I’ve started experiencing strange vision changes – almost as if my eyes are subtly shaking – along with dizziness. What could be the cause?
Shaking vision is often a sign there is something wrong with the brain, inner ear or nerves.
Involuntary eye movement – where the eyes move repeatedly without control, often side to side or up and down – is known medically as nystagmus.
This can create the sensation that the surroundings are moving or shaking. Over time, nystagmus can also cause headaches.
Many patients also experience balance problems, sensitivity to light and difficulty seeing clearly, particularly at night.
The condition itself is not a disease, but it is a sign that something is affecting the systems that control eye movement – namely the eyes, the brain and the inner ear.
The inner ear is particularly important, as it helps regulate balance. One of the most common conditions that disrupts this system is vertigo, which leads to both dizziness and abnormal eye movements.
A GP should be able to diagnose vertigo and suggest treatment. The most likely option would be a particular form of physiotherapy, called vestibular rehabilitation therapy, which involves eye and head movement exercises to improve vertigo symptoms. These can be done with the help of a physiotherapist.
Problems with the inner ear can lead to dizziness and abnormal eye movement
Less commonly, nystagmus may be linked to neurological conditions, such as multiple sclerosis – a degenerative disease that occurs when the immune system overreacts and begins to attack the nerves.
Yet multiple sclerosis usually triggers other symptoms, such as muscle weakness and co-ordination problems.
In these situations, a GP would want to fully investigate it to ensure no serious cause.
I am 80 and have been taking amitriptyline for Crohn’s disease for many years. Lately, I’ve had more forgetfulness, particularly with words. Could the medication be to blame – and would stopping it help?
The most likely cause of mild memory lapses is age-related rather than medication, although drugs such as amitriptyline can contribute.
Many patients experience what is known as age-related cognitive decline. This is not dementia, but a normal part of ageing where recall becomes slower and it becomes more difficult to find the right words.
Importantly, it usually does not interfere significantly with day-to-day functioning or worsen rapidly over time.
However, amitriptyline – a nerve-pain drug which is also used as an antidepressant – is known to cause side effects that can affect memory.
It can make patients drowsy, interfere with sleep quality and slow cognitive processing – all of which may contribute to forgetfulness.
Some studies have suggested a possible link between long-term use of amitriptyline and an increased risk of dementia, but this is not definitive.
That said, Crohn’s disease, a type of inflammatory bowel disease, can affect quality of life, and if amitriptyline is effectively controlling pain or symptoms, then this benefit must be weighed carefully against any potential risks.
There is no guarantee that stopping the medication would reverse memory problems, particularly if they are age-related. But if the drug is not providing a clear benefit, it may be reasonable to review its use.
This is not a medication that should be stopped suddenly. Doing so could trigger withdrawal symptoms, such as nausea, vomiting and headaches.
Patients who want to come off these tablets should talk to their GP, who may gradually reduce the dose or advise them to consider alternative treatments.
Did you beat hormone woes with diet changes?
Florence Pugh is a known sufferer of polycystic ovarian syndrome
Are you a woman who struggles with excess body hair? How about difficulty losing weight? Embarrassing acne?
After decades as an NHS GP, I’m all too familiar with these symptoms – often it’s polycystic ovarian syndrome, also known as PCOS. The condition, suffered by actress Florence Pugh, above, is caused by an imbalance of hormones. It can also trigger fertility problems and irregular periods, and affects as many as one in eight British women.
One of the most effective measures against it is the easy-to-follow low-glycemic diet, which involves avoiding sugar-rich foods such as white bread and biscuits.
It helps PCOS patients lose weight and also alleviates other symptoms. Are you a PCOS patient who benefited from a low-glycemic diet? Please write in and let me know.
