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Prairie Village, KS
A 42-year-old male asked:

Feeling dizzy for over a month. have seen two ents. first said bppv, other said migraine associated vertigo. sneezing causes it. pain behind left ear.

4 doctor answers6 doctors weighed in
Dr. Michael Perez
Internal Medicine 39 years experience
Many factors: Sneezing can trigger blood pressure changes (high, then low) that make you unsteady temporarily by affecting circulation to your brain. Sneezing also can be part of upper airway and ear congestion from allergies which may need to be addressed. The pain behind the ear makes me wonder about mastoiditis. A correct diagnosis should lead to a treatment that alleviates your symptoms. Keep your mind open
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Dr. Edwin Ishoo
A Verified Doctoranswered
30 years experience
Endolymphatic Hydrop: Since symptoms started or exacerbate with the trauma of sneezing, you may have secondary Endolymphatic hydrous (primary idiopathic is called Ménière’s disease). Sx are ear pressure, ringing, possible hearing loss & dizziness)This needs to be diagnosed by vestibular studies. If suspected, start on low salt diet, limit alcohol and caffein. ENT may start diuretics and antihistamine for sx control.
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Dr. Olav Jaren
Neurology 21 years experience
Helping dizziness: It's sometimes difficult to know the cause. Many of the treatments can be used for multiple causes. BPPV is worse with movement. Vestibular therapy would be an option for that. Migraine-associated vertigo responds to migraine treatment. Some people find magnesium to be a helpful migraine preventer. There are also treatments of meclizine, salt restriction, etc.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Murray Grossan
ENT and Head and Neck Surgery 75 years experience
Could be an excessively open Eustachian tube 0 sneezing raises middle ear pressure, etc.
Dec 30, 2014
Dr. Eric Weisman
Neurology 38 years experience
More info needed: BPPV is positional (by definition) There is a short latency from assuming a position to onset of true vertigo. Pain behind the ear with change in pressure (sneezing) is an important clue. Is the mastoid area behind the ear tender to tapping on it? Is the pain being referred from the inner or middle ear ? My gut feeling is that neither diagnosis fits the picture.
Created for people with ongoing healthcare needs but benefits everyone.
Last updated Oct 29, 2018

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