Dr. Seyedaidin Sajedi
Neurology
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Patient's Query
Hello doctor,
I am a 40-year-old male. I weigh about 79 kg and my height is 5'11". My BP is 130/78 and pulse rate is 90 bpm. I have no diabetecs and I am a non-smoker, and non-alcoholic. I am a software engineer.
I am having neck and back pain issues for the past 10 years particularly more severe neck pain for the last one week, as my neck is hurting and pain is radiating into my head and shoulders, etc. Till now there is no pain in my hands or fingers. My job is computer programming so I have to focus hours on the screen this is one of the main reasons behind it as I never had any vehicle or sports accident.
Now more terrible thing is that I have started vertigo/spinning in head while lying down and move my head towards the left side. Because of this vertigo fear, I kept laying straight on my back full night. I can cope with the pain but vertigo/spinning of my head is putting me under stress and depression as it could affect my daily life too. I have taken thousands of medicines in the last ten years.
Currently, my doctor advised me some medicines, which I am using since four days. I take Zenorit 8mg (Azithromycin), Lavistina 16 mg (Betahistine dihydrochloride), Parafon (Chlorzoxazone 250 mg and Paracetamol 300 mg) and Neurobion Forte.
Well my first question is, what is the main reason for having vertigo/spinning head while lying down and tilt the head on the left side? My doctor has diagnosed that my ear is having balancing issue. Is that true? However, I guess any of my cervical disc pinches some nerve or artery while I lay down and turn my head as you can see from the MRI report that almost all of my discs are having issues.
Moreover, regularly I do a light massage with deep-heat cream and then keep a hot water bottle on my neck/back for some time. Earlier I had some physiotherapy sessions as well for pain management. However, there is no chiropractor available in our city. I will be greatly thankful to you if you could at least diagnose the root cause of this vertigo which comes up while lying down and turn head to the left side. Once the vertigo is subsided we can start working on pain management. Please note that I feel quite relax and less pain while I walk or even stand up, however having full of pain while sitting and had neck pain and vertigo in the bed.
Hello,
Welcome to icliniq.com.
I read your history and reviewed your total spinal MRI. (attachment removed to protect patient identity).
Do not be nervous. Vertigo that you are experiencing is not related to your discopathy. You have disc bulging in the cervical spine (C5-C6 and C6-C7), at least one mild disc bulging in the thoracic spine and two more disc problems in the lumbar area, especially in L5-S1 that is complicated by spondylolisthesis (i.e. spinal body sliding). Nevertheless, as I said, none of them is related to vertigo.
Your vertigo is a benign paroxysmal peripheral vertigo (BPPV) that is caused due to a benign problem in one of your horizontal semicircular canal in the inner ear. In simple words, one of your sensors which reports the brain any horizontal rotation of the head, suffers from a temporary problem and gives exaggerated data to the brain.
I agree with the prescribed medicine, except the antibiotic Azithromycin that seems unnecessary if you do not have a fever or ear pain. The key treatment is not medicine. Please accept my advice and do not avoid the head movement that triggers your vertigo. In contrast, repeat it more and more. In every try, you will notice that the severity of vertigo will lessen. It is similar to seasickness. By repeating the movement and sending exaggerated data by your ear, your brain habits the situation and will neglect the bad data and you will improve. If this strategy does not work after five days, in combination medicines, then you will need to be treated by a maneuver that is called Gufoni' maneuver. It should be done by a trained neurologist or ENT specialist.
I hope this helps.
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