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  • somspv
    Post count: 2


    Dear Doctor, I have a peculiar problem.Kindly go through this letter patiently and advise me.I was in dialemma and very disturbing. Does this vertigo resulted because of the middle ear problem or from spondylosis?. Or from small syrynx in spinal canal.?


    I am 69 year old male .I have cervical spondylosis from 1995. In December last while i was in bed, i have stretched my hands over my head and stiffened my hands to ward of lethargy. immediately after that when i got up, i felt dizzy and lost balance for the first time in my life.. since i have spondylosis, i immediately taken stugeron 25 mg and then gone to see ortho. He asked me to undergo MRI for cervical spine, since i have spondylosis for many years. Accordingly I ve gone for MRI of the cervical spine.He diagnosed it as postural vertigo (bppv). He asked me to take stugeron twice a day for 10 days and aceproxivon twice for 3 days. Besides this , accidentally , in the MRI he has seen a small syrinx at c4 and c5 level.He said not to worry about this, since it is asymptomatic and as i have never experienced weakness in limbs or pain in head etc. He further told me some elderly people have some abnormality and there is nothing alarming. It takes a long time to expand.He further said that it is most likely a cyst.I took the stugeron and aceproxivon. After that the vertigo lasted for about 16 to 20 days and subsided. In this period I felt spinning of the room while getting up from the chair or bed and also while turning sideways in the bed and while moving . I lost balance while going to the bath room. Again in May this year, I have again in the same position in the bed as in December , resulted again dizziness. Again i took stugeron for about 3 days but it was not subsided. Then on somebodys suggestion i ve gone to an ENT surgeon. He asked me to take Audiometry. Accordingly i took it and it shown 60 % loss in the left ear and 25 % loss in right ear. and apart from this some fluid secretion resulted in the middle ear and i am told that this is preventing the air to pass freely and it is building up the pressure and creating vertigo as my eushtachian tube is somewhat narrow.As such, he suggested me to take vertin 16 mg twice daily , allegra 120 mg one a day and ambrodil syrup thrice daily for 20 days .He further suggested if we implant gromets, the loss of hearing may be improved to some extent and the vertigo may also subside.But he has not given any assurance. Now the vertigo has gone. But at times, when i woke up from sleep in the morning I feel reeling or dizzy ness, particularly when i bend my head to wash my face in sink. I never had any head ache.

    My medical history is as under: Had IHD in the year 1977 (T wave inversion in V1 to V6) No complications since then .
    Had mild Hypertension in the year 1980 (under control)
    Had prediabetes in the year 2010 (IFG) (under control)
    Had subclinical hypothyroidsm in 2011
    Medicines now being used
    Heart * (from the year 1977)

    I have been taking Stamlo Beta 50 MG,(since 2006) Ismo 10 mg (since 1996), ASA 50 mg ,(since 191) TG tor 5 mg (since 2006) and glycomet 250 mg (since 2910)

    mri report
    . Early changes of cervical spondyilosis with multiple level changes of degenerative discs, marginal osteophytosis and mild disc bulge is seen at C3/4, C4/5,C5/6,C6/7 discs. No obvious thecal sac indentation/neural foraminal encroachment seen at any level

    Mild flateening of contour with slight posterocentral disc bulge is seen at c3/4, c4/5,c5/6 ,c6/7 discs. No obvious thecal sac indentation/neural formainal encroachment seen at any level.
    A mall syrinx is seen at c4 and c5 level.

    Questions about the two problems

    Now i would like to know from you first regarding VERTIGO …1. what are the other effective medicines in curing vertigo? 2.Do i have to take vertin as maintanence dose say 8 mg or 16 mg once day for the rest of my life to prevent vertigo? 3. what are the precautions i have to take when i go into the cold weather and travelling in an a/c compartment. 4.does this vertigo is a combination of middle ear problem and also cervical spondylosis? 5. If so do i have to take stugeron along with the vertin . 6. If so what is the dosage. 7.. How to differentiate the vertigo from spondylosis or from the middle ear problem ?. 8. Can the vertigo be cured permanently or do i have to live with it for the rest of my life? 9.Do i have to keep Vertin always handy? 10. Do I have to wear a cervical collar whenver i have dizziness?11.Do i have a cervical pillow while lying in bed?
    Then regarding Syrinx . .1. Whether this syrinx has any bearing over vertigo. 2. Does this syrinx give me any problem at this age of 69 years or will it be dormant. 3.How much time does it take to grow? Already 6 months have passed after taking MRI. I did never have any symptoms through out my life so far. . Kindly advise me, as I wish to hear from you as an expert.Thanking you in advance.

    Donald Corenman, MD, DC
    Post count: 8614

    Syrinx symptoms depend upon where the syrinx lies. Normal syringomyelia symptoms have to do with numbness, pain and burning in a “shawl like” distribution and syringomyelia can be associated with a condition called “Arnold Chiari syndrome”, See “central cord syndrome” on the website for further information regarding possible symptoms.

    Generally, vertigo or the sensation of the room “spinning” is related to the vestibular mechanism or the “inner ear”. I am certainly no expert on this condition. Medications can be quite helpful. There is evidence that in some vertigo patients, otoliths are present. These small “stones” grow in the villi of the inner ear. If they break off and cascade down these hair-like projections, the sensation of falling or room spinning can occur. There are some head positioning maneuvers that can sequester these stones. You will have to consult an ENT specialist for further information.

    Dr. Corenman

    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Post count: 2

    Dear Dr.Corenman,
    I thank you very much for your valuable advise.

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