Dizziness and Leg Discomfort: A Neurological Perspective

Q: Dizziness and Leg Discomfort: A Neurological Perspective

Hello： The vascular stenosis you mentioned, if identified through a neck ultrasound, refers to the extracranial vessels, with the vertebral artery typically being more associated with dizziness. <br>Controllable risk factors for stroke include metabolic syndrome, and your overwei

Increased dizziness, swelling in the left leg, and occasional numbness in both hands, with the left hand being more affected?

Hello, doctor.
Basically, I'm experiencing dizziness and issues with my left leg (the hot weather affects me significantly; my dizziness worsens and my left leg feels more uncomfortable, particularly in January and early October this year.
In Australia, spring is in September, October, and November, while summer is in December, January, and February).
The dizziness occurs when I wake up in the morning, but it's manageable, so I exercise in the morning.
However, after 11 AM, it worsens, though I don't faint.
Sometimes, I feel a heaviness and warmth in the back of my head, and I sway while walking, but I don't experience dizziness while driving.
The symptoms lessen during exercise, and by 7 or 8 PM after showering, the dizziness decreases.
My left leg also feels swollen; after sitting for a long time, my buttocks and the inner thigh swell.
Sometimes, I feel uncomfortable at night while sleeping, but lying on my stomach and walking feels fine.
I don't have sciatica (I have had a CT scan), and the doctor said it's due to muscle tension.
I suspect it might be piriformis syndrome.
The issues with my left leg started after a major episode last year, initially accompanied by a slight tremor in my head.
However, the Western medicine practitioners said I need to lose weight (they prescribed diabetes medication claiming it could help with weight loss, although I don't have diabetes).
Later, they mentioned my blood pressure was slightly high (155/101) and advised me to take antihypertensive medication.
I took the diabetes medication for 14 days and the blood pressure medication for 3 days, during which I experienced numbness in my head and limbs.
When I went to the emergency room, the doctor said it was a side effect of the medication, and subsequently, the doctor discontinued the medications.
After stopping, I had two days of severe insomnia, followed by a host of symptoms.
I underwent numerous tests, which indicated mild narrowing of the blood vessels in my right brain, but a neurologist conducted further tests (intracranial blood flow) and said everything was fine, suggesting it has been like this since birth and wouldn't affect my dizziness.
I have lost 28 kg (I am 182 cm tall, previously weighing 118 kg, now 90 kg), and my blood pressure is normal.
I have severe obstructive sleep apnea (I now use a CPAP machine for sleep; I hadn't treated it for seven years and only started using it last year).
May I ask if the narrowing of the blood vessels in my right brain truly has no impact on my dizziness? The doctor mentioned that I am too anxious and that after numerous tests, only the sleep apnea and anxiety are related to my dizziness (according to the doctor).
I have also undergone autonomic nervous system testing (which was normal).
Doctor, am I at risk of having a stroke or any other strange conditions?

Alvin, 40~49 year old female. Ask Date: 2017/12/09

Dr. Jiang Junyi reply Neurology

Hello: The vascular stenosis you mentioned, if identified through a neck ultrasound, refers to the extracranial vessels, with the vertebral artery typically being more associated with dizziness.
Controllable risk factors for stroke include metabolic syndrome, and your overweight status is one of them; however, if your waist circumference is normal (indicating low visceral fat) and you have a high muscle mass, this could actually be a protective factor.
Additionally, do you have issues such as postprandial hyperglycemia or elevated low-density lipoprotein cholesterol? Regarding the numbness in your hands, is there any peripheral nerve compression? If you are concerned about a possible past stroke, an out-of-pocket MRI of the brain can provide clarity, as brain cells do not regenerate, and strokes or brain injuries will leave traces.
It is advisable to consult a neurologist for examination and discussion.
Wishing you good health, peace, and joy.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2017/12/09

More Info

Understanding dizziness and leg discomfort can be quite complex, especially when multiple factors are at play. Based on your description, it seems that you are experiencing a combination of symptoms that may be related to several underlying issues, including anxiety, potential musculoskeletal problems, and possibly vascular concerns.

Firstly, dizziness can arise from various causes, including inner ear issues, neurological conditions, cardiovascular problems, or even anxiety. In your case, you mentioned that the dizziness worsens in the heat and improves with exercise, which suggests that it might be related to blood flow or blood pressure regulation. The fact that you do not experience dizziness while driving but do when walking could indicate that your symptoms are influenced by posture or movement patterns.

