A radiologist and ENT came to different conclusions, so I'd like more thoughts and ideas on the subject.
I am the patient's guardian/conservator. Last fall the patient showed up at the ER with a high fever and complaining of dizziness. The flu was diagnosed and subsequently ran its course. However, the dizziness persisted for weeks, then months, and is still present.
But it's more of a perception of dizziness, rather than actual vertigo. There's no loss of balance involved. He often complains that his field of vision is spinning or jerking or that he feels pulled to one side, but there's never been any outward sign of disequilibrium or loss of balance.
Other symtoms include more visual distortions and a headache with a feeling of pressure behind the eyes. The severity of the symptoms wax and wane but don't seem to disappear completely.
Transient esotropia was reported on two occasions this year: once by a neuro-ophthamologist at an office visit and once by the patient's co-workers.
The patient was run through a battery of hearing and balance tests, and everything checked out. An EEG also came back normal.
An MRI was also done, and I've attached a composite images. The views 1A and 1B are SAG T1, view 5 is AX FLAIR, view 6 is AX BFFE, view 7 is AX T1 THINS PRE, view 8 is AX T1 THINS +C, and view 9 is COR T1 THIN +C.
More recently, a CT scan was made, and two slices are also attached as ct(lo).jpg.
The patient is autistic and has a history of OCD. One of his fixations is on his body. He had the flu about ten years ago, and it was accompanied by similar dizziness, which scared him greatly at that time.
The patient had multiple ear infections as a child, and tubes were placed in his ears early in his life.
For years (continuing to the present) he has exhibited what might be called mild facial spasms. Every so often his face will slightly contort for a few seconds, and he will appear to be "out of it." Over the years this has motivated speculation about absence seizures, but EEGs have provided no real evidence. He hasn't taken anti-convulsants for over a decade.
What would you diagnose or suspect based on his history and this MRI and CT imaging? Thank you for your attention.
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