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Medical Forum / Diseases and Disorders / Sinusitis / June 2007sinisitis
I have been off work for seven months do to a feeling of vertigo. I do not fall down, I just feel off balance and am unable to drive comfortably for long distances, which is what I do for a living. The feeling of vertigo initially was very strong and over 3 months got better slowly to the point that I am at now. A CT scan showed chronic sinusitis but was not considered severe enough to treat. I convinced my family doctor to treat it anyway and he prescribed 14 days of Biaxin and a nasal steroid spray. Within 3 weeks I felt considerably better and then my condition seemed to reverse. My family doctor does not think it is a bacterial infection of my sinus' do to the fact I can breath through my nose and I have no obvious signs of an infection. For the entire time I have been off work I have had feeling of pressure on the left side of my face from the bridge of my nose over to my ear and from just below my eye to my upper jaw. The pressure is not severe but it is always there. When I was on Biaxin the pressure seemed to lessen and was was replaced by a feeling palsy. Now the pressure is back, it is annoying but I can live with it. I am wondering if there can be an infection or inflammation of the sphenoid sinus that could be causing my feeling of vertigo as well as the feeling of pressure I have. I would like to try and convince my doctor to try an antibiotic for a longer period of time, but which one. Les > ....I am > wondering if there can be an infection or inflammation of the sphenoid > sinus that could be causing my feeling of vertigo as well as the > feeling of pressure I have. I would like to try and convince my doctor > to try an antibiotic for a longer period of time, but which one. > Les Dizziness is a common symptom of sinusitis, triggered by the sinus pressure inside your head. If you're so dizzy that you are bedridden, that suggests labyrinthitis: infection that has reached the inner ear. I would do two things. First, in your line of work, you can't afford to get vertigo, so you might ask your physician for prescription-strength Meclizine or the equivalent, which will help fight that dizziness. And note that dizziness and nausea are worsened when your blood sugar level is low. Black coffee and a doughnut is NOT a substitute for three square meals a day; because once the coffee and unrefined sugar wears off, your blood sugar level tends to drop significantly. So change your diet so your blood sugar level stays good. Second, you've been sick so long that you might ask your doctor for a "big gun" antibiotic in the quinolone class--either Levaquin or Avelox. Those have very wide coverage and will get the bugs that Biaxin leaves behind. And you should take them for AT LEAST 3 weeks. Sinus infections can be very stubborn, as you're learning the hard way. If even Levaquin and Avelox fail, it may be time to see an ENT specialist. Good luck.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. I have vertigo at times too. I usually know right away what the cause is. As I have had inner ear infections in the past. A couple of weeks ago I got up in the morning and passed out, fell off a chair landed under the dining room table. When I saw my MD the the next day I told him about it. He checked my ears and said I did not have any fluid or an infection. Before I fell my ears had a thumping sound in them for 2 days . No problem with them now but I do take my allergy meds. shirleyann On 6/11/07 10:28 PM, in article u3b0xeo7h.fsf@earthlinkNOSPAM.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: > Dizziness is a common symptom of sinusitis, triggered by the sinus > pressure inside your head. If you're so dizzy that you are bedridden, > that suggests labyrinthitis: infection that has reached the inner > ear. Dizzyness is not associated with sinus disease. There is no direct or indirect association. Patient may feel weak or lightheaded due to infection, but not dizzy. > Dizzyness is not associated with sinus disease. There is no direct or > indirect association. Patient may feel weak or lightheaded due to infection, > but not dizzy. Bulshit. Dizzy spells used to be my first sign that my sinus infection was acting up. It's also a sign of adrenal suppression, which is common with chronic infections. Susan Vertigo can be caused by many things, and is difficult to diagnois accurately as the temporal bone can't be imaged: all work ups for vertigo involve tests of vestibular function. I