Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Neurological examination, Photophobia, Tinnitus, Vertigo
Clinical narrative: 3/4/21 - can?t stand up, room is spinning.  Headache, nausea, sensitive to light and sound, ears ringing. 3/4/21 - Visit ER: Sitting up is painful, horizontal is the only ?comfortable? position.  IV fluid, blood draw, pain meds, nausea meds.  Bloodwork came back normal.  ?this is a reaction to vaccine.  Could last 4-5 days, hydrate, given prescription for anti-nausea meds? 3-8-21(mon)   Visit with PCP.  He says bad reaction to vaccine.  Just need to wait it out.  Dizziness will eventually go away.  Writes a doctor?s note for missing school.  Anticipates unsteadiness lasting a week or so.  Prescribes meclizine, 12.5 mg.(I only took this for a few days, was not noticing any improvement)   3-16-21(tues)5:00pm  Go to ER.  EKG and bloodwork come out fine.  Horizontal is only comfortable position, still have headache.  See the neurologist, she talks with me and does a few tests.  We talk about migraines.  Is this a massive migraine?  She says I need to see ENT.  Prescribes a ?migraine cocktail? ? magnesium, 2 benadryl and Zofran.   3-22-21(mon) 3:30pm  ENT, hearing test.  No changes since December of 2019 (went in for ringing in ears).  Talked mostly with physician assistant,  identified that I most likely needed the Epley maneuver on the right side.  Audiologist, was not available that day (I was supposed to have appt with her, but they made a change).  The earliest she had an opening was 3-24-21.  Dr. recommended taking magnesium  for head. 3-24-21(wed) 10:30 am  appt.  She performed the Epley on the right side one time.  Said that she wanted my body to calm down.  Keep head up for rest of day, sleep on two pillows.  Don?t lean over with head down.  Next day to walk around and use full range of motion on head so my brain/eyes get back to normal.  Scheduled a follow up for afternoon 3-26-21(48 hours) to assess progress.  She recommends to take ?preventa migraine? vitamin.  Magnesium and riboflavin (I start taking 3/28/21).  Able to roll over in bed without room spinning. 3-31-21(wed) 11:00 am.  She runs the test where I am in a dark room and she spins my chair around, watching what my eyes do.  Apparently I passed that test?  Then she tests me to check the inner ear crystals.  I am not in need of the Epley.  But, I feel terrible.  She says, something else is going on.  We have gotten the crystals back in place, she has done what she can for me.   1:00 pm appt with Dr.  Says chronic migraine.  Recommends vestibular therapy. 4-2-21 (fri) 3:00pm appt with PT, DPT, ATC, MS.  She identifies that my eyes are not tracking properly, the left one.  ?VOR deficit?  She says don?t google it b/c I have a mild case.    Homework is brain exercises:  pencil pushups and seated gaze stabilization with head rotation.  We schedule 2 sessions per week for 4 weeks.  She is hopeful of full recovery with work.  Says I would not recover by sitting in a dark room.  We need to retrain the brain and get back to normal.   4-7-21(wed) 10:00am appt for vestibular therapy.  Work on brain exercises, she times me.  Add some neck exercises to strengthen those muscles.  I notice a ?pinching? sensation on left side.  When I laid down on the foam roller, I had to put hands down to stabilize myself (room spinning).  2:00pm appt with deep tissue massage therapist.  (I have been working with her for over a year)  my head is very tender.  My neck and shoulders are extremely tight.  I have a large knot at the base of my skull on the left side.  It took a long time for my body to calm down today. 4-8-21 (th) 2:30pm appt.  Not feeling great  - suspect that I have ear crystals out of position again.  She sees me and says let?s test you.  She performs several Epley maneuvers.  3 on right side and one on left side.  Left me dizzy, unsteady and lightheaded.  I need help walking to car after appt.  go home and crawl in bed.  Cold, exhausted.  Slept for hour or so. 4-9-21(fri) don?t feel great.  Still waiting on body to calm down after Epleys. 4-10-21 (sat) still feeling yucky 4-11-21 (sun) Rolling over in bed, room spinning (left side).  when I sat up in the morning, my body swayed.  Was very dizzy walking to bathroom.  Headache.  Pressure in head/ears.  Those symptoms subsided slightly as the day wore on.  Sleeping Sunday night was better.  Rolling over was fine. 4-12-21(mon) headache,  pressure, ringing in ears.  Working on computer is fatiguing.  Head feels full/ fluid.  Rolling side to side / feel fluid move? / increases dizziness.