the ear and vertigo remains constant or intermittent?
6.Is there any history if exposure to loud noise or sound like hearing loudspeaker/headphone?
7.Has patient done hearing test?
8.Any history of ear discharge?
9.Is the patient suffering from diabetes?
10.Any history of self cleaning of ear after which the ear pain started?
Awaiting for your answer.
Regards.
Please see the answer
Detailed Answer:
Hi,
I would like to ask you few questions for better understanding of the patient's situation:
1.Did the complains of ear pain,hearing loss,vertigo ,sound in the ear,and nausea, started at once or patient had earlier complain of hearing loss,sound in ear and mild vertigo and the complain of ear pain started new?
2.Since how long the patient is suffering from these complains?
3.What is the sequence of occurrence of these complains?
4.Is there any history of viral infection like cold after which all the symptoms or some of the symptoms occurred?
5.Does the symptoms of hearing loss,sound in the ear and vertigo remains constant or intermittent?
6.Is there any history if exposure to loud noise or sound like hearing loudspeaker/headphone?
7.Has patient done hearing test?
8.Any history of ear discharge?
9.Is the patient suffering from diabetes?
10.Any history of self cleaning of ear after which the ear pain started?
Awaiting for your answer.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
My mother just woke up and got out of bed one morning when the situation started. There were no symptoms before. She has suffered these complaints for the past few weeks.... 3-4 weeks. Initially she felt her ear was blocked and there was pain. No history of viral infection. Hearing loss is constant. ENT has done hearing test to discover there is some hearing loss in left ear. Vertigo is not constant but occurs intermittently daily. No exposure to loud noise. She and my dad lead a relatively quiet life and she does not like TV nor does she use ear phones for listening to music. No history of ear discharge. She does not have diabetes. I don't believe there was any self-cleaning of ear after ear pain started.
Thank you for answering my questions. She has another appt with another ENT in XXXXXXX WV on Friday, but we're not really expecting much. An MRI has already been done and didn't show anything.. no blockage, no nothing. We are stumped... don't know where to turn.
Thank you for answering my questions. She has another appt with another ENT in XXXXXXX WV on Friday, but we're not really expecting much. An MRI has already been done and didn't show anything.. no blockage, no nothing. We are stumped... don't know where to turn.
Brief Answer:
Please see the answer
Detailed Answer:
Hi,thank you for your reply.
Looking at the information given by you,your mother might be suffering from Labyrinthitis(inflammation of inner ear).Viral infection might be a cause.
She may find relief by taking the following medications:
A short course of oral steroid like Prednisolone,it will help in reducing the inflammation,which in turn will help in reduction of all the symptoms,
Tablet Prochlorperazine: which would help in nausea and vertigo,
Herbal medicine like Gingko Biloba:it might help in reducing tinnitus(sound in the ear),
Analgesic with Anti-inflammatory like Ibuprofen if there is ear pain,it should be taken with Antacid like Rantac.
Other measures which might help in tinnitus:
Listening to white noise sound(which can be downloaded from the internet), would help in masking the tinnitus,
Brahmri Pranayam(it can be learned again from internet),
Avoid loud sounds.
Hope this answers your question.Take care.
Please see the answer
Detailed Answer:
Hi,thank you for your reply.
Looking at the information given by you,your mother might be suffering from Labyrinthitis(inflammation of inner ear).Viral infection might be a cause.
She may find relief by taking the following medications:
A short course of oral steroid like Prednisolone,it will help in reducing the inflammation,which in turn will help in reduction of all the symptoms,
Tablet Prochlorperazine: which would help in nausea and vertigo,
Herbal medicine like Gingko Biloba:it might help in reducing tinnitus(sound in the ear),
Analgesic with Anti-inflammatory like Ibuprofen if there is ear pain,it should be taken with Antacid like Rantac.
Other measures which might help in tinnitus:
Listening to white noise sound(which can be downloaded from the internet), would help in masking the tinnitus,
Brahmri Pranayam(it can be learned again from internet),
Avoid loud sounds.
