HomeAnswersOtolaryngology (E.N.T)ear painWill steroids for ear pain and headaches cause side effects?

Can steroids consumed for infectious ear pain and headache cause serious side effects?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At August 23, 2022
Reviewed AtOctober 10, 2023

Patient's Query

Hi doctor,

I went to a doctor with vertigo. He said I have benign paroxysmal positional vertigo. Also, I started having mild, dull pain in my head and ears, so he checked that too. There were no sinus issues or no ear problems. He said the pain comes from the slightly enlarged lymph nodes below the jaw because I have some infection. But I do not have a temperature, and I feel fine. Also, I have no sore throat and no nasal discharge. However, he prescribed me ear drops and a steroid medicine called Prednisolone. But I read about it on the internet, and I do not understand why I must suppress my immune system if the body is supposedly fighting an infection. As the doctor said, it can be a viral infection or any infection, I do not recall, but he said it is the one that is passed on over speaking with other people. Also, this medicine has many side effects. Even thinking about it makes me have a full-blown panic attack. Kindly give me a solution for this.

Hello,

Welcome to icliniq.com.

Thank you for contacting us on icliniq.com. So you went to the doctor for vertigo, and he examined you and concluded you have BPPV (benign paroxysmal positional vertigo). Well, there are certain conditions in which short-course steroids can be beneficial. One such condition is acute vestibular neuronitis. Steroids also are effective in controlling vertigo due to other causes. Also, a short course of steroids does not cause significant adverse effects and helps reduce the inflammation associated with infections when given in bolus doses or short courses. However, I have a few questions, 1. Can you elaborate on the symptoms that you have? 2. Did you have ringing in your ears? 3. Do you have any hearing impairment? Kindly follow up with the answers.

Patient's Query

Hi doctor,

Thank you for your reply. Here are my answers to your questions. 1. I have random sounds in my ear that occurs once every few days, lasting two to five seconds maximum. They go away, when I rub my ears. 2. He sent me to the BPPV clinic and said vertigo should go away. 3. About vertigo, the episodes started occurring severely, and I could not walk. And once, when I started wearing colored prescription lenses for three days and stayed at the computer for 10 to 11 hours daily, I had severe vertigo as soon as I looked at my screen. So I took the lenses off and put on my normal daily lenses, which are very thin. 4. Then, for the next few days, I did some exercises which I saw on the internet, and the dizzy spells went to level 10, and they worsened with stress and panic. 5. Last night I started having dull pain in my temple region. It is more like if you put your index finger into your ear and put your thumb on your face next to that ear. But somehow, the pain is reduced now, and it is not there when I am not stressed. 6. Another symptom is when I got a weird shooting pain on my cheekbones, which also disappeared when I calmed down. The doctor pressed on my face, and I felt no pain triggers. So I am sure the cause of the pain is due to some other reason. He tested my eyes, put his finger in front of me, slowly moved left to right, and then said I had mild nystagmus. But I do not know because when I try to do it myself, I see no eye movement, and it may be minor and more horizontal, I feel. But he did not put that into diagnosis. What should I do now? Kindly suggest.

Hi,

Welcome back to icliniq.com.

Given your history of sudden severe onset, clinical evidence of nystagmus, and your age, the doctor might have concluded vertigo of peripheral origin, of which BPPV is the most common cause. The other important cause may be acute vestibular neuronitis. However, kindly answer the questions mentioned below for a more detailed diagnosis, 1. Did he check your ears with an otoscope? 2. If he checked, did he find anything abnormal? 3. Do you have any vesicular eruptions on the face or in the oral cavity? 4. Do you have nausea or vomiting? 5. Is your hearing fine? 6. Did he put you on any other medications like Betahistine (anti-vertigo medication) or Prochlorperazine (antipsychotic medicines) or Meclizine (antihistamine), or Cinnarizine (antihistamine)? Because you might need them also. 7. Did you have a viral illness recently that might have precipitated this attack? Severe attacks of vertigo usually show a good response to steroids. Kindly follow up with answers.

Patient's Query

Hi doctor,

Thank you for your reply. Here are my answers to your questions. 1. Yes, the doctor checked my ears, and they are fine. 2. I have no vesicular eruptions on my face and my mouth. 3. My hearing is also perfect. 4. And no, he did not give me anything else apart from the ear drops called Panotile and steroids. But they gave me intense sharp pain last night that lasted for five to ten minutes, and I took a half dose only. The doctor asked me to take two pills a day. But I am afraid my stomach will not tolerate it. Regarding vertigo, When I had vertigo last year, I threw up once. It occurred this year also. Last year's vertigo was also sudden, and it was very traumatic as I did not know what it was back then. And it happened three days after I started wearing the wrong contact lenses. Just like this time, I became sensitive to specific backgrounds, busy spaces, etc. Last year it resolved completely after a few months once I started driving. Driving cleared the dizziness and all eye-related issues. This year's vertigo came the same way as last year's. But since I already knew what it was, the next day, I ignored it and got physically busy, like moving boxes, helping my builders to carry small things up the stairs, and moving houses, so vertigo and everything associated with that disappeared completely for two days. I went out, and everything was fine until the restaurant started filling with moving people and smoke. Then I felt a little dizzy, and we walked to the beach instead. Since that night, I started having pain in my temple region. Is this a stress response? And the next day, I had the most severe vertigo ever when everything was a triggering factor, and I could not walk. After doing some exercises for BPPV for two days, I could walk on pavements on the street without losing balance or getting a massive panic attack. The condition gets better if I limit my screen time too. I know it is related. I know it came on right after I wore the wrong lenses for two days and stared at my screen non stop as it was the same pattern last year. And I was not sick in any shape. In the last four years, I had one minor sinus issue, which went away in 48 hours. What should I do next? Kindly advice.

Hi,

Welcome back to icliniq.com.

In that case, the strain caused by wearing contacts could well be the cause. Since balance requires close coordination between visual proprioception and body position (vestibular input), a snap or strain anywhere can cause vertigo. At times it can be more than one thing. Additional strains of prolonged posturing, mental strain, and fatigue could compound this sense of imbalance. If vestibular exercises are helping it is a good sign. There a number of vestibular rehabilation exercises like Cooksey-Cawthorne, and Brandt-Daroff exercises that you can try. However, I suggest you to take the medications mentioned below, 1. Take steroids for a few days. 2. Take proton pump inhibitors (antacid) to prevent gastric irritation. 3. If headaches bother you, I suggest you to take a combination of Prochlorperazine (dopamine antagonist) and Paracetamol (painkiller), which shall help with headaches and vertigo. Please consult with a specialist, talk to them and take the medications with their consent. 4. If vertigo does not stop or keeps coming back, you might need to get an audiogram and an electronystagmography. I hope this has helped you. Take care.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Syed Peerzada Tehmid Ul Haque
Dr. Syed Peerzada Tehmid Ul Haque

Otolaryngology (E.N.T)

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