Unusual vertigo easily triggered
DEAR DR. ROACH: After many years of various treatments, including allergy shots, food studies and an ear tube, I was recently diagnosed with “semicircular canal dehiscence.”
Can you explain what this is and the treatment (besides surgery) to relieve the symptoms of inner ear pressure, dizziness and pressure and pulsation in the head? Are there any medications?
ANSWER: Semicircular canal dehiscence syndrome is an unusual cause of vertigo.
Vertigo is sometimes referred to as dizziness, but “dizziness” may refer to both unsteadiness (a feeling that you are going to pass out, which medically is referred to as “presyncope”) or true vertigo (a sensation of movement when the person is actually still).
The vertigo in semicircular canal dehiscence syndrome is different from most other causes of vertigo because it can be provoked by loud noises, coughing or sneezing. It is caused by abnormally thin bone in the semicircular canals, part of the organ of balance in the inner ear. The diagnosis is confirmed by a CT scan of the temporal bone.
The only treatment I have read that consistently is effective is surgery. An ear tube is sometimes tried in people who have symptoms with pressure changes.
Medications used in some cases of vertigo, such as meclizine (Antivert), usually will make SCDS symptoms worse in the long term. Anti-nausea medications like ondansetron (Zofran) may help if nausea is severe, but have their own side effects.
Vestibular rehabilitation by a specially trained physical or occupational therapist may have some benefit if surgery isn’t contemplated.
DEAR DR. ROACH: I suspect you’ve covered this topic, but thought I’d check. My niece recently was diagnosed with breast cancer.
Radiation was recommended. Her mother said that first she’d have to boost her immune system. Is it possible to actually do that?
ANSWER: Radiation is a common treatment after breast cancer surgery. It’s done to reduce the risk of recurrence, depending on the exact type of cancer.
Boosting the immune system is a new adjunct for many types of cancer. There are several ways to do this: One is to genetically modify the patient’s own immune T-cells, but many other techniques are in trials now.
However, if your niece’s mother is talking about supplements, I’d be cautious. Supplements that are promoted to boost the immune system generally are ineffective at doing so.
Making sure your niece has proper nutrition, gets good sleep and experiences as little stress as is manageable are ways to prevent stress on the immune system. Everyone could benefit from those deceptively simple steps, but especially a person being treated for cancer.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth @med.cornell.edu.