Dizziness: Neurological Concerns and Solutions

Dizziness. Brain issues?

Hello.
This has been going on for three years.
Whenever I make even a slight movement, I feel lightheaded (it takes about 5 to 10 seconds to feel better).
I have the urge to stretch my heels and stick out my tongue.
I'm not sure if this is how I originally was or if I'm just trying to hold on (as long as I stay still for a while, when I move again, it happens).
It was manageable at first, but recently it has become more frequent.
I have had an electrocardiogram and EEG done, both of which were normal.
I don't know what to do; I really need your help.

fu09, 10~19 year old female. Ask Date: 2017/08/09

Dr. Jiang Junyi reply Neurology

Hello, based on your description, benign paroxysmal positional vertigo (BPPV) should be considered first.
The characteristic symptoms include brief episodes of dizziness related to changes in head position, such as bending over, leaning back, lying down, getting up, turning over, and sudden head movements, which may trigger vertigo.
This may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and feelings of weakness.
The exact cause is often unknown, but some causes include inflammation, degeneration, or dislodgment of otoliths in the utricle of the inner ear due to 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.
It is advisable to consult an otolaryngologist to discuss examination and treatment options.
Wishing you good health and peace.

Reply Date: 2017/08/09

More Info

Dizziness can be a perplexing and distressing symptom, particularly when it persists over an extended period, as you have described. Your experience of feeling "floaty" or dizzy with even minimal movement, and the need to pause for several seconds before resuming activity, suggests that there may be underlying neurological or vestibular issues at play. Given that you have already undergone tests such as an electrocardiogram (ECG) and an electroencephalogram (EEG) that returned normal results, it is essential to consider other potential causes and avenues for further investigation.

Firstly, dizziness can stem from various sources, including vestibular disorders, neurological conditions, or even psychological factors. The vestibular system, which is responsible for maintaining balance and spatial orientation, can be affected by inner ear problems, such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease. These conditions can lead to sensations of spinning, imbalance, or lightheadedness, particularly with changes in head position or movement.

Neurological conditions, such as migraines, multiple sclerosis, or even transient ischemic attacks (TIAs), can also manifest as dizziness. While your EEG results are normal, it may be beneficial to consult with a neurologist for a comprehensive evaluation, including a detailed history and possibly advanced imaging studies like an MRI of the brain. This can help rule out any structural abnormalities or lesions that might be contributing to your symptoms.

Another aspect to consider is the role of anxiety and stress in exacerbating dizziness. Psychological factors can lead to heightened awareness of bodily sensations, which may amplify feelings of dizziness or lightheadedness. If you find that your symptoms worsen in stressful situations or are accompanied by feelings of anxiety, it may be worthwhile to explore cognitive-behavioral therapy (CBT) or other forms of psychological support.

In terms of management, there are several strategies you can employ to help alleviate your dizziness. Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy that focuses on exercises to improve balance and reduce dizziness. A physical therapist trained in vestibular rehabilitation can design a personalized program to help you regain stability and confidence in your movements.

Additionally, lifestyle modifications can play a significant role in managing dizziness. Staying hydrated, avoiding sudden movements, and ensuring you have a stable base of support when moving can help mitigate symptoms. If you notice that certain activities or environments trigger your dizziness, it may be beneficial to modify your routine to avoid these triggers.

Lastly, maintaining open communication with your healthcare provider is crucial. If your symptoms continue to worsen or if new symptoms arise, it is essential to seek further evaluation. Keeping a symptom diary can also be helpful in identifying patterns or triggers associated with your dizziness, which can provide valuable information for your healthcare team.

In conclusion, while dizziness can be a challenging symptom to navigate, a thorough evaluation by a healthcare professional, along with appropriate management strategies, can significantly improve your quality of life. Don't hesitate to reach out for further assistance and support as you work towards understanding and managing your symptoms.

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