Sudden Dizziness and Nausea: Possible Causes and Concerns

I have been experiencing sudden dizziness lately?

I have been experiencing sudden dizziness and nausea recently, occurring four times with the same symptoms.
My eyes suddenly feel uncomfortable, and there is a sensation of whiteness in both eyes as if there is light, followed by significant pain in the eye sockets (on both sides).
After that, I feel very dizzy and have a persistent urge to vomit.
Initially, the dizziness would subside, but in the later episodes, I kept vomiting.
However, I feel much better after waking up from sleep.
I have essential thrombocythemia with a platelet count over 15 million, and my liver function is not very good (the doctor suspects it may be an autoimmune issue, but it hasn't been confirmed yet).
Could this be related to my platelet count?

Qiao, 20~29 year old female. Ask Date: 2017/03/11

Dr. Wu Fangcan reply Family Medicine

What you described seems more like an episode of migraine; however, primary thrombocythemia causing blood thickening or vascular obstruction cannot be ruled out.
Please consult a neurologist for further evaluation and differential diagnosis.

Reply Date: 2017/03/11

More Info

Sudden dizziness and nausea can be alarming symptoms, especially when they occur repeatedly. Based on your description, it sounds like you have experienced these symptoms multiple times, accompanied by visual disturbances and significant discomfort. Given your medical history of primary thrombocythemia (essential thrombocythemia) and concerns regarding your liver function, it is essential to consider several potential causes and seek appropriate medical evaluation.

Possible Causes of Your Symptoms
1. Vestibular Disorders: Conditions affecting the inner ear, such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease, can lead to sudden dizziness and nausea. These conditions often present with episodes of vertigo, which may be triggered by changes in head position or may occur spontaneously.

2. Migraines: Migraines can sometimes present with dizziness and nausea, even without the typical headache. This is known as vestibular migraine. The visual disturbances you described could also be related to migraine aura.

3. Cardiovascular Issues: Orthostatic hypotension (a drop in blood pressure when standing up) or other cardiovascular problems can cause dizziness and nausea. Given your history of elevated platelet counts, there may be concerns about blood viscosity and circulation.

4. Neurological Conditions: Although less common, neurological issues such as transient ischemic attacks (TIAs) or other cerebrovascular events could present with sudden dizziness and visual changes. Given your symptoms, it would be prudent to rule out any serious neurological conditions.

5. Autoimmune Conditions: Since your doctor suspects an autoimmune issue, it is worth considering that autoimmune disorders can affect various systems in the body, including the nervous system, leading to symptoms like dizziness and nausea.

6. Liver Dysfunction: Impaired liver function can lead to a buildup of toxins in the bloodstream, which can cause neurological symptoms, including dizziness and nausea. It is essential to monitor liver function closely, especially if there are underlying autoimmune concerns.

Recommendations for Further Evaluation
1. Consult a Specialist: Given the complexity of your symptoms and medical history, it would be advisable to consult a neurologist or an ear, nose, and throat (ENT) specialist. They can conduct a thorough evaluation, including a physical examination and possibly imaging studies (like an MRI) to rule out any serious conditions.

2. Blood Tests: Regular monitoring of your blood counts, liver function tests, and any autoimmune markers is crucial. This can help identify any changes that may correlate with your symptoms.

3. Vestibular Testing: If vestibular disorders are suspected, specific tests can help assess your balance and inner ear function.

4. Lifestyle Modifications: Keeping a symptom diary may help identify triggers for your dizziness and nausea. Additionally, staying hydrated, avoiding sudden movements, and managing stress can be beneficial.

5. Emergency Care: If you experience severe dizziness, loss of consciousness, or any other alarming symptoms, seek immediate medical attention.

Conclusion
In summary, your symptoms of sudden dizziness and nausea, combined with your medical history, warrant a comprehensive evaluation by healthcare professionals. It is essential to address these symptoms promptly to determine their underlying cause and to develop an appropriate treatment plan. Your health and well-being are paramount, and understanding the potential connections between your symptoms and your existing medical conditions is crucial for effective management.

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