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Labyrinthitis - advice please

8 Jan 2014 by Jancis Robinson

Well that's the last time I have a completely clear day and evening in my diary… This rare phenomenon applied to yesterday when I planned to make progress with all sorts of desk jobs.

Instead of which I spent most of it in University College Hospital's A&E department, having been rushed there from my north London doctor's surgery. Turns out the extreme dizziness, light-sensitivity and nausea that suddenly came over me yesterday morning is nothing more sinister than something I had never heard of, labyrinthitis, a viral infection of the inner ear that disturbs your balance. I'm back home now but, most unfortunately, will have to bow out of this year's concentrated London season of burgundy 2012 tastings that begins in earnest this morning. I'm so glad I had a week in Burgundy last month to enjoy hundreds of these rather charming wines in situ.

Fortunately we have an expanded and experienced team at JancisRobinson.com, including four of us who have sailed through the Master of Wine exams. Julia, who arrived back from Australia last night, and Richard - who were planning to attend some of the tastings anyway - are kindly covering for me.

Luckily, Julia had a good night's sleep last night - as did I, despite spending much of yesterday in a rather dozy state. I plan to take it easy for the rest of this week, but would welcome any advice from anyone who has also suffered from labyrinthitis. (See comments box below.)

Funny thing is that the rather strange way I feel now - a bit dizzy - is probably how most people think we wine writers spend most of our time.

Comments

Thanks so much, Dr Mishalove.  Yes PPV on any sort was excluded and I was extremely lucky that the symptoms persisted only a day or two. I am in great shape now, thank you.

 

10 Feb 2014 11:56 by Jancis Robinson

Hello Jancis, I am an American physician and love your books.  With regard to your "labyrinthitis",  I presume that you are still experiencing vertigo.  I also assume that your physician excluded Benign Paroxysmal Positional Vertigo (BPPV).  If your vertigo persists, vestibular rehabilitation therapy is often very effective (see link: http://vestibular.org/understanding-vestibular-disorder/treatment/treatment-detail-page).  This is directed more at the cause of the persistent vertigo than is acupuncture or medications.  Best regards,

31 Jan 2014 18:52 by R. David Mishalove M.D. (Pennsylvania, USA)

I realise this is not a forum for scientific bickering, however, In response to the doubts about acupuncture http://www.ncbi.nlm.nih.gov/pubmed/15193624clearly shows that acupuncture has specific neurological effects which treat the nausea, vomiting and dizziness associated with labyrinthine disorders. Oh, and if you would like to know, chocolate, massage and red wine facilitate acupuncture treatment!Dr Bill Meyers 

18 Jan 2014 11:10 by Bill Meyers

Very many thanks, Duncan.

I went to my first wine tasting of the year yesterday - Lay & Wheeler's, the smallest of the three that took place in London yesterday - without ill effects. Though I certainly didn't feel like drinking a glass of wine in the evening.

I suspect this episode may turn me into someone sensible which is a rather gloomy thought.

14 Jan 2014 09:34 by Jancis Robinson

Dear Jancis - Yet another for your collection: Have now logged 15 years living in São Paulo and have had labyrinthitis a few times. My own conclusion is dehydration, for which the fastest turn-around has proved to be a prompt intravenal drip at the local hospital's A&E, plus tablets for few days. Highly disconcerting, I agree, but manageable. Also echo above counsel on lying low for a brief period on alcohol (local WS Level 3 course week was a good test), caffeine and other dehydrators - substituting Dioralyte/ Gatorade type liquids to restore salts/potassium balance. Inner-ear balance: You may not have been practicing aerobatics recently (now probably less than ever), but you can lose balance for a while after doing so, while your inner-ear gyroscope/liquids catch up. Your earlier correspondent mentions physio - which is worth a try: Aim as I understand it is to dislodge crystals which are delaying the return-to-normal of the inner-ear liquid, which in turn is key to the body-balance mechanics. All-in-all, I'd go for the drip plus a brief decaf/detox! Bon courage, Duncan

13 Jan 2014 01:24 by Duncan Lawrie

Very many thanks, one and all. It's especially interesting to know what the effects will be on my post mortem!

I do so appreciate all this useful advice and support. I am back to around 80% now, thank you very much, and feel extremely lucky. Have not taken any medication since Friday lunchtime and feel the better for it.

May try the smallest of tomorrow's three burgundy tastings and see how I get on.

