Prolonged Dizziness

[Demondawg18]

Looking for a little advice/knowledge...My girlfriend and I went diving in Hawaii in early Sept. It was her first openwater dives (after certification). We did 6 dives with a max depth of about 75 ft.
During her 2nd certification dive (7 weeks prior to Hawaii), she ruptured a small blood vessel in her middle ear & experienced vertigo as a result. She surfaced (at appropriate accent speed) & did not continue her remaining dives. We went to the ER, just to be safe & the doc's were not concerned...Just to be safe, I had her visit an ENT (we managed to find one that is a diver as well). He recommended she wait 1 week before completeing her Open Water Cert. She waited 2 weeks, finished her last 2 dives without incident.
We did all of our dives in Hawaii with no issues, no pain, no dizziness/vertigo. We had 4 days between our last dive and our flight home.
3 weeks after returning home, she started getting very dizzy. This has now become quite dibilitating (cant drive, generally uncomfortable...no vomitting) and has lasted 4 weeks. We have been in and out of Doctor's offices, done CT scans, MRIs, etc. and nobody can find anything.
Does anyone think this could be dive related. To the best of my knowledge, a dive injury wouldnt manifest 3+ weeks after diving, but I'm no expert.
Any advice is greatly appreciated!

 

[doctormike]

Looking for a little advice/knowledge...My girlfriend and I went diving in Hawaii in early Sept. It was her first openwater dives (after certification). We did 6 dives with a max depth of about 75 ft.
During her 2nd certification dive (7 weeks prior to Hawaii), she ruptured a small blood vessel in her middle ear & experienced vertigo as a result. She surfaced (at appropriate accent speed) & did not continue her remaining dives. We went to the ER, just to be safe & the doc's were not concerned...Just to be safe, I had her visit an ENT (we managed to find one that is a diver as well). He recommended she wait 1 week before completeing her Open Water Cert. She waited 2 weeks, finished her last 2 dives without incident.
We did all of our dives in Hawaii with no issues, no pain, no dizziness/vertigo. We had 4 days between our last dive and our flight home.
3 weeks after returning home, she started getting very dizzy. This has now become quite dibilitating (cant drive, generally uncomfortable...no vomitting) and has lasted 4 weeks. We have been in and out of Doctor's offices, done CT scans, MRIs, etc. and nobody can find anything.
Does anyone think this could be dive related. To the best of my knowledge, a dive injury wouldnt manifest 3+ weeks after diving, but I'm no expert.
Any advice is greatly appreciated!

Hi, Demondawg... thanks for writing! Sorry to hear about your girlfriend.

With most of these things, the devil is in the details, and it's hard to say much without more information. I'm not sure how the diagnosis of "a ruptured blood vessel in her middle ear was made", but acute vertigo can come from a number of dive related conditions, with hemotympanum (blood in the middle ear related to barotrauma) actually being one of the less common ones. Other sources are from outer ear stimulation by cool water (caloric responses), altenobaric vertigo (assymetric ventilation of the middle ears), inner ear fluid leakage (perilymph fistula), or even inner ear decompression injury.

There are a number of threads hear about all of these injuries, but it might be helpful if you could tell us things like the results of a hearing test, of the microscopic examination of the ear, the results of any balance testing and/or ENG testing (inner ear evaluations), etc.. Of course, we can't diagnose or treat anyone over the Internet, but to even have a useful discussion we need a bit more detail.

If she hasn't seen an ear specialist (an otologist), and you tell me where you are writing from, I might be able to give you a local referral..

Good luck, and keep us posted!

Best,

Mike

 

[Demondawg18]

Hi Dr. Mike. This is actually Mike's girlfriend, Carin. Hope this answers some of your questions.

First I had bloodwork done and all that was fine. Then I had a VNG test and the ENT did not see anything. My hearing test was excellent too. The MRI was diagnosed as normal, and I am waiting to hear the results from my CT Scan. The ENT is looking for evidense of Superior Canal Dehiscence Syndrome. We then may try diuretics to see if that helps... I guess if I have Meniere's disease, that may help.

As for the vertigo during my certification dive, the ER saw blood in my ear and thinks just that bit of pressure, combined with the pressure of the water, was enough to give me vertigo. The vertigo went away as soon as I surfaced.

We live in Fairfax, VA. Anything else?

Thanks for your help!

 

[doctormike]

Hi Dr. Mike. This is actually Mike's girlfriend, Carin. Hope this answers some of your questions.

First I had bloodwork done and all that was fine. Then I had a VNG test and the ENT did not see anything. My hearing test was excellent too. The MRI was diagnosed as normal, and I am waiting to hear the results from my CT Scan. The ENT is looking for evidense of Superior Canal Dehiscence Syndrome. We then may try diuretics to see if that helps... I guess if I have Meniere's disease, that may help.

As for the vertigo during my certification dive, the ER saw blood in my ear and thinks just that bit of pressure, combined with the pressure of the water, was enough to give me vertigo. The vertigo went away as soon as I surfaced.

We live in Fairfax, VA. Anything else?

Thanks for your help!

Aha..! That's good information... It sounds like you are in good hands, and are having the appropriate workup.

Certainly, if you do have any sort of bony dehiscience (that would show up on the CT scan), you could be at risk for inner ear symptoms. On the other hand, it may be not dive related at all, as you suggested (Meniere's, etc..).

Good luck, and feel free to keep me posted...!

Best,

Mike