Last Friday I wrote a post about my current condition of Meniere’s disease, later that same evening I again had another attack this time it was involving spinning which lasted quite awhile. I had taken an phenagan which helped me to sleep but I woke up on Saturday around noon. I was still very tired.
Now that I have had time to think about the attack I believe that I had nystagmus that evening. I was watching TV and my eyes jerked to the side rapidly. The definition of nystagmus is involuntary eye movement. It was definitely involuntary!
It seems that nystagmus is common with vertigo and meniere’s patients. The way to test if you have nystagmus is by using the caloric water test. That is the test that I chickened out on with the VRT therapist.
Maybe I should reconsider.
Anyway if you want to read more on nystagmus click on the following link
http://www.tchain.com/otoneurology/practice/nystagmus.html
Dr Hain is well known as an expert on all things dealing with dizziness and balance.
Monday, June 22, 2009
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9 comments:
Hi David, I had caloric test carried out as part of my investigatations / diagnosis.
It wasn't an unpleasant experience and didn't provoke any dizziness at all, this sort of surprised me as it was expected to.
I'm not a medical bod but it seems to me that caloric testing is a bit hit and miss as it relies upon heat counduction along the three tiny bones in the middle ear.
I have a grommet fitted now and recently went swiming, as soon water found it's way into my middle ear I had an instant reaction to that, this is the sort of reaction I think they were expecting from my caloric test. Not much of any use there for you but it's just my take on the subject. Hope you are feeling ok
Julian.
Hi David. Having administered many caloric tests, I can tell you that very few patients have a problem with them. Air calorics can be used instead of water calorics, which tend to be less stressful on the patient. Caloric testing will not give a definitive answer to the diagnosis of Meniere's. It is only one of the tests of a battery of tests that can be helpful in this diagnosis.
Hi thank for the comments, I guess the reason I was so hesitant about having the caloric test is my ears are awfully sensitive. I had the gentamcin injections last year and that was the worst thing I ever went through.
I'm still not sure I've got a handle on what nystagmus really is and what is means (isn't it just a complex description of a symptom?), but I get two different types of eye effects depending on the severity of an attack.
With a bigger attack (less frequent for me now, thankfully) the main symptom is the 'washing machine' effect where the world appears to be spinning around me. (Occasionally it's not as strong and instead of rotation is a shift from one side to the other.) Naturally my eyes try to sort out the mess by tracking the movement for a second, until either I blink or my eyes snap back to the centre and start tracking again. I wouldn't describe this as completely involuntary, though, more of an instinctive response; if I want to I can stop my eyes tracking in which case they would drift to one side and lose focus. A relatively big attack is gone in an hour.
With a lesser attack, I get what feels like a slight side-to-side shaking of what I see, which results in a slightly blurry picture and difficulty focussing closely. Now I *would* describe this as involuntary as there doesn't seem to be anything I can do to affect it. In fact, I'm not sure that my eyes are moving at all and that this isn't something that's just happening in my brain! After about 20mins the shaking has usually gone.
These lesser attacks are a more recent development. I think they're probably less severe versions of the bigger attacks, but they do feel like something slightly different at the same time.
Jeff,
Most of the attacks this year have been sudden and my head seems to jerk quickly to one side. The spinning isn't as great and luckily the attacks aren't as rough and long.
David
That definitely sounds like an improvement. Does your head actually jerk or does it just feel like it does? I sometimes get a sudden feeling that my head has fallen forwards a few inches, but I don't think it actually moves. If anything, I think I instinctively move in the opposite direction and so I jerk upright.
It really seems like it jerks but then again it happens so quickly I'm not sure.
I had a really big jerk a couple of weeks ago, my biggest ever. My head suddenly jolted forward, just like I'd been hit in the back of the head but with no pain. I was sitting down at the time so I ended up with my head over my knees.
However, I'm sure it's an instinctive reaction to a sudden change in the balance system, that makes you feel as though you're falling in the *opposite* direction (backwards in this case). We all know about the falling feelings that we can get with Meniere's; in this case I think it comes and goes suddenly. I also get a momentary visual spinning but that passes in a few seconds.
Jeff,
That falling feeling can seem awfully real!
David
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