Dizziness, Cold Sweats, and Nausea: A Guide to Inner Ear Issues

Dizziness, cold sweats, vomiting?

Hello Doctor, I am Bruce from Taichung.
Recently, I have been suffering from a very troubling condition that has made it difficult for me to work.
Around mid-July, one morning while tossing in bed, I felt a sensation like an earthquake in my head, which was very uncomfortable.
After getting up, I noticed that I was walking off-balance and felt extremely uncomfortable, along with nausea.
I returned to bed to rest, and when I got up again, I felt fine.
However, in the following days, I experienced a series of recurrent dizziness, vomiting, and difficulty walking (this has continued for three weeks now, with symptoms almost always occurring on Wednesdays and Thursdays).

By mid-August, I had visited the emergency room twice; once, I was unable to walk due to dizziness, sweating profusely, and vomiting.
My company called an ambulance to take me to the hospital.
However, every time I went to the emergency room, the doctors would give me an anti-nausea medication and IV fluids, and after resting for a bit, I would feel fine again.

In the past few weeks, I have undergone examinations at a major hospital in Taichung.
An ENT specialist checked my eye movements and hearing, and all tests came back normal, initially ruling out Meniere's disease.
The doctor then suggested I see a neurologist.
The neurologist conducted nerve examinations, and upon receiving the report, he mentioned that I have nerve inflammation and need to rest more.
He performed preliminary tests such as walking in a straight line, tapping my joints, touching my nose and then the doctor’s finger, and following the doctor’s finger with my eyes; all these preliminary checks were normal.

I further inquired whether this could be "vestibular neuritis," but the doctor did not provide a definitive answer, only mentioning that it is nerve inflammation.
When I asked how to treat it, the doctor simply advised me to rest more.
My family is very concerned about what kind of illness this is, as they have never heard of "nerve inflammation." It does not present like a common cold with symptoms such as coughing or a runny nose, where medication can lead to noticeable improvement.

I kindly ask for your advice on whether I need to undergo any further examinations or rehabilitation.
I found information online about vestibular neuritis and inner ear imbalance, and upon further research, I discovered that these two conditions closely resemble my symptoms.
Should I continue to see an ENT specialist or a neurologist for follow-up examinations?

Yu Xiaodi, 20~29 year old female. Ask Date: 2011/08/18

Dr. Hu Kexin reply Otolaryngology

Based on your description, a clinical examination is still necessary for an accurate assessment.
It is recommended that you consult an otolaryngologist for a thorough clinical evaluation and to receive their diagnostic and treatment recommendations.

Reply Date: 2011/08/18

More Info

Hello Bruce,
Thank you for sharing your concerns regarding your recent health issues. It sounds like you have been experiencing a challenging combination of symptoms, including dizziness, cold sweats, and nausea, which have significantly impacted your daily life and work. Based on your description, it seems that you may be dealing with vestibular dysfunction, potentially linked to inner ear issues.

Dizziness and balance problems often arise from disorders of the inner ear, which plays a crucial role in maintaining equilibrium. One common condition that aligns with your symptoms is vestibular neuritis, which is an inflammation of the vestibular nerve, typically caused by a viral infection. This condition can lead to sudden, severe vertigo, imbalance, and nausea, similar to what you have described. The fact that your symptoms seem to occur in a pattern, particularly on Wednesdays and Thursdays, may suggest a recurring issue that could be related to your activity levels or stress.

Given that your initial evaluations, including eye movement tests and hearing assessments, returned normal results, it is reassuring that more serious conditions like Meniere's disease have been ruled out. However, the diagnosis of "nerve inflammation" is somewhat vague and can encompass various conditions, including vestibular neuritis or even labyrinthitis, which involves inflammation of the inner ear structures.

In terms of next steps, it would be prudent to follow up with both an ear, nose, and throat (ENT) specialist and a neurologist. The ENT can further evaluate your vestibular function and may recommend additional tests such as a VNG (videonystagmography) or an MRI to rule out any structural abnormalities in the inner ear or brain. Meanwhile, the neurologist can assess for any underlying neurological conditions that may contribute to your symptoms.

Rehabilitation may also be beneficial. Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy designed to help patients with balance disorders. It involves exercises that promote compensation for inner ear deficits, helping to improve balance and reduce dizziness.

As for your concerns about "nerve inflammation," it is essential to understand that this term can refer to various conditions, and treatment often focuses on managing symptoms and promoting recovery. Rest is indeed crucial, but you may also benefit from specific therapies aimed at improving your vestibular function.

In summary, I recommend the following steps:
1. Follow-Up Appointments: Schedule follow-up visits with both an ENT specialist and a neurologist for comprehensive evaluations.

2. Vestibular Rehabilitation: Consider engaging in vestibular rehabilitation therapy to help manage your symptoms and improve balance.

3. Monitoring Symptoms: Keep a detailed log of your symptoms, noting any triggers or patterns, which can be helpful for your healthcare providers in diagnosing and treating your condition.

It's understandable that you and your family are concerned, especially since these symptoms can be quite debilitating. With the right evaluations and treatment plan, there is a good chance of improving your condition and returning to your normal activities. Please ensure to communicate openly with your healthcare providers about your symptoms and any changes you experience.

Wishing you a speedy recovery and better health ahead.

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