Managing Dizziness and Nausea After a Stroke: A Caregiver's Concern - Neurology

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The mother had a minor stroke a year ago and has recently been experiencing frequent dizziness and vomiting?


Hello Doctor, my mother had a mild stroke a year ago, and her stroke-related symptoms have improved.
Her blood pressure and blood sugar levels are being managed with medication and are within normal ranges.
However, around March, she started experiencing occasional dizziness and vomiting at night.
After seeing a doctor, she was told it was due to ear degeneration.
During the visit, my mother mentioned that she has had tinnitus since the stroke, but the doctor said that after a year, it cannot be improved, and the dizziness tends to occur with seasonal changes.
The doctor prescribed medication for dizziness and nausea to be taken as needed, but I would like to ask if this condition is not likely to improve.
The dizziness and nausea medications cannot be taken continuously; although taking them alleviates the dizziness for a while, she still experiences vomiting during that period.
It is very distressing to see her suddenly feeling dizzy and nauseous.
Thank you, Doctor.

Yu, 20~29 year old female. Ask Date: 2020/05/12

Dr. Hong Weibin reply Neurology


Hello: Indeed, dizziness caused by peripheral systems is more challenging to treat, and medication can only be used to manage the condition.
It is recommended that you discuss with your physician to choose medications with fewer side effects and take them regularly to reduce the frequency and severity of dizziness episodes.

Reply Date: 2020/05/12

More Info


Managing dizziness and nausea after a stroke can be a complex issue, especially when considering the long-term effects of the stroke and the potential for other underlying conditions. Your mother's situation, having experienced a mild stroke a year ago, is not uncommon. Many stroke survivors face a variety of symptoms that can persist long after the initial event, including dizziness, nausea, and tinnitus (ear ringing).
The dizziness and nausea your mother is experiencing, particularly if they are exacerbated by seasonal changes, could be related to several factors. One possibility is vestibular dysfunction, which can occur after a stroke. The vestibular system, located in the inner ear, plays a crucial role in maintaining balance and spatial orientation. If this system is compromised, it can lead to symptoms such as dizziness and vertigo. Additionally, the ear ringing (tinnitus) she has reported could also be linked to vestibular issues or even changes in blood flow post-stroke.

It's important to note that while some symptoms may improve over time, others can become chronic. The fact that your mother's dizziness and nausea have been persistent for several months suggests that they may be related to the stroke's impact on her neurological function or the vestibular system. Unfortunately, if the underlying cause is related to structural changes or damage from the stroke, complete resolution may be unlikely.

The medications prescribed for dizziness and nausea can provide temporary relief, but as you mentioned, they are not a long-term solution. Continuous use of these medications can lead to side effects and may not address the root cause of the symptoms. It’s crucial to have a comprehensive management plan that includes both pharmacological and non-pharmacological approaches.

Here are some strategies that may help manage your mother’s symptoms:
1. Vestibular Rehabilitation Therapy (VRT): This is a specialized form of physical therapy aimed at improving balance and reducing dizziness. A trained therapist can tailor exercises to your mother's specific needs, helping her adapt to her symptoms and improve her overall stability.

2. Lifestyle Modifications: Encourage your mother to stay hydrated, avoid sudden movements, and rise slowly from sitting or lying positions. Maintaining a stable routine can also help manage symptoms.

3. Dietary Adjustments: Sometimes, nausea can be exacerbated by certain foods or eating patterns. Keeping a food diary to identify any potential triggers may be beneficial.

4. Regular Follow-ups: Continuous communication with her healthcare provider is essential. If her symptoms worsen or new symptoms arise, it may be necessary to reassess her treatment plan.

5. Stress Management: Stress and anxiety can exacerbate dizziness and nausea. Techniques such as mindfulness, meditation, or gentle yoga may help her manage stress levels.

6. Hearing and Balance Evaluation: Since the doctor mentioned ear degeneration, it might be worthwhile to consult an audiologist or an ear, nose, and throat (ENT) specialist for a thorough evaluation of her hearing and balance function.

In conclusion, while some aspects of your mother’s condition may not improve significantly, there are various strategies to help manage her symptoms and improve her quality of life. It’s essential to work closely with her healthcare team to develop a comprehensive care plan that addresses both her physical and emotional well-being. Your concern for her health is commendable, and with the right support and interventions, she can continue to make progress in her recovery journey.

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