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“In Benign Paroxysmal Positional Vertigo (BPPV) dizziness is thought to be due to debris which has collected within a part of the inner ear. This debris can be thought of as “ear rocks”, although the formal name is “otoconia”. Ear rocks are small crystals of calcium carbonate derived from a structure in the ear called the “utricle”. While the saccule also contains otoconia, they are not able to migrate into the canal system. The utricle may have been damaged by head injury, infection, or other disorder of the inner ear, or may have degenerated because of advanced age. Normally otoconia appear to have a slow turnover. They are probably dissolved naturally as well as actively reabsorbed by the “dark cells” of the labyrinth which are found adjacent to the utricle and the crista, although this idea is not accepted by all.
BPPV is a common cause of dizziness. About 20% of all dizziness is due to BPPV.
The symptoms of BPPV include dizziness or vertigo, lightheadedness, imbalance, and nausea. Activities which bring on symptoms will vary among persons, but symptoms are almost always precipitated by a change of position of the head with respect to gravity. Getting out of bed or rolling over in bed are common “problem” motions . Because people with BPPV often feel dizzy and unsteady when they tip their heads back to look up, sometimes BPPV is called “top shelf vertigo.” Women with BPPV may find that the use of shampoo bowls in beauty parlors brings on symptoms. An intermittent pattern is common. BPPV may be present for a few weeks, then stop, then come back again.
What causes BPPV?
The most common cause of BPPV in people under age 50 is head injury . There is also an association with migraine. In older people, the most common cause is degeneration of the vestibular system of the inner ear. BPPV becomes much more common with advancing age. In half of all cases, BPPV is called “idiopathic,” which means it occurs for no known reason. ”
To read the entire article, click this link: Benign Paroxsymal Positional Vertigo
I had my ENG test at DePaul Hospital’s Hearing & Balance Center in Norfolk yesterday. It took over 2 hours. The first part was the easiest. I had to wear huge goggles over my face and follow a red light on a bar on the wall. They recorded my eye movements through the goggles onto the computer to check my balance. I did fine in that part of the test.
The second part was the worst. They held my head and laid me down real fast with my head hanging down the table, to catch the spinning at its best and watch my eye movements. This wasn’t fun at all! It scares me when I spin that fast. It’s a very disturbing feeling. It only lasts for about 30 seconds or so but it’s long enough to freak me out. I’ve been trying to avoid this spinning by lying very slowly and on raised pillows since my accident. I still can’t prevent the spinning. It spins fast for a minute or less every time I lie down. If I do it fast or move my head around, then it spins faster. It was much worse the first days right after my injury. Now maybe I got used to it or it’s getting better, but it’s still there. I strongly held onto the audiologist’s arm with fear when the spinning escalated as he laid me down. They had to repeat it several times because they made a mistake and recorded over the first trial which was the worst one. It didn’t spin as bad on my left side, my right side was far worse.
The third part of the test was very uncomfortable too. They blew warm and cool air into my ears, and held it there for a long time. After that, she asked me random questions like ‘name countries or food starting with this letter’ and going down the alphabet, just to make sure my brain was still functioning! At the end, she had me look through the goggles which had been kept shut throughout the second and third parts of the test, and stare at her thumb which she was holding over a flashlight.
I passed the first and third parts of the test as far as I know. The second part was where the problem was. I was diagnosed with BPPV: Benign Paroxsysmal Positional Vertigo. They said I had my ‘crystals’ moved out of their place where they should be in the middle ear and moved to another area. They said it was one of the ‘better’ problems to be diagnosed with as a result of this test and it was treatable. They did the treatment right away which was a lot like the test itself. They kept moving my head to different areas in a certain sequence, to move the crystals back to their place.
Now, I’m having to wear a soft cervical collar for the next two days as a reminder to refrain from bending over or looking up. Also, for the first two nights, I need to sleep on a reclining position at about 45 degrees. They recommended a Lazy Boy or other upright chair, sleeping with the collar on. After the first two nights, I may take the collar off but I still need to be careful with my head movement and activity. Starting on the third night , I need to sleep on my left side, the opposite side of the procedure, for the next 5 nights.
After completing all the directions for one week, I need to call the hospital to let them know how I feel. I should not experience any true vertigo (room spinning) during this week if the treatment was successful. They say this procedure has a 92% success rate. If not, they’ll repeat the treatment. We’ll see how lucky I will get this time.
