My vestibular loss is bilateral, not unilateral.
After the first round of vestibular rehabilitation exercises that I got a little while ago, it was time for me to go back to the VRT clinic so they could check up on how the exercises were going. I saw a different therapist this time, who was just as friendly and helpful as my regular therapist.
I told her about some positional discomfort I have when lying down on my stomach, and she asked if we could try a few more tests with the goggles with the infrared camera. I never mind more tests, since I’m always hopeful it will provide more answers.
So we went through the head-shake tests again (where the therapist shakes your head and then asks you to look to the right and then to the left), and then I watched the videotaped results again.
Much to my surprise, the nystagmus (abnormal eye movements indicating a loss of vestibular function) was present on both sides — meaning that while my right ear is worse, my left ear’s vestibular system is likely also damaged.
While obviously this isn’t really great news, the therapist said it does explain quite a bit. Usually, the full-functioning ear will kind of ‘take over’ from the deficient ear, and then your balance ends up being pretty normal afterward.
But in my case, since the second ear is damaged as well, even the compensating ear is having trouble. So not only am I getting mixed signals from my eyes and damaged right ear — I’m also getting them from my damaged left ear (no wonder my brain is confused)!
The physiotherapist advised me to stop with the balance exercises for now, and just focus on the gaze stabilization exercises (shaking my head from left to right and trying to focus on a letter on a business card held at arm’s length in front of me).
She also let me know that the movement of my head was too extreme from side to side — that it’s better to use small head motions, as this gets your eyes to do the work, not your head.
She also gave me a new exercise — holding a pen in each hand, which I then have to focus on, then turn just my eyes to focus on the other pen, then follow with my head.
This new exercise (and doing the other exercise properly now) make me very dizzy. I really don’t like doing them, but I’m willing to try anything at this point. She said if they don’t work, that they have another machine that we can try, but that that therapy is quite expensive.
Well, now that I know I have a bilateral loss as opposed to a unilateral loss, I’m hoping that the therapy can be tailored further to help me out. As usual, I’ve got my fingers crossed.
3 Comments, Comment or Ping
tonia
Hi again!
Sorry to hear that the damage is in both ears. But it’s good that you have a more clear diagnosis. Thanks for sharing your experiences here. I’m really dreading my VRT appointment this Wednesday. I know that I need to do the VRT, but I’m so afraid of it making me feel worse. Ughh.
Hope you see some improvements real soon!!
Aug 11th, 2008
Vertigo Guy
Thanks Tonia… I am definitely not happy to hear it’s both ears that are damaged, but it is great to have a clearer diagnosis for sure.
I’ll be honest, the VRT will probably make you feel worse at first. But give it a few weeks, and you should start to feel some improvement. And that’s what it’s really all about. For me, even have a therapist that actually understands what I’m going through is so great. They know how awful you feel, and will tailor your exercises to push you, but not to the point where you feel totally terrible.
I hope your VRT appointment went well — I hope you’ll leave another comment to let me know how it went.
Aug 17th, 2008
Jim
I’m not a doctor or anything, but I have read more than I should about vestibular injury, compensation, and rehabilitation, I certainly don’t have all the answers otherwise I wouldn’t be sat here with a less than full life some 10 years after my original problem. I will say that a therapists exam isn’t in ANY way diagnostic. What your’e describing here is that you get nystagmus in moving each direction, well considering that both ears work in all directions it really isn’t diagnostic of anything… infact you said ENG/Calorics was within normal ranges – which isn’t suprising as that’s the case in over 60% of patients with vestibular dysfunction (these test only test part of the ear, and only test quantity of signal, not quality and are very inaccurate (ie they are the equivelent of a doctor holding up 3 fingers, and getting you to say how many you see – if you get it wrong, then there is obviosuly something wrong, but just because you can count the fingers doesn’t mean you can see perfectly!) . The only way to truly diagnose bilateral loss is using rotation chair testing (which most people don’t have access to). I’m not saying this to worry you or concern you – as unilateral or bilateral loss is compensated in the same way….
Anyway, I digress, my original point was that therapists are trained to do this test for bppv, which as that often affects just a single canal is often diagnostic as to which side is causing the issue, with a vestibular injury then it’s not the case, as the ears respond in all directions, and you must be aware that with nystagmus, you’re not looking at the issue directly, but at the brains response to try and interpret movement through a faulty vestibular system.
Sep 21st, 2009
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