Dizziness Symptoms: When to See a Neurologist

Q: Dizziness Symptoms: When to See a Neurologist

Hello： Based on your description, you may be experiencing vestibular migraine. <br>I recommend that you consult a neurologist who specializes in headaches for evaluation and treatment. <br>Additionally, it is advisable to maintain a regular schedule and limit the use of electroni

Dizziness symptoms

Hello, I would like to ask which specialty I should consult regarding the following symptoms.
Since March 9th until now, March 25th, every morning when I get up (from lying down to sitting), I experience dizziness in a clockwise direction, accompanied by a feeling of pressure in the back of my head.
When I fall back onto the bed, I feel like I'm falling down again, and I also have a sensation of nausea.
At this time, whether I slowly turn to my left side or my right side, I still feel dizzy.
Throughout the day, I almost experience left-sided headaches, feel nauseous when drinking water, and have a sensation of unsteadiness in my legs.
In the afternoon, when I return home, I feel relaxed, but if I lie down to rest, the dizziness symptoms return, and later I also experience tingling in my lips.
Additionally, I have recently noticed that I feel slightly short of breath even while walking.
On March 23rd, I consulted some doctors, and they speculated that it might be related to low blood pressure.
Since that day, I have been monitoring my blood pressure changes; my normal blood pressure is about (96-110 mmHg / 65-75 mmHg), and when I feel uncomfortable, my blood pressure is approximately (91 mmHg / 54 mmHg).
Before March 9th, I had been experiencing stiffness in my shoulders, swelling of the lymph nodes behind my right ear, and headaches.

Tang, 20~29 year old female. Ask Date: 2020/03/25

Dr. Hong Weibin reply Neurology

Hello: Based on your description, you may be experiencing vestibular migraine.
I recommend that you consult a neurologist who specializes in headaches for evaluation and treatment.
Additionally, it is advisable to maintain a regular schedule and limit the use of electronic devices, as this may help reduce the frequency of episodes.
Wishing you a speedy recovery.
Hong Wei-bin

Reply Date: 2020/03/25

More Info

Based on the symptoms you've described, it is advisable to consult a neurologist. The symptoms of dizziness, particularly when transitioning from lying down to sitting up, along with feelings of nausea, headaches, and a sensation of pressure in the back of your head, could indicate several neurological conditions that require further evaluation.

Dizziness can arise from various causes, including vestibular disorders, migraines, or even issues related to blood pressure. In your case, the fact that you experience dizziness upon changing positions and that it is accompanied by headaches and nausea suggests that it could be related to a vestibular issue, such as Benign Paroxysmal Positional Vertigo (BPPV) or vestibular migraine. These conditions can cause significant discomfort and may require specific treatments or therapies.

The mention of low blood pressure (hypotension) is also significant. Your recorded blood pressure readings (around 91/54 mmHg) indicate that you may be experiencing orthostatic hypotension, which can lead to dizziness, especially when standing up or changing positions. This condition occurs when blood pressure drops significantly upon standing, leading to reduced blood flow to the brain and causing dizziness or fainting. It can be exacerbated by dehydration, certain medications, or underlying health conditions.

Additionally, the symptoms of shoulder stiffness and lymph node swelling behind your ear could suggest a possible infection or inflammation, which may also contribute to your overall feeling of malaise and dizziness. It is essential to consider that these symptoms could be interconnected, and a thorough evaluation by a neurologist can help determine the underlying cause.

During your visit, the neurologist may perform a comprehensive neurological examination, which could include tests of your balance, coordination, and reflexes. They may also recommend imaging studies, such as an MRI or CT scan, to rule out any structural abnormalities in the brain or inner ear. Blood tests may also be conducted to check for any underlying metabolic or infectious causes.

In summary, given the complexity of your symptoms and their potential neurological implications, it is crucial to seek a consultation with a neurologist. They will be able to provide a more accurate diagnosis and develop an appropriate treatment plan tailored to your specific needs. In the meantime, it may be beneficial to keep a symptom diary, noting when your symptoms occur, their duration, and any potential triggers, as this information can be invaluable for your healthcare provider in making an accurate diagnosis.

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