Sudden Dizziness: When to Worry and When to Relax - Family Medicine

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Sometimes I suddenly feel dizzy?


Hello Doctor: I’m not sure if it’s related to the increasingly hot weather, but I have occasionally experienced dizziness when sitting or standing up from a low position.
I consulted an ENT specialist who mentioned it was normal and gave it a name that I forgot, but I remember the doctor said it wouldn’t last long and that it was fine as long as I didn’t feel nauseous.
However, in the past couple of days, I’ve been feeling dizzy for a second or two while sitting, especially when I stand up suddenly, which can last about 3-4 seconds.
I would like to ask if I need to have my brain checked for this, or if it’s just a result of the heat and possibly blood pressure issues that don’t require too much concern.
I had my hearing checked about six months ago, and it was normal with no issues.
Thank you for your response.

Mr. Chen, 20~29 year old female. Ask Date: 2020/05/14

Dr. Xiao Yongxun reply Family Medicine


Dear Mr.
Chen:
There are many causes of dizziness, which can be primarily categorized as follows:
1.
Dizziness originating from peripheral issues (approximately 40%):
- Meniere's disease
- Vestibular neuronitis and acute labyrinthitis
- Benign paroxysmal positional vertigo (BPPV)
2.
Dizziness originating from central issues (approximately 20%):
- Vertebrobasilar insufficiency (VBI)
- Cerebellar stroke must be ruled out first
- Migraine
- Multiple sclerosis, where about 20% of patients may experience dizziness
- Brain tumors, particularly acoustic neuromas, which commonly occur in the cerebellopontine angle
- Dizziness following head trauma
- About 70% of patients with posterior fossa strokes will experience dizziness, often accompanied by hemiparesis, speech difficulties, diplopia, and limb numbness
3.
Dizziness originating from medical issues (approximately 30%):
- Hypoglycemia
- Anemia
- Orthostatic hypotension
- Side effects of medications (antihypertensives, sedatives, antiepileptics, aminoglycosides)
- Infections
- Hypothyroidism
- Diabetic peripheral neuropathy combined with autonomic dysfunction, leading to orthostatic hypotension and dizziness
- Alcohol intoxication
4.
Dizziness originating from psychological or emotional issues (approximately 10%):
- Anxiety disorders: If you experience dizziness, chest tightness, palpitations, or shortness of breath, it should be differentiated from anxiety disorders
- Panic disorder
- Hyperventilation syndrome
- Claustrophobia
Based on your description and the results from your ENT consultation, it does not appear to be a serious issue.
I personally believe it may be caused by orthostatic hypotension or hyperventilation syndrome.
I recommend ensuring adequate sleep, maintaining a balanced diet, and engaging in regular exercise, while avoiding unnecessary stress and caffeine-containing foods and beverages; this should help improve your condition.
If symptoms persist for more than two weeks, it may be advisable to discuss this with your primary care physician for further evaluation, or to seek care at a neurology outpatient clinic at a regional hospital.

Reply Date: 2020/05/14

More Info


When it comes to sudden dizziness, understanding the underlying causes and when to seek medical attention is crucial. Dizziness can be a common experience, especially in response to changes in posture, temperature, or even stress. In your case, it seems that the dizziness occurs primarily when you stand up quickly or when the weather gets warmer. This could be related to a phenomenon known as orthostatic hypotension, which is a drop in blood pressure that occurs when you stand up from a sitting or lying position.
When you stand up quickly, gravity causes blood to pool in your legs, which can temporarily reduce the amount of blood returning to your heart and, consequently, the amount of blood that reaches your brain. This can lead to feelings of lightheadedness or dizziness, which typically resolves quickly. If this is the case, it is often not a cause for concern, especially if it is brief and does not come with other alarming symptoms such as nausea, vomiting, or prolonged episodes of dizziness.

However, there are several factors that could contribute to dizziness, particularly in warmer weather. Dehydration is a common issue during hot weather, and it can lead to decreased blood volume, which may exacerbate dizziness. Additionally, if you are not eating or drinking enough, your blood sugar levels may drop, leading to similar symptoms.
Given that you have previously had your hearing checked and found no issues, it is less likely that your dizziness is related to an inner ear problem, which can also cause balance issues. However, if your symptoms persist or worsen, or if you experience additional symptoms such as severe headaches, visual disturbances, or difficulty walking, it would be prudent to seek further evaluation.
In terms of when to worry, consider the following guidelines:
1. Duration and Frequency: If your dizziness lasts more than a few seconds or occurs frequently, it may warrant further investigation.

2. Associated Symptoms: If you experience other symptoms such as severe headache, confusion, difficulty speaking, or weakness, you should seek immediate medical attention.

3. Impact on Daily Life: If dizziness interferes with your daily activities or causes you to feel unsafe, it’s worth discussing with a healthcare provider.

4. Underlying Health Conditions: If you have pre-existing conditions such as heart disease, diabetes, or neurological disorders, it’s essential to monitor any new symptoms closely.

In summary, while occasional dizziness, particularly in response to posture changes or heat, is often benign, it’s important to listen to your body. Staying hydrated, moving slowly when changing positions, and monitoring your symptoms can help manage your dizziness. If you have concerns or if your symptoms change, don’t hesitate to consult a healthcare professional for a thorough evaluation.

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