have chronic vertigo due to multiple reasons: lingering effects of a severe virus, recurrent episodes of BPPV (benign paroxysmal vertigo-- crystals that get in the wrong place in the semi circular canals) and a component of silent migraine. I definitely get horribly dizzy when my sinuses are infected or even congested. Vertigo is best treated by either an otoneurologist or a neuro- otologist, and the vestibular disorders association maintains a listing of physicians in each state. http://www.vestibular.org/ While Steven recommended meclizine, it's very sedating. Most vestiubular physicians and ENT's will use a benzodiazepams for vestibular suppression: at the lowest possible dose, because your recovery is delayed if you can't habituate. Often an MRI is needed--as you had--to rule out a central nervous system reason for vertigo. Judy > x-no-archive: yes > [quoted text clipped - 9 lines] > > Susan > Vertigo can be caused by many things, and is difficult to diagnois > accurately as the temporal bone can't be imaged: all work ups for [quoted text clipped - 7 lines] > I definitely get horribly dizzy when my sinuses are infected or even > congested. I have to wonder if Murray has ever even asked a patient about vertigo, or just summarily dismissed it when reported as a symptom? It's so very common with sinusitis. > Vertigo is best treated by either an otoneurologist or a neuro- > otologist, and the vestibular disorders association maintains a > listing of physicians in each state. > http://www.vestibular.org/ Sometimes vertigo can be helped by those folks, but often it requires aggressive management of infectious disease. In my case, my vertigo was so bad during acute infectious tick borne diseases, that I was holding onto the sides of my bed because the room was spinning so fast that I felt I'd fly off. Those docs don't do a comprehensive evaluation for root causes in my experience. Two weeks ago, I had a sudden episode of this with near vomiting induced by a super low dose of a retinoid medication that suppressed my adrenal function. I get dizziness now from moisturizers with salicylic or lactic acid them for the same reasons. Tylenol inhibits ACTH and it's hard to find a drug that has no capacity to reduce pituitary/adrenal function. Years ago I had debilitating vertigo from indomethacin. > While Steven recommended meclizine, it's very sedating. Most > vestiubular physicians and ENT's will use a benzodiazepams for > vestibular suppression: at the lowest possible dose, because your > recovery is delayed if you can't habituate. Yes, I know folks who've been to balance disorder docs, and they've very successfully used either low dose Valium or Klonopin for it. > Often an MRI is needed--as you had--to rule out a central nervous > system reason for vertigo. MRI can't rule that out. Susan On 6/12/07 2:41 PM, in article 5d8i7vF320sjuU1@mid.individual.net, "Susan" <nevermind@nomail.com> wrote: > I have to wonder if Murray has ever even asked a patient about vertigo, > or just summarily dismissed it when reported as a symptom? It's so very > common with sinusitis. Of course not, do you expect me to take a history on a patient too? Your statements get more ridiculous and non-sensible as you go along. Ask my pharmacist who writes the most prescriptions for vertigo. Ask the Vestibular Rehab clinic who refers the most patients to them. If you are having vertigo and sinusitis it is two separate entities. Yes you can have vertigo and an ingrown toenail and a runny nose, but that's not sinusitis. By the way I am on the referral list for vertigo patients. > On 6/12/07 2:41 PM, in article 5d8i7vF320sjuU1@mid.individual.net, "Susan" > <nevermind@nomail.com> wrote: [quoted text clipped - 10 lines] > vertigo and an ingrown toenail and a runny nose, but that's not sinusitis. > By the way I am on the referral list for vertigo patients. That's scary. How is it that you are unaware that dizziness is a very common sinusitis symptom. Susan On 6/13/07 4:26 AM, in article 5da2k2F326rrnU1@mid.individual.net, "Susan" <nevermind@nomail.com> wrote: > How is it that you are unaware that dizziness is a very common sinusitis > symptom. Because I see patients with both for the past decades and they are separate entities. Weakness is not dizzyness. A runny nose is not sinusitis. I bring this up because if someone does have both and neglects the ear that can lead to serious consequences. Statistically a person can have sinusitis and also have an ingrown toenail, but the sinusitis didn't cause it. Person with sinusitis can get pregnant