Temporal bone fracture is what I have on the left side of my head, next to my ear. That must be where I hit the ground real hard when I fainted on March 31. The link below seems to have some good information about it, including my symptoms of vertigo and cranial nerve damage as a result of a temporal bone fracture.
As it is suggested on this site, I need an MRI, more than just a CT scan to show the nerve damage. “Although CT scanning may be appropriate for assessing complications, magnetic resonance imaging (MRI) is useful for identifying vestibular hemorrhage, determining the extent of brainstem injury, and demonstrating nerve compression.” The hard part is to find the right doctor to take the necessary steps towards some answers and recovery.
This seems like what’s going on in my mouth. I think I have suffered cranial nerve injury. Now, I need to find a doctor who will read and understand this, and prescribe the required medicine.
UConn Taste and Smell Center – General Information
It is estimated that approximately 2 million adult Americans have a taste and/or smell disorder. These include anosmia (complete smell loss), hyposmia (partial smell loss), ageusia (complete taste loss), hypogeusia (partial taste loss), parosmia (smell distortion or phantom smell), and dysgeusia (persistent abnormal taste). There are actually three “chemosensory” systems in the nose and mouth. The first, olfaction, is the ability to detect and identify odors. The second is gustation or taste. Taste function is limited to detection and identification of sweet, sour, salty, and bitter substances in the mouth. The third sense, the “common chemical sense”, is the ability to detect the irritating properties of substances in the mouth and odors in the nose. Through the common chemical sense, we perceive the burn of chili pepper and the tingle of ammonia.
Information about taste is picked up by numerous taste buds distributed throughout the oral cavity. Smell information is processed by specialized nervous tissue at the very top of the nasal cavities. The common chemical sense is transmitted through many tiny nerve endings in the linings of the nose and mouth. Information from these three senses is transmitted via a number of separate paths to the brain.
The terms “flavor” and “taste” are often confused. Flavor is determined by the aroma (smell), taste (sweet, sour, salty or bitter quality), texture, temperature and spiciness (or irritation) of food and beverages. All of these sensory experiences together form “flavor”. Frequently, when individuals say they cannot taste, they are really telling us that they cannot appreciate the flavor of food. As the aroma of food contributes to about 3/4 of its flavor, these individuals usually have suffered a loss of smell ability only.
UConn Health Center
Causes of Smell Loss
Olfactory disturbance has many possible causes. In most instances, loss of smell is caused by nasal and sinus disease, upper respiratory tract infection or head trauma.
Olfactory impairment is estimated to occur in nearly 10 percent of patients with head trauma. Post-traumatic smell loss is usually caused by shearing injuries to the olfactory nerve fibers at the level of the cribiform plate, but it can also be caused by direct injury to the olfactory bulbs, olfactory tracts or frontal and temporal lobes.
In general, the olfactory system regenerates poorly after a head injury. Most patients who recover smell function subsequent to head trauma do so within 12 weeks of injury.
http://www.aafp.org/afp/20000115/427.html
Posttraumatic olfactory loss
Head injury is the leading cause of posttraumatic anosmia. Complete or partial loss of olfactory function may occur when the nasal passages are blocked, olfactory nerves are injured or there are contusions or hemorrhages in olfactory centers of the brain. Evaluation of patients with posttraumatic olfactory loss should include a physical examination by the otolaryngologist. Nasal endoscopy and radiological studies should be performed as well as olfactory function tests to determine the degree and type of olfactory impairment. Although treatment options may be limited, physicians should provide information and counseling regarding the risks and hazards associated with loss of olfactory function. Costanzo RM, Miwa T.
Head Trauma
Smell and/or taste problems can also be caused by trauma to the head. Somewhere between 5% and 30% of head trauma patients will lose their sense of smell. Taste loss is estimated to occur in 0.5% of head trauma patients. Parosmias and dysgeusias may also occur. There is no known treatment for chemosensory problems caused by head trauma. Some patients will get better with time, although this may take years. Spontaneous recovery rates of 8% to 39% have been reported for smell function, with the majority of patients showing improvement within 3 months of injury.
http://www.uchc.edu/uconntasteandsmell/head.html
This is for any doctor who might come to this page and want to help me; summary of my situation;
My story is not a very pleasant one. I am a 33 year old female who has never suffered anything remotely similar to this before. I fainted in a store on March 31, 2007 after throwing up all night the day before after a bad meal and had a severe head injury. When I opened my eyes in the ER, my ears were clogged and I was very dizzy, not to mention the severe bruising and pain at the back of my head next to my left ear where I hit the ground.
