Persistent Dizziness: Causes and Solutions for Your Symptoms

Feeling dizzy and bloated every day?

Hello Dr.
Jiang: About two years ago, I experienced similar symptoms where I felt dizzy every day, especially when moving or turning my neck, and even while chewing food.
Although I felt dizzy, it wasn't severe enough to cause nausea or vomiting.
At that time, I underwent examinations related to inner ear balance at neurosurgery departments in Taipei and Kaohsiung.
The doctor prescribed medication, but it did not cure the issue.
Eventually, I got used to it and gradually stopped feeling particularly uncomfortable.
A week ago, I had a motorcycle accident while avoiding a pedestrian, and since then, my head has started feeling like it did before—dizzy, pressure in my head, and sometimes accompanied by headaches.
The symptoms are particularly noticeable when I change the position of my head, walk, shift my gaze, turn my neck, or eat.
Conversely, I don't feel as uncomfortable when sitting and watching TV, using the computer, or focusing my vision on a single point.
I also sleep well at night, and my daily routine is regular.
Could you please help me understand what might be causing these symptoms and what kind of issue this could be? Thank you!

Mr. Huang, 20~29 year old female. Ask Date: 2017/10/31

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, tilting back, lying down, getting up, rolling over, and sudden head turns, which may trigger vertigo.
This can be accompanied by symptoms such as nausea, palpitations, cold sweats, and feelings of weakness.
The causes are mostly unknown, but some are attributed to inflammation, degeneration, or head trauma that leads to the displacement of otoliths from the utricle into the semicircular canals.
When the head position changes, the movement of these otoliths within the semicircular canals alters the electrical potential of the inner ear, resulting in vertigo.
Patients with BPPV are more commonly female.
Treatment methods may include canalith repositioning maneuvers, which utilize changes in body and head position along with gravity to relocate the displaced otoliths back to the utricle in the inner ear.
Some medications can also help alleviate symptoms.
It is recommended that you consult an otolaryngologist to discuss examination and treatment options.
Wishing you good health and happiness.

Reply Date: 2017/10/31

More Info

Persistent dizziness can be a challenging symptom to manage, especially when it has been ongoing for an extended period. Based on your description, it seems like your dizziness is exacerbated by certain movements, such as turning your head or changing your position, and it is accompanied by a sensation of pressure or heaviness in your head. This could suggest a few potential underlying causes.

1. Vestibular Disorders: Given that you have previously undergone evaluations related to your inner ear and balance, it is possible that you are experiencing a vestibular disorder. Conditions such as Benign Paroxysmal Positional Vertigo (BPPV) can cause dizziness when you move your head in certain ways. BPPV occurs when tiny calcium crystals in the inner ear become dislodged and disrupt the normal balance signals sent to the brain.

2. Cervical Vertigo: Your symptoms may also be related to cervical vertigo, which can occur due to issues in the cervical spine (neck). If you had a fall or injury, it could have affected the neck structures, leading to dizziness when you move your head or neck. This type of dizziness is often associated with neck pain or stiffness.

3. Migraine-Associated Dizziness: Another possibility is vestibular migraine, where dizziness is a symptom of migraine without the typical headache. This can occur even if you do not experience nausea or vomiting. The dizziness can be triggered by specific movements or changes in posture.

4. Anxiety and Stress: Psychological factors can also contribute to dizziness. Anxiety can manifest physically, leading to symptoms such as dizziness, especially in stressful situations or after an accident.

5. Neurological Issues: Although you have been evaluated by neurologists, it is essential to consider that persistent dizziness can sometimes be a sign of underlying neurological conditions. If your symptoms have worsened after your recent fall, it may be worth revisiting a neurologist for further evaluation, including imaging studies like an MRI, to rule out any structural issues.

Recommendations:
- Follow-Up with a Specialist: Since your symptoms have returned and worsened after your fall, it would be prudent to follow up with an ear, nose, and throat (ENT) specialist or a neurologist. They can perform a thorough examination and possibly recommend vestibular rehabilitation therapy if a vestibular disorder is diagnosed.

- Physical Therapy: If BPPV or cervical vertigo is suspected, a physical therapist specializing in vestibular rehabilitation can help. They can guide you through specific maneuvers to reposition the crystals in your inner ear or exercises to improve neck mobility and strength.

- Lifestyle Modifications: Maintaining a regular sleep schedule, staying hydrated, and managing stress through relaxation techniques can help alleviate symptoms. Avoiding sudden head movements and being cautious while moving can also reduce the risk of exacerbating your dizziness.

- Medication: If your dizziness is related to migraines or anxiety, medications may be prescribed to help manage these conditions. Discuss with your healthcare provider about potential options.

In conclusion, persistent dizziness can stem from various causes, and it is essential to identify the underlying issue to provide appropriate treatment. Given your history and recent exacerbation of symptoms, a comprehensive evaluation by a specialist is recommended to ensure you receive the best care possible.

Similar Q&A

Understanding Persistent Dizziness: Possible Causes and Solutions

Hello: I have been experiencing persistent dizziness for over a year. I have undergone various tests, including CT scans and brain ultrasounds, all of which returned normal results. The dizziness, which starts in the afternoon and radiates from the back of my neck to the back of ...

Dr. Lai Lunxiang reply Neurology
Hello, I believe you may be experiencing 1. neurosis and 2. polycythemia. Therefore, please visit the outpatient clinic for a consultation. Thank you!

Understanding Persistent Dizziness: When to Seek Treatment and Management Tips

Hello, doctor. I have been experiencing dizziness, but it is not severe and does not affect my daily life. The symptoms usually occur suddenly, making me feel like I'm swaying, and they are particularly noticeable in crowded places. I have previously undergone tests and ther...

Dr. Jiang Junyi reply Neurology
Hello Ms. Chen, You mentioned that you "suddenly feel a sense of swaying, often thinking it's an earthquake, or that the symptoms become particularly pronounced in crowded situations." There are many causes of dizziness. If your dizziness is related to your menstr...

Understanding Persistent Dizziness: Causes and Solutions for Your Symptoms

I have been experiencing dizziness for the past two weeks. I have seen a doctor and undergone a hearing test, which showed no issues, but the symptoms still persist. It feels like being on a boat, with a sensation of swaying, especially when my body is in motion (for example, typ...

Dr. Lin Zijing reply Neurology
The sensation of dizziness can feel like the world is spinning or similar to the feeling of an earthquake or being on a boat. This is caused by a dysfunction of the vestibular system in the inner ear. There are many causes of vestibular dysfunction, and people generally fear seve...

Understanding Persistent Dizziness: Causes and Management Options

Hello Doctor: I have been experiencing dizziness for almost three years, and I have been taking medication to manage it. The dizziness initially presented as a gradual onset of vertigo, after which I sought medical attention and started medication. My condition has been fluctuati...

Dr. Ye Boshou reply Neurology
1. There are many causes of dizziness. In a 23-year-old individual with normal EEG results, tinnitus may occur. Is there any hearing impairment? If so, it could be related to inner ear balance issues. 2. Additionally, autonomic nervous system dysfunction and anxiety can also occa...