but the sinusitis didn't cause it. . > Because I see patients with both for the past decades and they are separate > entities. Weakness is not dizzyness. A runny nose is not sinusitis. I bring > this up because if someone does have both and neglects the ear that can lead > to serious consequences. Statistically a person can have sinusitis and also > have an ingrown toenail, but the sinusitis didn't cause it. > Person with sinusitis can get pregnant but the sinusitis didn't cause it. I know the difference between weakness and feeling the room spin, thank you. It's been so clear for so long, from your responses, that you don't listen to your patients, and that you dismiss out of hand patient reports that don't square with your dogmatic beliefs. Dizziness is an extremely common symptom of sinus infection. Susan > x-no-archive: yes > [quoted text clipped - 16 lines] > > Susan I thought the sinuses were involved with balance. Once mine get inflamed my balance can be off making me feel very dizzy. Most people I know complain of dizziness with sinusitis. Susan your remarks make sense to me. hydromed@adelphia.net (Murray Grossan) wrote: >Because I see patients with both for the past > decades and they are separate entities. [quoted text clipped - 6 lines] > didn't cause it. Person with sinusitis can get > pregnant but the sinusitis didn't cause it. I have experienced dizziness at certain times, and have wondered if it was associated with my chronic sinusitis. ...Mind you, I have also gone long stretches without any dizzy symptoms, in spite of having the odd acute sinusitis flair-up. ...Perhaps the dizziness that some here have experienced, is a result of an increase in certain medications or nose sprays (which seem to go hand in hand with a flair-up), as opposed to the sinusitis causing the dizziness itself. ...maybe aspirin, tylenol, or certain types of antibiotics are a contributing factor. ....In my case, I also take a powerful Nsaid for my arthritis. Perhaps at times this interacts with the odd aspirin I may take to help relieve the sinusitis pain ...Jon On 6/14/07 8:41 AM, in article 24270-467161BB-64@storefull-3252.bay.webtv.net, "Johnny1000@webtv.net" > hydromed@adelphia.net (Murray Grossan) wrote: >> [quoted text clipped - 20 lines] > powerful Nsaid for my arthritis. Perhaps at times this interacts with > the odd aspirin I may take to help relieve the sinusitis pain ...Jon Minocycline is a frequent cause of dizzyness/vertigo, but ceases when you stop the medication. Dizzyness is not easy to diagnose. It can mean weakness, poor circulation, cochlear hydrops, meningeal irritation, etc. It can also come from whiplash. One reason not to neglect it is that if its Benign Positional Vertigo, that is easily treated. Some of the descriptions here suggest this dx. > On 6/14/07 8:41 AM, in article > 24270-467161BB...@storefull-3252.bay.webtv.net, "Johnny1...@webtv.net" [quoted text clipped - 30 lines] > One reason not to neglect it is that if its Benign Positional Vertigo, that > is easily treated. Some of the descriptions here suggest this dx. Les does mention a feeling of palsy when using clithromycian,, but the vertigo seems to have predated any medication. What did he say that indicated it was positional? Thanks for all the responses. In reply to truehawk I never mentioned the vertigo was positional. I convinced my GP to give me a prescription for Alti-Amoxi Clav. I have taken it for four days now and although the vertigo (?) is still present I feel less pressure on the left side of my face and there is a feeling that the left cheek is sagging/loose (palsy?). Although 7 months ago the feeling of vertigo was very strong I wonder if it is not quite accurate anymore. I feel more off balance then spinning. I definitely have/had chronic sinusitis according to the CT scan. I believe due to the inflammation (infection) of the sphenoid sinus pressure is being put on the optic nerve and possibly another nerve as well (left cheek?). I have four to six weeks of antibiotic and hopefully this will help. Les On Jun 16, 11:18 am, leswjen...