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Suggest Treatment For Vertigo And Basal Ganglia Calcification Seen In CT Scan
I experienced vertigo 2 months ago. This included head spinning and lose of functions in my arm/legs, it last seconds, afterwards i was nausau/sick to stomach. Since then i ve had episodes of quick spins in my head, but not the lose of functions. I ve had CT scans,MRI and a VNG test. All came back clear except the CT scan came back abnormal. The CT scan said it showed some slight coarse symmetirc basal ganglia calcification. Im seeing a neoroligist tomorrow about that, but they say it shouldnt be the problem. I have also started physical therapy, which seemed to help. But now in the past few days, the episodes started up again. I m really scared, because im not living my normal life anymore, and if this were to happen while i was driving, i would get into an accident. Please help
posted on
Fri, 14 Mar 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 26 Oct 2019
Answered on
Tue, 5 Nov 2019
Last reviewed on
Hello,
To start, basal ganglia calcifications are considered normal and occur as part of the normal aging process, so unless the calcification is severe, I would not call it abnormal. None the less, if would not be related to your symptom of vertigo.
Vertigo can occur for multiple different reasons and the most common cause by far is inner ear pathology. The most common causes are viral infections and what is called "benign paroxysmal positional positional veritigo" in which crystals become dislodged and end up in semicircular canals causing an abnormal sense of movement.
Rarer causes are cerebrovascular disease, in which blood flow to the back of the brain is diminished, Menier's disease which also causes hearing loss, tumors/growths and malformations of the structure of the inner ear.
You have had part of the workup done, but the first thing is to find out whether your vertigo is central or peripheral. Your VNG was normal which can be helpful, but if you are not experiencing symptoms at the time of the test, it may miss it.
Your neurologist may perform what is called a "dix-hallpike" maneuver in attempt to trigger your vertigo. Also a head-thrust may be done to visualize corrective eye movements. However, the VNG is usually more sensitive than the head thrust test.
An MRI of the brain and an MRA of the blood vessels in the neck and brain would be a reasonable test to perform to rule out any vascular problems. Lastly a high resolution CT scan of the temporal bone can help look for any small malformations in the structures of the inner ear. An audiogram may also be useful to screen for any hearing loss that may not be evident in daily conversations and function.
Almost all of these causes are treatable, it just needs to be determined what is causing your symptoms.
In the mean time the vertigo can be treated with vestibular suppressants. Meclizine is sometimes used, but is not very effective in my personal experience. Benzodiazepines such as diazepam can be used to treat severe vertigo as well. I suggest you speak with your neurologist regarding which medication is most appropriate for you
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Janne Kristoffer Nissinen, Neurologist
To start, basal ganglia calcifications are considered normal and occur as part of the normal aging process, so unless the calcification is severe, I would not call it abnormal. None the less, if would not be related to your symptom of vertigo.
Vertigo can occur for multiple different reasons and the most common cause by far is inner ear pathology. The most common causes are viral infections and what is called "benign paroxysmal positional positional veritigo" in which crystals become dislodged and end up in semicircular canals causing an abnormal sense of movement.
Rarer causes are cerebrovascular disease, in which blood flow to the back of the brain is diminished, Menier's disease which also causes hearing loss, tumors/growths and malformations of the structure of the inner ear.
You have had part of the workup done, but the first thing is to find out whether your vertigo is central or peripheral. Your VNG was normal which can be helpful, but if you are not experiencing symptoms at the time of the test, it may miss it.
Your neurologist may perform what is called a "dix-hallpike" maneuver in attempt to trigger your vertigo. Also a head-thrust may be done to visualize corrective eye movements. However, the VNG is usually more sensitive than the head thrust test.
An MRI of the brain and an MRA of the blood vessels in the neck and brain would be a reasonable test to perform to rule out any vascular problems. Lastly a high resolution CT scan of the temporal bone can help look for any small malformations in the structures of the inner ear. An audiogram may also be useful to screen for any hearing loss that may not be evident in daily conversations and function.
Almost all of these causes are treatable, it just needs to be determined what is causing your symptoms.
In the mean time the vertigo can be treated with vestibular suppressants. Meclizine is sometimes used, but is not very effective in my personal experience. Benzodiazepines such as diazepam can be used to treat severe vertigo as well. I suggest you speak with your neurologist regarding which medication is most appropriate for you
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Janne Kristoffer Nissinen, Neurologist
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