Unexplained Dizziness: When Medication Doesn't Help

Q: Unexplained Dizziness: When Medication Doesn't Help

Hello： Your symptoms should first be considered as Benign Paroxysmal Positional Vertigo (BPPV). <br>The characteristic symptoms include brief episodes of dizziness that are related to changes in head position, such as bending over, tilting back, lying down, getting up, rolling ov

Sudden unexplained dizziness that persists even after taking medication?

Hello Doctor: Last night around 7 PM, after finishing dinner, I suddenly felt dizzy.
I thought it would pass, but it actually got worse, and by around 9 PM, I vomited.
When I looked at things, it felt like the whole room was spinning.
This morning, I still didn't feel any better.
I went to see a doctor, and after taking some medication, I wasn't as dizzy as before, but I still felt lightheaded.
I can't walk straight; if I try to stand upright, my head feels very dizzy, so I can only walk bent over to feel less dizzy.
I also feel dizzy when lying down.
My mom suggested that it might be related to eating toast that had been in the fridge for over ten days, but I think that's unrelated.
In early February, I was in a car accident, and I only felt dizzy for a moment, but it quickly got better, so I didn't go to the hospital for a check-up since I didn't feel very uncomfortable.
In early February, while taking the train, I also experienced dizziness and cold sweats, but I think that was due to not eating and my menstrual period.
Around the end of February, I accidentally got hit on the head several times by a heavy object, and I felt dizzy for just a moment.
I'm wondering if this is a residual effect from the car accident because previously, after taking medication, I didn't feel much dizziness, but this time, even after taking medication, I'm still very dizzy.
I usually go to bed around 1 or 2 AM and don't exercise much.
Could this be related to my lifestyle? Sorry for the lengthy message.

emma, 20~29 year old female. Ask Date: 2017/04/01

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms should first be considered as Benign Paroxysmal Positional Vertigo (BPPV).
The characteristic symptoms include brief episodes of dizziness that are related to changes in head position, such as bending over, tilting back, lying down, getting up, rolling over, or suddenly turning the head.
These episodes may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and a feeling of weakness.
The causes are mostly unknown, but some may be due to inflammation, degeneration, or displacement of otoliths in the utricle of the inner ear following head trauma, which then enter the semicircular canals.
When the head position changes, the movement of the otoliths within the semicircular canals causes alterations in the neural potentials of the inner ear, resulting in vertigo.
Patients with BPPV are more commonly female.
It is recommended that you consult an otolaryngologist or a neurologist to discuss examination and treatment options.
Wishing you good health and peace.
Dr.
Tao, Neurology, is concerned about you.

Reply Date: 2017/04/01

More Info

Unexplained dizziness can be a perplexing and distressing symptom, especially when it doesn't respond to medication. Based on your description, it seems that you have experienced several episodes of dizziness, some of which were triggered by specific events such as a car accident and a head injury. Additionally, your recent experience of severe dizziness and vomiting after dinner raises concerns that warrant further investigation.

Firstly, it's important to understand that dizziness can have various underlying causes, including vestibular disorders, neurological issues, dehydration, anxiety, and even medication side effects. Given your history of head trauma, it's crucial to consider the possibility of post-concussion syndrome, which can manifest as persistent dizziness, headaches, and cognitive difficulties following a head injury. The fact that you experienced dizziness after a car accident and again after being struck on the head suggests that these incidents could be contributing factors.

Moreover, your mention of feeling dizzy when standing upright and the need to bend over to alleviate the sensation could indicate a vestibular issue, such as benign paroxysmal positional vertigo (BPPV) or other inner ear disorders. These conditions can cause episodes of dizziness that may be triggered by changes in head position.
Your lifestyle factors, such as irregular sleep patterns and lack of physical activity, can also contribute to feelings of dizziness. Poor sleep can lead to fatigue and exacerbate feelings of dizziness, while a sedentary lifestyle can affect your overall health and well-being. It’s essential to maintain a regular sleep schedule and incorporate physical activity into your routine, as this can improve circulation and overall health.

Regarding the potential link between your symptoms and the food you consumed, while food poisoning or gastrointestinal issues can cause nausea and dizziness, it seems less likely that stale bread would cause such severe symptoms. However, if you suspect that something you ate might be the cause, it would be wise to monitor your symptoms and consult a healthcare professional if they persist.

Since your dizziness has not improved significantly with medication, it may be time to revisit your healthcare provider for a comprehensive evaluation. This evaluation should include a detailed medical history, a physical examination, and possibly imaging studies (like a CT scan or MRI) to rule out any serious underlying conditions. Additionally, a referral to a neurologist or an ear, nose, and throat (ENT) specialist may be beneficial for further assessment of your dizziness.

In summary, unexplained dizziness can stem from various causes, and when medications do not provide relief, it is essential to seek further evaluation. Given your history of head trauma, lifestyle factors, and the nature of your symptoms, a thorough assessment by a healthcare professional is warranted. They can help identify the underlying cause of your dizziness and develop an appropriate treatment plan tailored to your needs. In the meantime, focus on maintaining a healthy lifestyle, including regular sleep patterns and physical activity, to support your overall health.

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