Dizziness and Nausea: When to Seek Neurological Help

Dizziness, nausea, and feeling weak while walking?

Hello Dr.
Jiang: Recently, I have been feeling dizzy and nauseous, and even a short walk makes me feel very lightheaded and weak all over.
I often stay up late and wake up late, so I usually have brunch, a habit I've had for 20 years without any issues.
However, in the past few months, I have been experiencing dizziness and nausea regardless of whether I eat.
My menstrual cycle is normal, so I am not pregnant.
Thank you, Dr.
Jiang!

Ivy, 40~49 year old female. Ask Date: 2016/06/17

Dr. Jiang Junyi reply Neurology

Hello, based on your description, there are many factors that can cause symptoms of dizziness, such as anemia, autonomic dysfunction, and inner ear imbalance.
Your symptoms are more severe when standing, so it is essential to rule out anemia or fluid deficiency that could lead to inadequate cerebral circulation.
You can improve your symptoms by replenishing fluids and electrolytes.
Additionally, consider the possibility of sympathetic nervous system dysfunction, which may not provide sufficient blood pressure to the brain.
I recommend discussing further evaluation and treatment with a neurologist.
Wishing you good health and peace.
Dr.
Tao, Shen Nei, cares about you.

Reply Date: 2016/06/17

More Info

Dizziness and nausea can be distressing symptoms that may indicate a variety of underlying health issues. Given your description of experiencing frequent dizziness, nausea, and a sense of weakness, it is essential to consider several factors that could be contributing to these symptoms.
Firstly, it is important to recognize that dizziness can stem from numerous causes, including vestibular disorders, neurological conditions, cardiovascular issues, or even metabolic disturbances. The fact that you have been experiencing these symptoms consistently over the past few months, despite a long history of stable health, warrants further investigation.

When to Seek Neurological Help
You should seek neurological help if you experience any of the following:
1. Persistent Symptoms: If your dizziness and nausea persist for more than a few days or worsen over time, it is crucial to consult a healthcare professional.

2. Neurological Signs: If you notice additional neurological symptoms such as weakness on one side of your body, difficulty speaking, vision changes, or coordination problems, these could indicate a more serious condition that requires immediate attention.

3. Severe Headaches: If your dizziness is accompanied by severe headaches, especially if they are sudden and intense, this could be a sign of a migraine or other serious conditions like a subarachnoid hemorrhage.

4. Changes in Consciousness: If you experience fainting, loss of consciousness, or confusion, you should seek emergency medical care.

5. Recent Trauma: If you have had a recent head injury and are experiencing dizziness, it is essential to get evaluated for potential concussions or other brain injuries.

Possible Causes of Your Symptoms
1. Vestibular Disorders: Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease can cause dizziness and nausea. These disorders affect the inner ear and balance.

2. Migraines: Migraines can present with dizziness and nausea, even without the classic headache. Vestibular migraines are particularly known for causing these symptoms.

3. Anxiety and Stress: Psychological factors can also manifest physically. Anxiety can lead to dizziness and a feeling of nausea, especially if you are under stress.

4. Metabolic Issues: Conditions such as dehydration, low blood sugar, or electrolyte imbalances can cause dizziness and nausea. Given your eating habits, it might be worth evaluating your nutritional intake.

5. Cardiovascular Issues: Dizziness can be a sign of low blood pressure or other cardiovascular problems. If you have a history of heart issues, this should be assessed.

Recommendations
- Keep a Symptom Diary: Document when your symptoms occur, their duration, and any associated factors (like food intake, sleep patterns, and stress levels). This information can be invaluable for your healthcare provider.

- Hydration and Nutrition: Ensure you are adequately hydrated and consuming a balanced diet. Skipping meals or having irregular eating patterns can lead to fluctuations in blood sugar levels, contributing to dizziness.

- Sleep Hygiene: Since you mentioned late sleeping habits, consider establishing a more regular sleep schedule. Poor sleep can exacerbate feelings of fatigue and dizziness.

- Consult a Healthcare Provider: Given the persistence of your symptoms, it is advisable to consult a healthcare provider. They may recommend tests such as blood work, imaging studies, or referrals to specialists like a neurologist or an ear, nose, and throat (ENT) doctor.

In conclusion, while dizziness and nausea can be benign, their persistence and your description of accompanying symptoms suggest that a thorough evaluation is warranted. Early intervention can lead to better management of any underlying conditions and improve your quality of life.

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