Dr. Vinay. S. Bhat
Otolaryngology (E.N.T)
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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Patient's Query
Hi doctor,
I have been suffering from tinnitus and vertigo for the past 15 years. Tinnitus had started first in my left ear and that is partially cured. Now I am hearing just a small sound. Now for two years, tinnitus affected my right ear. I am working in a car workshop at their office only. Still, the workshop is closer to our office, so every afternoon onwards, the tinnitus sound increases because of very loud sound, and I am getting vertigo. I have been in homeopathy treatment for six months, but before two weeks, vertigo also started. Now the sound is heard in my right ear, and vertigo happens daily when the sound is too much. It is very difficult for me to live. I cannot go and work now. Please help.
Hi,
Welcome to icliniq.com.
I understand your concern. I need to know a few more details before commenting on further management in your case. 1. Is the tinnitus on the right side present throughout the day with the same intensity? 2. Do you feel like hearing your speech loudly? 3. What type of vertigo do you have? Is it like everything rotating around you, or is it like a sense of falling or imbalance? 4. Since how many days or months have you had vertigo? 5. Is vertigo present throughout the day? Or is it intermittent? If yes, how long does each attack of vertigo stay? 6. Have you taken MRI (magnetic resonance imaging) scan for this problem? 7. Does loud sound worsen your vertigo? I am unable to open the reports you have attached. Please send it again if possible with the answers to my queries.
Patient's Query
Hi doctor,
Thanks for your reply.
When I am at home, tinnitus is much lower. When I am at my workshop or on the road or hearing loudspeaker speech, tinnitus on the right ear increases and affects my hearing. The sound increases in the left ear when the right ear sound is too loud. My vertigo is like everything is vibrating, and I cannot move when it happens. Vertigo and right ear tinnitus started last year. I have not improved through allopathy, so I started homeopathy treatment for six months. Then vertigo is cured, but still, tinnitus is present, but before one week when I layed on bed by using phone suddenly vertigo occurred. It is around one hour and it is a high Vertigo. Otherwise it is around five to ten minutes, but my body and the head are affected. High vertigo has happened two times since vertigo was restarted one week ago. Already took an MRI scan two times, the last one ten months before. Everything is normal. I attached the report herewith. Loud sound is worsening my tinnitus. That is why most of the time, vertigo is happening. Please help.
Hi, Welcome back to icliniq.com. I understand your concern. Your symptoms are non-specific. It is difficult to make an accurate diagnosis unless a few more tests are done. There are three possible diagnoses we can make with the history you have given. 1. Vestibular migraine: This is one of the common conditions which can have all non-specific symptoms such as tinnitus, vertigo, imbalance, vomiting sensation. No test can confirm the diagnosis. We generally give a trial of treatment for a few weeks. Depending on the outcome, we decide to continue treatment or go for further tests. 2. Meniere\'s disease: This condition rarely can present with non-specific symptoms, and confirmation needs to be done with further tests. 3. Superior canal dehiscence syndrome: It is a rare condition where there will be tinnitus and vertigo, which worsens by a loud sound. I suggest you may need to undergo tests known as videonystagmography to rule out Meniere\'s disease and a test known as VEMP (vestibular evoked myogenic potential) to rule out superior canal dehiscence syndrome. Before that, I would suggest you try treatment for possible vestibular migraine. I suggest you take tablet Sibelium 10 mg (Flunarizine 10 mg) once daily at night for two weeks. If there is no improvement with this trial, you can get the tests mentioned. I hope this helps.
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Otolaryngology (E.N.T)
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