Hope this answers your question.Take care.
Above answer was peer-reviewed by :
Dr. Prasad
Dr Shah: What is the normal course for something like labyrinthitis to run? I was wrong when I told you 3-4 weeks. Talked to my mother today and she said almost exactly 6 weeks today. First went to dr about it 3-4 days later. She also called 911 and was taken to hospital when she awoke and felt funny, thinking way her head felt that she had had a stroke, but tests at the hospital didn't confirm that..
I posed the following questions to her with the following responses:
Ringing in ears: sounds more like buzzing/chirping..
No falls/head injury
No recent sinusitis/cold
Not on any new meds
No hives/redness/pain in face
No loss of sensation in face.
No confusion/drowsiness
No discharge from ear
Does pain go anywhere from ear like down neck/face/chest? Maybe neck
No joint pain
ENT Drs have checked for ruptured eardrum.
Her bp has been high: 165/90-95
Ear does not itch
Doesn't think was checked for Meniere's Disease, but was checked for earwax blockage.
She can move her face on the (left) affected side.
No swollen lymph glands in neck.
Does have problems with balance with and without vertigo.
No difficulting talking/seeing/speaking/swallowing.
No speech delay or trouble comprehending.
No visual auras.
No lump in throat, no sores in mouth, no swelling in jaw, no cough or change in voice.
She was put on antibiotics/steroid combination by dr.
Do you still think it sounds like labyrinthitis? Thank you!
I posed the following questions to her with the following responses:
Ringing in ears: sounds more like buzzing/chirping..
No falls/head injury
No recent sinusitis/cold
Not on any new meds
No hives/redness/pain in face
No loss of sensation in face.
No confusion/drowsiness
No discharge from ear
Does pain go anywhere from ear like down neck/face/chest? Maybe neck
No joint pain
ENT Drs have checked for ruptured eardrum.
Her bp has been high: 165/90-95
Ear does not itch
Doesn't think was checked for Meniere's Disease, but was checked for earwax blockage.
She can move her face on the (left) affected side.
No swollen lymph glands in neck.
Does have problems with balance with and without vertigo.
No difficulting talking/seeing/speaking/swallowing.
No speech delay or trouble comprehending.
No visual auras.
No lump in throat, no sores in mouth, no swelling in jaw, no cough or change in voice.
She was put on antibiotics/steroid combination by dr.
Do you still think it sounds like labyrinthitis? Thank you!
Brief Answer:
Please see the answer
Detailed Answer:
Hi,thank you for the additional information.
Looking at the information given by you,the possible underlying condition which your mother is suffering from might be Chronic Labyrinthitis or Meniere's disease.
1.)Labyrinthitis:Generally ,the labyrinthitis gets resolved in 2-6 weeks,but few people might suffer from the symptoms for a longer duration of time, especially vertigo.But the intensity of symptoms would be less than in the acute stage.
For the ongoing problem of vertigo:vestibular rehabilitation therapy is helpful.
In case of hearing loss with tinnitus:hearing aid with tinnitus masker might be helpful.
2.)Meniere's disease:It is characterised by fluctuating episodes of reduced hearing,vertigo,tinnitus and fullness in ear.Generally the patient is symptom - free between the episodes.
A test named Electrocochleography might be helpful in the diagnosis,during the active phase of disease.
In the treatment,medicine like Prochlorperazine is helpful ,which helps in vertigo and nausea.
Also Diuretics are also helpful in this case.
Patient needs to eat less salty food and avoid triggers like chocolate, caffeine,etc.
Vestibular rehabilitation therapy and hearing aid with tinnitus masker is helpful if the symptoms remain chronic.
Hope this answers your question.Take care.
Please see the answer
Detailed Answer:
Hi,thank you for the additional information.
Looking at the information given by you,the possible underlying condition which your mother is suffering from might be Chronic Labyrinthitis or Meniere's disease.
1.)Labyrinthitis:Generally ,the labyrinthitis gets resolved in 2-6 weeks,but few people might suffer from the symptoms for a longer duration of time, especially vertigo.But the intensity of symptoms would be less than in the acute stage.