@gmail.com wrote: > Thanks for all the responses. In reply to truehawk I never mentioned > the vertigo was positional. I convinced my GP to give me a [quoted text clipped - 9 lines] > six weeks of antibiotic and hopefully this will help. > Les Amox is not good against a biofilm. It depends on the bacteria replicating rapidly. On 6/12/07 1:16 PM, in article 1181679404.888947.207090@i38g2000prf.googlegroups.com, "judy.n" >> Bulshit. Dizzy spells used to be my first sign that my sinus infection >> was acting up. Then you had something else going on, not vertigo from sinusitis. > On 6/12/07 1:16 PM, in article > 1181679404.888947.207090@i38g2000prf.googlegroups.com, "judy.n" [quoted text clipped - 3 lines] > > Then you had something else going on, not vertigo from sinusitis. It's happened many, many times with sinus infection, and remits once it's treated for years now. Thanks anyway, but I don't need a bogus internet diagnosis. Susan Although you quoted the text as mine, that wasn't my post. I do, however, get dizzy when my sinuses are infected or congested: I believe that congestion in the eustachian tube can effect the vestibular system, also, people with vestibular disorders often feel dizzy when ill. I'll agree with Steven on this: we'll have to agree to disagree Judy > On 6/12/07 1:16 PM, in article > 1181679404.888947.207...@i38g2000prf.googlegroups.com, "judy.n" [quoted text clipped - 3 lines] > > Then you had something else going on, not vertigo from sinusitis. > Although you quoted the text as mine, that wasn't my post. Right. If it's profane, it's usually moi. :-) Susan Hurumph!!!!!!!!!!!! Doc: I know that you mean to make a distinction between ostiamedia an infection of the inner ear, an sinusitis an infection of the sinuses. leswgen Go to Pubmed.gov and search on biofilm sinusitis. You do not have to have a blockage in order to have a biofilm infection on your tonsiles, adenoids, and the tissues of your sinuses. Steven is correct in that it takes a tissue cycle, a minimum of three weeks to get rid of the pesky stuff. Once the biofilm forms, you can't really kill the bacteria, the best you can do is impede it's ability to form goo and the protein that allow it to latch onto new cells, as the old lining of your sinuses sloughs away. The most effective treatment is a combination of a macrolide antibotic such as azithromycian (Zithromax), and a antifungal such as itraconazol (Sporanox.) Most bacteria live in biofilms and most ENTs never heard of them. Work is being done on biofilms at U Penn, U Michigan, MIT, Stanford, George Washington University in St Louis, and the Navy. A sinus center associated with one of those schools would be a better bet than others. On 6/13/07 9:06 PM, in article 1181793992.384957.138710@d30g2000prg.googlegroups.com, "truehawk" > Hurumph!!!!!!!!!!!! > [quoted text clipped - 22 lines] > A sinus center associated with one of those schools would be a better > bet than others. Research on biofilm includes use of enzymes to dissolve the coating and sticky stuff. Another approach is to use vibration / frequency which can displace the biofilm. ( perhaps that is the value of "oooommmmm") Another research is to take out the signal that causes them to seed other tissue/locations. > x-no-archive: yes > [quoted text clipped - 5 lines] > Bulshit. Dizzy spells used to be my first sign that my sinus infection > was acting up. For me, dizzy spells used to be a sign that my sinus infection was getting worse to the point that antibiotics were needed. BTW, Ivker's "Sinus Survival" book lists dizziness as a common symptom of acute sinusitis. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. On 6/12/07 9:05 PM, in article M1Kbi.3748$tb6.2869@newsread3.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: >> x-no-archive: yes >> [quoted text clipped - 11 lines] > BTW, Ivker's "Sinus Survival" book lists dizziness as a common symptom > of acute sinusitis. I will let you know when I see the first case of sinusitis causing vertigo. > On 6/12/07 9:05 PM, in article > M1Kbi.3748$tb6.2869@newsread3.news.pas.earthlink.net, "Steven L." [quoted text clipped - 15 lines] >> > I will let you know when I see the first case of sinusitis causing vertigo. OK. I guess we'll just have to agree to disagree on this one. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > x-no-archive: yes > [quoted text clipped - 9 lines] > > Susan For me, Sinusitis and dizziness go hand in hand. Sinusitis affects the whole head with all kinds of bizarre symptoms. I feel sinusitis is a systemic disease for some. It has totally ruined my life. Despite irrigations, surgery, protocols, etc. > For me, Sinusitis and dizziness go hand in hand. Sinusitis affects > the whole head with all kinds of bizarre symptoms. I feel sinusitis is > a systemic disease for some. It has totally ruined my life. Despite > irrigations, surgery, protocols, etc. All infections have systemic effects, and chronic infections suppress immune and adrenal function. Susan |
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