I also lost my sense of smell and most of my taste. I can only taste the main four: salty, sweet, sour and bitter, but no flavor. CT scans show a fracture in my skull (temporal bone) from hitting my head so hard on the floor of a store and I am still dizzy and spinning. I am scheduled for an ENG test for balance on May 4.
The first ENT I saw said there isn’t much hope for recovery as far as the loss of smell goes but he prescribed steroids. I finished a 6 pack Prednisone the first week after my injury, which didn’t seem to make any difference. When I went to see him a week later on April 17, he prescribed more streoids. Two days into the 12 pack of Prednisone, I started smelling a horrible nauseating burnt/chemical like poisonous smell which is still going on non-stop. It’s an unbearable nauseating smell which makes it very hard to breathe. He didn’t know and didn’t recommend anything for the bad smell I’ve been suffering from for the last two weeks now.
I’m desperately seeking some help and recovery but my doctor doesn’t appear to be competent. He’s an Ear Nose Throat specialist and said “I don’t know what the nose has to do with the ear”! He doesn’t do any smell tests either, so I’m trying to go to a Smell and Taste Clinic to get further evaluated. I contacted the nearest Smell and Taste Clinic to me which is in Richmond, VA. VCU Smell and Taste Clinic They gave me an appointment for June 4! I don’t know how I am supposed to go on with this sickening smell in the mean time.
If you know of any good doctors (ENT, neurologist, counseling) that could help in my area (Virginia Beach,VA), please let me know. I can’t take this poisonous smell any more which makes everything taste like poison too. I also have soreness and burning in my palate which started a few days after the bad smell for no apparent reason, on April 21 (about 3 weeks after my head injury). It seems like my sympotms are getting worse instead of better with time. The first week after the injury, I had no smell, but I didn’t have this horrible fume like smell which keeps choking me either. For the first few days immediately after the injury, I was able to catch a hint of a smell if the odor was strong enough, but then two and a half weeks after the injury, this horrible gas/burnt nerve like smell (reminds me of a root canal at the dentist) started, and my palate and tongue started to burn and get sore. The front part of my palate, directly behind my front teeth looks like it may have an infection under the skin. It has become wrinkled and white-ish in color and is very tender when touched.
A bit more than a month after the injury, whenever I am exposed to any kind of smell – walking into a restaurant is the worst – that bad smell is intensified, and it starts a burning sensation in my nose. This nasty smell is the ONLY smell in my nose, and the only taste down my throat for the last two weeks. I am suffering from all of these symptoms with the added pain of my head where I cracked the temporal bone. Any references that you could provide that would lead me to some good doctors who can understand my situtation better and might be able to help would be greatly appreciated.
I went to see another ENT doctor two days ago. He didn’t know much about my sore palate either. He just prescribed some zinc and told me to hope for the best. I can’t get anyone to understand that I cannot go on living with this fume smell and taste in my nasal cavity and my throat. All I keep hearing is that they don’t know much about nose problems. Please contact me if you know of a specialist who knows about and has experience treating parosmia and anosmia.
I’ve been without smell and taste for 30 days now. This is the ‘fun’ I had for the past month;
3.30.07 – I came home from PT and had lunch. I got severely nauseated and threw up all night.
3.31.07 – I fainted at K-Mart and had a severe head injury. My left ear was clogged when I opened my eyes in ER. I had severe bruising next to my left ear and fracture in my temporal bone. I wasn’t aware I also lost my sense of smell yet.
4.02.07 – Went to see Dr. Johnson. We also saw ENT Dr. Berry across the hall. They did not agree with ER dr’s ‘ear infection’ impression either. I had no ear problems prior to fainting.
4.06.07 – Had a CT scan of the temporal bone. It shows a crack in my skull.
4.07.07 – Started Prednisone 6-pack for inflammation.
4.12-4.15.07 – Pre-planned DC trip. Still no smell or taste. Very dizzy and no energy.
4.17.07 – Follow-up visit to ENT Dr. Berry. CT scan confirms a crack in my temporal bone. He said, “Sorry, not much hope for recovery” for my loss of smell. Gave more Prednisone-12 pack.
4.19.07 – Parosmia started. Smelling nothing but fumes and gas like poison 24/7. It’s burning inside my nasal cavity and throat. I can hardly breathe.
4.21.07 – My palate got very sore all of a sudden. It hurts to eat or drink or even to talk. The area behind my upper front teeth has a burning sensation and the skin looks wrinkled. Parts of my tongue is also burning. No doctor could tell me why so far.
