I’ve had several spells of nausea and vertigo. It seemed to come and go, but there was always at least some degree of background nausea. At the worst point I was unable to keep down water and eventually went to the ER and got an IV and some anti-nausea meds. During the worst episode, I spent most of the day lying on the floor and if I tried to lift or move my head at all the nausea would become much worse. At points throughout these weeks, I noticed that my vision seemed to skip if I turned my head or eyes too quickly. A small sense of spinning remained when I moved my eyes to the edges of my field of vision.
Nausea and vertigo go hand-in-hand. The stronger the sense of spinning, the more nauseating it tends to be. Moving the head worsens all forms of vertigo, so nausea will usually be more severe if you move. That’s why most people lie quietly and try to hold their head still during their spells. Unfortunately, the symptom of nausea does not give you any useful information about what is causing the vertigo.
Your story gives two helpful symptoms, however. You mention that your vision “skips” if you turn your head or eyes too quickly. This symptom is called oscillopsia. Another word for it is video-camera vision. Normally your inner ears help vision to remain stable whenever you move your head. As you know, video cameras do not have this reflex, so you have to be very careful not to jiggle the camera or swing it around too quickly or your video will be very jerky and blurry. Having this symptom is an indicator that one or both inner ears are not working to stabilize vision. You can tell if it’s just one ear because the vision will be OK when turning toward the good ear, and will show skipping or blurring when turning toward the other. If both ears are affected, it will be blurred no matter which direction you turn.
Another useful thing to notice is that spinning happens when you move your eyes far to the side, to the edge of vision. Nystagmus is a rhythmic jerking of the eyes that reflects a feeling of spinning. If it’s coming from an inner ear, it gets worse when you turn your eyes in the direction of the jerking. You’ll feel it speed up as you do this, and the spinning will appear faster. It gets less when you look in the opposite direction, so if you’re seeing the room spin, experiment to decide which way to direct your gaze. You can often find one direction that is not as bad.
Both of these suggest that there is a loss of function in one inner ear during the spells. Spells that are recurrent can mean this problem is causing an accumulating loss. Tests of inner ear function (audiogram and VNG) will often help define the problem ear and can lead to a diagnosis.
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