12 Jan 2014 10:59 by Jancis Robinson

From a long established medical friend of mine:Dear Jancis, Commiserations!I doubt if Acupuncture will work and I can say it is not a syndrome of old age, having had three attacks over many years and only the last might fit into the "senior citizen" group.   1.   Presuming it to be an Acute Idiopathic Paroxysmal Vertigo or Labyrinthitis and most likely caused by a Virus, then one would treat as for Bell's Palsy and Herpes (Shingles) Zoster. where the fatty Myelin protective sheath along a nerve or group of nerves comes under attack.  In cases of Shingles  (evidence-based)  with Post-Herpetic Neuralgia if untreated then the nerve dies and at post-mortem is seen to be black and very dead. The treatment is essentially with Vitamin B.12, (2.500 micrograms given daily) until better.  Ask the good Jonathan Harcourt for them. In Harley Street it is reported they charge "celebreetees" GBP 95.00 for one injection!   B.12  is cheap. Or your General Practitioner if not too haughty, could also give.   Do not put up with  the pompous response of one who declared "it is not within my remit to give such injections!"  Which is not so since Earl Howe of the Ministry assures me that B. 12 is so permitted. Vitamin B.12 is made by a combination of an Intrinsic Factor in Gastric Juice with an Extrinsic factor obtained from good red meat, steaks, liver, kidney, tongue and ox-tail or black pudding.  If anything interferes with the gastric juice, (does wine-tasting dilute it?) then  there will be a deficiency of Vitamin B.12.   There would seem to be no harm, in addition, taking those anti-viral tablets of  "Famvir" or "Acyclovir" which are commonly given for Shingles.  Though Vitamin B.12 has been in use for far longer at less expense since 1954.   One can add on cheap Vitamin B.1  (Thiamin) which encourages the transmission of sensation along a nerve fibre.   2.  Then there is a mention of crystals of Calcium being entangled with the sensory nerve endings in those Semi-circular canals of the Vestibular apparatus. (Not evidence-based).  Crystals can only form in a saturated, hypertonic solution. Then it would seem sensible  to maintain an adequate intake of water, not coffee, tea or milk, or Wine, to keep the fluid in those canals dilute, isotonic or even hypotonic. Calcium combined with what Base?  Not Urates from gouty Uric Acid?  An adequate intake of water may be judged by the output of urine which should be colourless,  like a clear (not a peaty Scottish one) mountain stream.   Stemetil I have never taken but given only for boat-sickness.  "Largactil" (Chlorpromazine) is better for Migraine.   Get better  soon.   With best regards,   George Caldwell

12 Jan 2014 10:28 by Andrew Smith

Hello Jancis. Sorry to hear you have been struck by this. When it happened to me about 5 years a go for the first time it really scared me. I could not believe, once it had occurred, how many people I knew it had also afflicted. It seems to be almost a 'silent' affliction. Altogether, it repeated itself about 6 times over about 3 years. For 2 years, touch head, I have been clear. I think it happened due to pressure of work and I certainly have to be very careful and recognise the signs of when extreme fatigue could spark it again. Without doubt the stematil is something to avoid if possible but I also wanted to acknowledge the ENT people I saw at Coventry University Hospital who provided me with a basic exercise that allowed me to train my brain to cope. You are not alone and I hope you recover quickly. I feel I was one of the lucky ones and have had it easy in comparison with some others I am aware of. I think it is great that you have communicated this and will respond if any encouragement is needed as necessary. Most important of all it has not diminished my love of wine. Good luck. 

11 Jan 2014 20:22 by Russell Moffatt

Dear Jancis, So sorry to hear you've been struck down with this horrible curse. It WILL pass but it may take time. Please don't be alarmed if the vertigo returns. I'm assuming you did have the horrible spinning. I was struck down at work and made an undignified exit in a wheelchair vomiting into a waste paper basket. I lay in bed spinning for about 15 hours. But it does stop, leaving you a bit wobbly, as you say. And it DOES come back, but usually at fairly long intervals and with less intensity. In between, you may indeed feel as though your head has been removed and put back wrong. I was told to be patient and wait for time to work its magic and for the brain to readjust to the new reality. Which it does. My advice is to stay off the prochlorperazine - which turn you into a zombie, be kind to yourself and know that it WILL pass and you'll get your life back. Nasty thing though. One of those conditions that the medical profession doesn't seem to have fully understood, yet. Hope this helps. Aneesa  

11 Jan 2014 10:45 by Ethan Higgins

Gosh!  Thank you ALL so much.  I feel very grateful for this, surely one of the great positive benefits of an online community. What a lot of sound practical advice there is here.

Jonathan Harcourt at the London Clinic was hugely positive and helpful last night. Tested everything, including hearing, balance and eye movements. Thinks I am making extremely good progress and, with any luck, there should be no need for exercises. Lab./vestibular whatsit seems to have struck acutely but relativly briefly. He said most people take six weeks to recover, some never and the lucky ones two weeks and that he thinks I'm one of the lucky ones. I certainly feel it as I have felt better every day and the nausea was very short-lived.

As for Stemetil/prochlorperzine, he pointed out they are designed to stem nausea rather than dizziness so I'm delightedly off them and on the grape once more. A glass of delicious Lassaigne, Vignes de Montgueux champagne was infinitely preferable.

Am feeling very, very much better - not least because of all the sympathy and helpful advice from you, and amazing support from Team JR.com. Thank you!

 

11 Jan 2014 09:21 by Jancis Robinson

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