For the ongoing problem of vertigo:vestibular rehabilitation therapy is helpful.
In case of hearing loss with tinnitus:hearing aid with tinnitus masker might be helpful.
2.)Meniere's disease:It is characterised by fluctuating episodes of reduced hearing,vertigo,tinnitus and fullness in ear.Generally the patient is symptom - free between the episodes.
A test named Electrocochleography might be helpful in the diagnosis,during the active phase of disease.
In the treatment,medicine like Prochlorperazine is helpful ,which helps in vertigo and nausea.
Also Diuretics are also helpful in this case.
Patient needs to eat less salty food and avoid triggers like chocolate, caffeine,etc.
Vestibular rehabilitation therapy and hearing aid with tinnitus masker is helpful if the symptoms remain chronic.
Hope this answers your question.Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dr Shah, I appreciate your detailed responses thus far. I have only one other question (well, maybe three) left. It is unusual for a patient this advanced in age to get such conditions as labyrinthitis and meniere's disease? Can such a patient ever expect to be cured from them or are they chronic, reoccurring conditions from this point on? Any idea what could have caused them in the first place? Whatever it was, I know she will want to avoid "it" at all costs! This has been so unpleasant...
Thank you...
Thank you...
Brief Answer:
Please see the answer
Detailed Answer:
Hi,thank you for your follow up query.
Viral labyrinthitis is usually observed in adults aged 30-60 years.But still the viral infection can occur at any age.
Meniere's disease can be seen at almost all ages: it has been described in children as young as 4 years and in elderly persons older than 90 years. It appears to be more common in females than in males.
A small number of people with chronic labyrinthitis have persistent symptoms that last for several months, or possibly years.
The prognosis of patients with Meniere's disease varies. Periods of remission punctuated by exacerbations of symptoms are typical. Some patients have minimal symptoms, whereas others have severe attacks. Episodes may occur as infrequently as once or twice a year or they may occur on a regular basis.
In general, the patient’s condition tends to spontaneously stabilize over time. The spontaneous remission rate is high: over 50% within 2 years and over 70% after 8 years but poor balance and poor hearing may remain.
The cause of Meniere's disease is unknown.Genetic factors,viral infection,hormonal imbalance, endocrine factors,etc might be the causative factors.
So,as such nothing can be done to prevent Meniere's disease or even Labyrinthitis.
In case of Meniere's disease, patient should avoid trigger factors like stress,avoid alcohol/chocolate/caffeine and eat a low salt diet.
I would advise that if you feel the symptoms are trouble-some,then please consult a Neuro-otologist.
Hope this answers your question.Take care.
Please see the answer
Detailed Answer:
Hi,thank you for your follow up query.
Viral labyrinthitis is usually observed in adults aged 30-60 years.But still the viral infection can occur at any age.
Meniere's disease can be seen at almost all ages: it has been described in children as young as 4 years and in elderly persons older than 90 years. It appears to be more common in females than in males.
A small number of people with chronic labyrinthitis have persistent symptoms that last for several months, or possibly years.
The prognosis of patients with Meniere's disease varies. Periods of remission punctuated by exacerbations of symptoms are typical. Some patients have minimal symptoms, whereas others have severe attacks. Episodes may occur as infrequently as once or twice a year or they may occur on a regular basis.
In general, the patient’s condition tends to spontaneously stabilize over time. The spontaneous remission rate is high: over 50% within 2 years and over 70% after 8 years but poor balance and poor hearing may remain.
The cause of Meniere's disease is unknown.Genetic factors,viral infection,hormonal imbalance, endocrine factors,etc might be the causative factors.
So,as such nothing can be done to prevent Meniere's disease or even Labyrinthitis.
In case of Meniere's disease, patient should avoid trigger factors like stress,avoid alcohol/chocolate/caffeine and eat a low salt diet.
I would advise that if you feel the symptoms are trouble-some,then please consult a Neuro-otologist.
Hope this answers your question.Take care.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Kampana
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