Unexplained Dizziness: Possible Causes and Solutions

Unexplained dizziness?

I would like to ask the doctor, I have been experiencing dizziness for over two years.
The symptoms include pain in my left side, a heavy feeling in the back of my head, dizziness that feels like I'm moving up and down in an elevator, occasional throbbing pain in my head, and sometimes a tingling or cool sensation in the back of my head, which can also feel warm at times.
I occasionally experience chest tightness, a sensation of something stuck in my throat, and my left hand and foot sometimes feel swollen and numb (similar to when I have a cold).
My eyes can feel swollen and hot at times, my lower back sometimes aches, and my shoulders and neck can also feel sore.
My urine is yellow, and my bowel movements are often irregular.
Sometimes I experience night sweats and insomnia due to heat in the back of my head.
The main issue is the dizziness, and I wonder why it tends to worsen around noon.
I have undergone many tests, but nothing significant has been found.
Could this be a symptom of autonomic nervous system dysfunction? Thank you.

Alvin, 40~49 year old female. Ask Date: 2018/04/23

Dr. Qiu Junda reply Psychiatry

Hello.
The letter describes not only dizziness symptoms but also issues in multiple areas of the body.
If many physical examinations have been conducted without finding significant problems, it is indeed necessary to consider whether it is caused by autonomic nervous system dysfunction.
It is recommended to seek treatment at a psychosomatic medicine clinic to facilitate early improvement of the condition.

Reply Date: 2018/04/23

More Info

Understanding unexplained dizziness can be quite complex, especially when accompanied by a variety of other symptoms. Based on your description, it seems you have been experiencing dizziness for over two years, along with left flank pain, a sensation of heaviness in the back of your head, and various other symptoms such as headaches, tingling, and changes in bowel habits. Given the multifaceted nature of your symptoms, it is essential to consider several potential causes and solutions.

Possible Causes of Your Symptoms
1. Vestibular Disorders: Dizziness can often be linked to issues within the inner ear, which is responsible for balance. Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease could contribute to your symptoms.

2. Neurological Issues: The combination of dizziness, headaches, and tingling sensations in your limbs may suggest a neurological condition. Migraines, particularly vestibular migraines, can cause dizziness and are often accompanied by other symptoms like nausea and sensitivity to light. Other neurological disorders, such as multiple sclerosis, could also present with similar symptoms.

3. Autonomic Nervous System Dysfunction: Your mention of dizziness worsening around midday and the presence of symptoms like palpitations, chest tightness, and gastrointestinal issues could indicate dysautonomia, a condition where the autonomic nervous system does not function properly. This can lead to symptoms like dizziness, lightheadedness, and changes in heart rate and blood pressure.

4. Anxiety and Stress: Psychological factors can also play a significant role in physical symptoms. Anxiety and stress can manifest as dizziness, tension headaches, and gastrointestinal disturbances. If you are experiencing significant stress or anxiety, it may be worthwhile to explore this aspect with a mental health professional.

5. Metabolic or Endocrine Issues: Conditions such as thyroid dysfunction or adrenal insufficiency can lead to a variety of symptoms, including fatigue, dizziness, and changes in mood. Blood tests to evaluate your thyroid function and adrenal hormones may be beneficial.

6. Nutritional Deficiencies: Deficiencies in vitamins such as B12, D, or minerals like magnesium can lead to neurological symptoms, including dizziness and tingling. A comprehensive nutritional assessment might help identify any deficiencies.

Suggested Solutions
1. Comprehensive Evaluation: Since you have undergone various tests without significant findings, it may be beneficial to seek a second opinion or consult a specialist in neurology or vestibular disorders. They may recommend additional tests, such as MRI or vestibular function tests, to further investigate your symptoms.

2. Physical Therapy: If a vestibular disorder is suspected, vestibular rehabilitation therapy (VRT) can help improve balance and reduce dizziness. A physical therapist specialized in vestibular rehabilitation can provide exercises tailored to your needs.

3. Lifestyle Modifications: Maintaining a healthy lifestyle can help manage symptoms. This includes regular exercise, a balanced diet, adequate hydration, and proper sleep hygiene. Reducing caffeine and alcohol intake may also be beneficial.

4. Stress Management Techniques: Incorporating stress reduction techniques such as mindfulness, yoga, or cognitive-behavioral therapy (CBT) can help manage anxiety and its physical manifestations.

5. Medication: Depending on the underlying cause, medications may be prescribed to help manage symptoms. For instance, if migraines are suspected, prophylactic medications may be beneficial. If anxiety is a significant factor, discussing options with a psychiatrist or primary care physician may be warranted.

6. Follow-Up: Regular follow-up with your healthcare provider is crucial to monitor your symptoms and adjust your management plan as needed.

In conclusion, while your symptoms are complex and multifactorial, a thorough evaluation and a multidisciplinary approach can help identify the underlying causes and lead to effective management strategies. It is essential to communicate openly with your healthcare providers about your symptoms and any changes you experience.

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