Sudden Dizziness: When to Worry and When to Relax

Sometimes I suddenly feel dizzy?

Hello Doctor: I am not sure if this is 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 that it is considered normal and gave it a specific name, but I forgot what it was.
I only remember the doctor said it wouldn't last long, and if there are no feelings of nausea or vomiting, it should be fine.
However, in the past couple of days, I have noticed that I sometimes feel 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 a special examination of my brain, or if this is just a result of the heat and possibly blood pressure issues that may not require too much concern.
About six months ago, I had a hearing test for my ears, which was normal with no issues.
Thank you for your response.

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

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 at the cerebellopontine angle
- Dizziness following head trauma
- In patients with posterior fossa strokes, 70% may 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, anticonvulsants, 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 also 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: 2020/05/20

More Info

When it comes to sudden dizziness, it is essential to understand the various potential causes and when to seek medical attention. Dizziness can arise from a multitude of factors, including changes in posture, dehydration, heat exposure, and underlying medical conditions. Given your description, it seems that your dizziness occurs primarily when you stand up quickly or after sitting for a while, which is often referred to as orthostatic hypotension. This condition can happen when there is a sudden drop in blood pressure upon standing, leading to temporary dizziness or lightheadedness.

In your case, the recent hot weather could indeed be a contributing factor. Heat can lead to dehydration, which in turn can affect blood volume and pressure, exacerbating feelings of dizziness. Additionally, if you have been spending more time outdoors or engaging in physical activities in the heat, your body may be struggling to maintain adequate hydration levels, leading to these symptoms.

The fact that you have previously consulted an ENT specialist and received reassurance that your symptoms are not indicative of a serious condition is a positive sign. If the dizziness is brief (lasting only a few seconds) and does not accompany other alarming symptoms such as severe headache, visual disturbances, difficulty speaking, or loss of consciousness, it is generally not a cause for immediate concern. However, if you experience any of these additional symptoms, it would be prudent to seek medical evaluation promptly.

Here are some strategies to manage and potentially alleviate your dizziness:
1. Hydration: Ensure you are drinking enough fluids, especially in hot weather. Dehydration can significantly impact your blood pressure and overall well-being.

2. Gradual Movements: When transitioning from sitting or lying down to standing, do so slowly. This can help your body adjust and reduce the likelihood of dizziness.

3. Diet: Maintain a balanced diet that includes adequate salt intake (unless contraindicated by other health conditions) to help manage blood pressure levels.

4. Monitor Symptoms: Keep a record of when the dizziness occurs, its duration, and any accompanying symptoms. This information can be helpful for your healthcare provider if further evaluation is needed.

5. Consultation: If your symptoms persist or worsen, or if you have any new concerns, it is advisable to consult a healthcare professional. They may recommend further tests, such as blood pressure monitoring, blood tests to check for anemia or electrolyte imbalances, or even imaging studies if deemed necessary.

In summary, while your symptoms may be related to benign causes such as dehydration or changes in posture, it is essential to remain vigilant. If you notice any concerning changes or if the dizziness becomes more frequent or severe, do not hesitate to seek medical advice. Your health and peace of mind are paramount, and a healthcare professional can provide tailored guidance based on your specific situation.

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