4.23.07 – CT scan of sinuses. It seems to be ‘normal’.
4.30.07 – Had an appointment with another ENT doctor. He prescribed zinc and told me to keep my hopes high. He didn’t know what was wrong with my palate. He didn’t give anything to ease my symptoms of bad smell or taste. He said I could get better in 6-12 months, or not.
It’s been 10 days since I started smelling nothing but this horrifying fume like smell in my nose and throat. It’s sort of like a mixture of snot, blood, rotten onion, burnt cable, dead flesh, ammonia type smell which is hard to describe. Not only this is all I smell now but everything tastes the same way too. I feel it in my nose and throat 24/7. It’s a pain to even brush my teeth. Anything I attempt to smell like food or perfume only intensifies this horrid smell more. I don’t even need to smell anything, just breathing is enough. What is more disturbing is that I still couldn’t find any satisfactory answers to what exactly is going on.
The doctors I’ve seen so far have been pretty useless. I’m going to try a new ENT specialist on Monday. They finally called from the Smell and Taste Clinic in Richmond with an appointment date after taking a whole week to get back to me. It is for June 4th! I have over a month to suffer before they can even start doing any tests on me!!
I hope I can survive this death gas and not lose my mind in the mean time. Not only it’s gross and nauseating but it also burns my tongue, throat, nose and ears. It makes me choke and makes it very difficult to breathe. I feel like I am stuck in a bubble with no escape. I am so tired of smelling and swallowing fumes. Everything I eat tastes like poison just like the smell. I am so desperate to find a cure, yet so in shock to see no doctor seems to care or understand the urgency of the situation.
My palate also got sore last Saturday all of a sudden for no apparent reason to me. The skin right behind my upper front teeth is all wrinkled and sore to the touch which makes it even harder to eat, drink or talk. There’s a constant burning sensation on my palate. I tried to get some answers from the doctors and the dentist but nothing so far. No one seems to know anything or even care. I might have to end up getting in the medical field myself to maybe find a cure or at least some answers!
How an ENT doctor doesn’t know the relation of the ear and the nose is beyond me. He didn’t even know of the smell and taste clinics in the area. He doesn’t do any smell tests nor did he even look into my nose once to check it!?! He kept saying, “I don’t know why the nose would be affected from a fall next to the ear!!” He thought I should have lost my hearing, not the smell. Just a basic search on the net was enough for me to find out that ‘head injury’ was one of the leading causes of sudden smell loss. Unfortunately, it’s not as easy to reach more detailed answers or specialists who could help.
I fainted in a store on 3/31/07 after throwing up all night the day before after a bad meal and had a severe head injury. When I opened my eyes in the ER, my ears were clogged and I was very dizzy, not to mention the severe bruising and pain at the back of my head next to my left ear where I hit the ground.
I also lost my sense of smell and most of my taste, which is very dependent on smell. I can only taste the main four; salty, sweet, sour and bitter, but no flavor. CT scans show a fracture in my skull (temporal bone) from hitting my head so hard on the floor of K-Mart(never liked that place!) and I am still dizzy and spinning. I am scheduled for more tests for balance.
ENT doctor I’ve been seeing says there isn’t much hope for recovery as far as the loss of smell goes but we’re still trying steroids. I finished a 6 pack which didn’t seem to make a difference. Now I’m on a 12 pack Prednisone but I started smelling a horrible nauseating burnt/chemical like poisonous smell for the past week. It’s very hard to breathe. I’m desperately seeking some help and recovery but my doctor isn’t so good. He’s an Ear Nose Throat specialist who said “I don’t know what the nose has to do with the ear!”. He doesn’t do any smell tests either, so I’m trying to go to a Smell and Taste Clinic to get further evaluated.
If you know of any good doctors that could help, please let me know. I guess I need prayers too. I can’t take this poisonous smell any more which makes everything taste like that too. I also have soreness and burning in my palate for the last few days for no apparent reason.
Has anyone had similar symptoms? Has anyone suffering from the same nasty burnt smell got rid of it? How long did it last? I don’t know how long more I can stand this nauseating smell. I smell nothing else.
I used to have a very sensitive nose and strong sense of smell, so it’s extra hard for me to cope with this situation. I feel like I am stuck in a poisonous bubble where I can’t even breathe. Has anyone ever gained their sense of smell back after a head injury? I am anxious to reach others who are suffering from similar symptoms.
No Smell No Taste 
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