Dizziness and Fainting: Low Blood Pressure and Seizure-Like Symptoms

Dizziness, blackouts, and suspected seizure symptoms, along with a feeling of low blood pressure?

Hello, doctor.
I often experience dizziness and blurred vision when I get up from lying in bed.
I feel faint and struggle to walk a few steps before losing consciousness.
I can distinctly feel myself grabbing onto something, and then my whole body trembles, resembling a seizure.
I find myself sitting on the floor, and when I regain consciousness, I'm a distance away from where I initially fell.
Throughout the episode, I can hear sounds around me.

There was another instance when I sat for a long time, and upon walking home, I developed a headache.
After lying down for a moment, when I got up, my vision went black again, and if I didn't stop moving immediately, I felt I would faint.
Recently, I've been experiencing frequent weakness, dizziness, and headaches.
Sometimes I feel a sensation of heat throughout my body, and as soon as I get up, I feel dizzy and nauseous.
I researched and found that mild symptoms could indicate orthostatic hypotension.
I went to the hospital for an examination, and there were no arrhythmias detected, and my eye exam showed no issues.
I would appreciate your diagnosis, as I occasionally experience similar situations aside from those two instances.

Sandy, 10~19 year old female. Ask Date: 2016/08/18

Dr. Zhang Hongwei reply Family Medicine

Hello, if the fainting episodes occur after a change in posture, it may be caused by orthostatic hypotension.
It is recommended to measure blood pressure changes within three minutes of sitting and standing.
If there is a change in systolic blood pressure greater than 20 mmHg and diastolic blood pressure greater than 10 mmHg, it may indicate orthostatic hypotension.
If these criteria are not met, other diseases should be considered.
Generally, in young individuals, the most common type of fainting is vasovagal syncope, which has specific triggers such as prolonged standing or seeing blood.
This type of fainting usually does not show specific abnormalities on tests.
However, if the episodes persist, it is best to visit a hospital for further evaluations such as blood tests, echocardiograms, or EEGs to rule out other conditions.
Thank you for your inquiry.

Reply Date: 2016/08/18

More Info

Dizziness and fainting can be alarming symptoms, and your description suggests that you may be experiencing episodes related to orthostatic hypotension, which is a form of low blood pressure that occurs when standing up from a sitting or lying position. This condition can lead to dizziness, lightheadedness, and even fainting, as you have described.
When you stand up, gravity causes blood to pool in your legs, which can reduce the amount of blood returning to your heart and subsequently decrease the blood flow to your brain. This can result in the symptoms you are experiencing, such as feeling faint, having blurred vision, and even losing consciousness. The shaking and trembling you described could be a response to the sudden drop in blood pressure, or it may be a reaction to the stress of the situation.

Your episodes of dizziness upon standing, along with the sensation of your vision going black, are classic signs of orthostatic hypotension. This condition can be exacerbated by dehydration, prolonged bed rest, certain medications, or underlying health issues such as anemia or heart problems. It’s also worth noting that if you have a history of low blood pressure, this could be a contributing factor.

The fact that you mentioned hearing sounds during your episodes and being aware of your surroundings suggests that you may not be experiencing true seizures, but rather a loss of consciousness due to low blood flow to the brain. Seizures typically involve a loss of awareness and control over bodily movements, and the postictal state (the period following a seizure) usually includes confusion and disorientation, which does not seem to align with your experiences.

Given your symptoms, it is crucial to monitor your blood pressure regularly, especially when changing positions. You might want to consider the following strategies to manage your symptoms:
1. Hydration: Ensure you are drinking enough fluids throughout the day. Dehydration can worsen low blood pressure.

2. Gradual Position Changes: When getting up from lying down or sitting, do so slowly. This allows your body time to adjust to the change in position and can help prevent sudden drops in blood pressure.

3. Compression Stockings: Wearing compression stockings can help improve blood circulation and reduce pooling of blood in the legs.

4. Dietary Adjustments: Increasing your salt intake (with your doctor’s approval) can help raise blood pressure. Eating smaller, more frequent meals can also prevent blood pressure drops that can occur after larger meals.

5. Medication Review: If you are on any medications, consult with your healthcare provider to see if they could be contributing to your symptoms.

6. Physical Activity: Engaging in regular physical activity can improve cardiovascular health and help your body adapt better to changes in posture.

7. Follow-Up with Specialists: Since you have already ruled out arrhythmias and eye issues, consider following up with a cardiologist or a neurologist for further evaluation. They may recommend additional tests, such as tilt table testing, to assess your blood pressure response to changes in position.

In conclusion, while your symptoms may be indicative of orthostatic hypotension, it is essential to work closely with your healthcare provider to determine the underlying cause and develop an appropriate management plan. Keeping a detailed log of your symptoms, including when they occur and any associated activities, can also be helpful for your healthcare team in diagnosing and treating your condition effectively.

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