The sensation of heaviness and discomfort in your left leg, particularly after prolonged sitting, could be attributed to muscle tightness or vascular issues. You mentioned that a doctor suggested muscle tightness and even speculated about piriformis syndrome, which can occur when the piriformis muscle irritates the sciatic nerve. However, since you have already undergone imaging studies that ruled out significant nerve compression, it may be worthwhile to explore physical therapy or stretching exercises to alleviate muscle tension.

Regarding your concerns about right brain vascular narrowing, it is essential to understand that mild narrowing of blood vessels can be common and may not necessarily lead to symptoms or complications. Your neurologist's reassurance that this is not affecting your dizziness is significant, especially since they conducted thorough evaluations, including intracranial blood flow assessments. However, it is always prudent to monitor any changes in symptoms and communicate them to your healthcare provider.

Your weight loss of 28 kilograms is commendable and can have a positive impact on your overall health, including blood pressure and potentially reducing the severity of sleep apnea. The fact that you are now using a CPAP machine for sleep apnea is crucial, as untreated sleep apnea can contribute to daytime fatigue, dizziness, and cardiovascular issues.

Anxiety can also play a significant role in your symptoms. It can manifest physically, leading to sensations of dizziness, heaviness, and discomfort. If your healthcare provider has indicated that anxiety is a contributing factor, it may be beneficial to explore stress management techniques, cognitive-behavioral therapy, or other therapeutic options to address these feelings.

In summary, while your symptoms may seem alarming, the combination of factors such as anxiety, muscle tightness, and mild vascular changes can contribute to your experiences of dizziness and leg discomfort. It is essential to maintain open communication with your healthcare providers, continue monitoring your symptoms, and consider lifestyle modifications that can improve your overall well-being. If you ever feel that your symptoms are worsening or if new symptoms arise, do not hesitate to seek medical attention promptly.

Similar Q&A

Dizziness, Blurred Vision, and Leg Pain: Neurological Concerns Explained

Hello Dr. Jiang, I have recently been experiencing symptoms as described in the subject. I am hesitant to go to the hospital for an examination because I fear that nothing will be wrong, so I am here to inquire. Note: I have previously had a concussion.

Dr. Jiang Junyi reply Neurology
Based on your description: You mentioned symptoms of dizziness and leg cramps, which are likely indicative of two potential issues. If the dizziness occurs primarily when standing, it may be due to reduced cerebral blood flow when standing, as the heart may not be able to immedia...

Understanding Neurological Symptoms: From Limb Weakness to Dizziness

Hello, doctor. I will first describe my medical history. At the end of May, I experienced a severe impact on the left side of my left knee, so on May 26, I visited the rehabilitation department of a hospital in Kaohsiung. The doctor diagnosed me with left leg iliotibial band synd...

Dr. Jiang Junyi reply Neurology
Dear Mr. Xiao Wu, You mentioned "1. axonal motor neuropathy in the left peroneal nerve; 2. demyelinating motor neuropathy in the left tibial nerve." These results indicate that there is neuropathy affecting the motor nerves in your left lower limb. However, they do not...

Understanding Headaches and Dizziness: Causes and Solutions for Young Adults

Hello, Dr. Yeh! I am 23 years old and often experience headaches and dizziness, with headaches being the most frequent. The location of the headaches varies each time. I usually feel dizzy after waking up and when I stand up after squatting, experiencing a sensation of spinning o...

Dr. Ye Boshou reply Neurology
Ms. Chen, there are many causes of headaches, and it is essential to understand the characteristics, location, and timing of the headache, along with a physical examination, to make a diagnosis. However, your dizziness and temporary vision impairment upon standing after squatting...

Understanding Neurological Symptoms: Dizziness, Numbness, and Nausea

Recently, I've been experiencing tingling on the top of my head, dizziness, nausea, tingling in my feet and calves, blurred vision, and a feeling of wanting to sleep after eating. What could be the issue?

Dr. Gao Chunde reply Neurology
The symptoms are not specific enough to pinpoint certain neurological disorders. It may be related to poor peripheral circulation, high stress, or lack of sleep. Other possibilities may require the physician to conduct a thorough evaluation, including taking a detailed medical hi...