“Vestibular Neuritis, Vestibular Migraine, or something else?”
What are the most likely diagnoses for a person whose vestibular tests were all normal except for the oVEMP (absent on one side) and the ocular counter roll (weakness on the same side as the absent oVEMP)? To add some detail, I believe I had vestibular neuritis in 2015. I decided to do what was suggested in my research and keep doing my usual activities so my brain could compensate. I would make an appointment if things did not improve. I thought I had compensated, but 2.5 years later, I began having problems with visual motion and head movements/positions. My first round of vestibular tests, VNG/calorics, came back normal. I didn’t have VEMPs done until 2020/2021, when the abnormal oVEMP was found. My doctors think it’s vestibular migraine, probably due to my history of one-sided pounding headaches (which I think are mostly, if not solely, triggered by eyestrain). I think the vestibular neuritis caused the damage found. My ENT doctor thinks I never had this because my caloric tests were normal, but with those being 2.5 years after the probable vestibular neuritis, I wonder if my caloric responses had recovered by then.
Female | 44 years old
Complaint duration: 5.5 years
Medications: Levothyroxine, supplements
Conditions: Hypothyroidism, wheat allergy
4 Answers
You should make an appointment with an excellent ear specialist. There are many possibilities; but superior semicircular canal dehiscence should be considered because of your abnormal test.
Any hearing loss or associated tinnitus? What symptoms convinced you that you had vestibular neuronitis? Dizziness/vertigo conditions are frequently multifactorial. It appears that you sustained no objective peripheral vestibular damage in 2015. Could have cervical vertigo component which affects your proprioceptive (position in space) sense. Any broadening of your gait, need to hold onto fixed objects when walking, problems with night driving. Vestibular migraine in most cases is a recurring symptom, complex, and can be a process of elimination diagnosis. You should be very careful on ladders and at heights.
Vestibular migraine is your most likely diagnosis, although many people can have 2-3 different conditions at the same time. You may well have had a compensated vestibular neuritis.
Vestibular neuritis is likely caused by virus. Your persistent symptoms could be due to a persistent viral infection. Especially if someone finds her you identify swollen and tender lymph nodes on the side you have the viral infection as further confirmation. Best of luck.
