Dizziness and Imbalance: Possible Neurological Causes

Q: Dizziness and Imbalance: Possible Neurological Causes

Hello： If dizziness is related to head position, it may be necessary to consider benign paroxysmal positional vertigo (BPPV), which is usually caused by inner ear imbalance. <br>However, since you mentioned symptoms of visual and sensory tilt, it may be important to consider issu

Dizziness and a sense of imbalance?

Hello Doctor, I have been experiencing frequent headaches and dizziness lately.
However, the dizziness is not like the room spinning; it feels more like a sudden moment of disorientation, accompanied by a sensation of my heart skipping a beat.
A few days ago, I had severe pain on the left side of my neck that radiated to the left side of my face, ear, and head.
Additionally, I feel like my center of balance is leaning to the left (I can walk in a straight line and stand on one foot without issues, but things appear slightly tilted, and when sitting, I feel my body naturally leaning to the left).
As a result, turning my head to the left causes dizziness.
The headache symptoms have not been as pronounced in recent days, but I still feel tightness on the left side of my head.
Could you please tell me what these symptoms might indicate?

Miss Wang, 20~29 year old female. Ask Date: 2018/03/01

Dr. Jiang Junyi reply Neurology

Hello: If dizziness is related to head position, it may be necessary to consider benign paroxysmal positional vertigo (BPPV), which is usually caused by inner ear imbalance.
However, since you mentioned symptoms of visual and sensory tilt, it may be important to consider issues related to brainstem function.
I recommend that you consult a neurologist to discuss this further, undergo neurological examinations, and receive appropriate treatment.
Wishing you good health and peace.
Dr.
Tao, Shen Medical Center, cares about you.

Reply Date: 2018/03/01

More Info

Dizziness and imbalance can be quite distressing symptoms, and they can arise from a variety of neurological causes. Based on your description, it seems you are experiencing a combination of dizziness, headache, and neck pain, particularly on the left side. The sensation of feeling "off-balance" or as if your body is leaning to one side can be indicative of several underlying conditions.

One potential cause of your symptoms could be vestibular dysfunction. The vestibular system, located in the inner ear, is responsible for maintaining balance and spatial orientation. If there is an issue with this system, such as vestibular neuritis or benign paroxysmal positional vertigo (BPPV), it can lead to feelings of dizziness and imbalance. In your case, the sensation of your body leaning to the left and the need to turn your head carefully could suggest a vestibular issue.

Another possibility is that your symptoms are related to cervical spine issues. The pain radiating from your neck to your head and face could indicate cervical radiculopathy or muscle tension in the neck, which can affect balance and cause headaches. The cervical spine houses nerves that communicate with the brain and can influence balance. If there is irritation or compression of these nerves, it could lead to the symptoms you are experiencing.

Migraines can also present with dizziness and imbalance, often accompanied by neck pain and headache. This type of migraine is sometimes referred to as vestibular migraine, where the headache may not always be prominent, but the dizziness and balance issues are significant. The fact that your headache symptoms have lessened but you still feel tightness on the left side of your head could align with this possibility.

Additionally, it’s important to consider the cardiovascular aspect of your symptoms. The sensation of your heart "skipping a beat" could indicate arrhythmia or other cardiac issues, which can sometimes manifest as dizziness or lightheadedness. If your heart rhythm is irregular, it could affect blood flow to the brain, leading to feelings of dizziness.

Given the complexity of your symptoms, it is crucial to seek a thorough evaluation from a healthcare professional. A neurologist would be well-suited to assess your condition, as they can perform a detailed neurological examination and may recommend imaging studies such as an MRI or CT scan to rule out structural issues. They may also consider vestibular testing or refer you to a physical therapist specializing in vestibular rehabilitation.

In summary, your symptoms could be attributed to a range of neurological causes, including vestibular dysfunction, cervical spine issues, migraines, or even cardiovascular concerns. It is essential to pursue a comprehensive evaluation to determine the underlying cause and develop an appropriate treatment plan. In the meantime, keeping a symptom diary, noting when your symptoms occur and any potential triggers, can be helpful for your healthcare provider in making a diagnosis.

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