Dizziness, Nausea, and Weakness: Possible Neurological Issues

Dizziness, nausea, and weakness or numbness in the limbs?

Hello, I started experiencing dizziness upon waking up on June 9th, initially thinking it was due to getting up too quickly.
However, the dizziness persisted throughout the day, occurring whether I was standing, sitting, or lying down.
By July 31st, I began to feel nauseous.
My balance has worsened while walking; although it doesn't severely impact my daily life, it is quite uncomfortable.
I am concerned whether this could be a precursor to a stroke or related to ear or cardiovascular issues.

I subsequently consulted both an otolaryngologist and a cardiologist.
The otolaryngologist conducted tests and determined that since I do not experience dizziness with sound and my hearing is intact, it is unlikely to be caused by an ear issue.
The cardiologist performed a 24-hour blood pressure monitoring and blood tests, revealing slightly elevated blood pressure (120-140/80-100).
However, the doctor assessed that this might not be the primary cause.
An MRI was scheduled for the end of July to check if the blood pressure has affected kidney blood flow, and the results showed no issues.
Consequently, the doctor prescribed antihypertensive medication (Diltiazem, half a tablet daily), with a follow-up appointment in October.
Since the onset of dizziness, I have also experienced various pains in different parts of my body.
Initially, it was in my chest (uncertain if it was muscle or bone pain), and now it has spread to my armpits and sides of my abdomen (again, uncertain if muscle or bone).
I also have a dull pain in my abdomen (in the depression between the ribs, which hurts when pressed, and I occasionally feel pain throughout my abdomen).
On July 29th, I did weight training, and afterward, I felt weakness in my limbs.
I initially thought it was a muscle strain, but two weeks later, the weakness persists.
Any exertion leads to soreness, and I experience numbness; even lifting my arms causes soreness, making me want to lower them.
My thighs also exhibit similar symptoms.
I am very concerned whether there is nerve damage or if it is simply a muscle strain.
The dizziness has accumulated for nearly two months, and I still have not identified the underlying cause.
With the additional pains in my body and no definitive answers from the doctors I have seen, I am truly at a loss for what to do.
If it were a serious illness like cancer, I worry about what my future life would look like.
I would greatly appreciate any advice from the doctor.
Thank you.

Howard, 30~39 year old female. Ask Date: 2020/08/03

Dr. Jiang Junyi reply Neurology

Hello, based on your description, I'm not sure if you have issues with sleep apnea.
Some symptoms may suggest autonomic nervous system dysfunction.
Our autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems; one acts as the accelerator, while the other serves as the brake.
The sympathetic nervous system is responsible for increasing heart rate, accelerating breathing, and increasing sweating during activities.
Once the activity stops, the parasympathetic nervous system takes over, slowing down the heart rate, reducing breathing, and decreasing sweating.
This could explain the dizziness, bloating, and high blood pressure you mentioned.
It is advisable to undergo a sympathetic nervous system evaluation.
Maintaining a regular lifestyle and focusing on aerobic exercise is recommended.
I suggest discussing further examinations and treatments with your primary physician.
Wishing you good health, peace, and joy.
Dr.
Jiang from Taoyuan Hospital cares about you.

Reply Date: 2020/08/03

More Info

It sounds like you are experiencing a complex array of symptoms that are understandably causing you significant concern. Dizziness, nausea, weakness, and various pains can stem from a multitude of underlying issues, and it’s crucial to approach this systematically.

First, let’s address the dizziness and nausea. Dizziness can be caused by several factors, including vestibular disorders (related to the inner ear), neurological issues, or even cardiovascular problems. Since you have already consulted with an ENT specialist who ruled out ear-related causes, we can consider other possibilities. Neurological conditions such as migraines, transient ischemic attacks (TIAs), or even more serious conditions like strokes can present with dizziness. Given the duration of your symptoms, it’s wise to continue with the MRI scheduled for the end of July, as it can help rule out any structural abnormalities in the brain.

Your mention of high blood pressure is also significant. While your readings (120-140/80-100) are not excessively high, they are on the higher end of normal, and managing blood pressure is crucial for overall cardiovascular health. High blood pressure can contribute to dizziness and may also affect kidney function over time, which is why your doctor is monitoring it closely. The prescription of antihypertensive medication is a proactive step to manage this risk.

The weakness and pain you are experiencing in various body parts could be related to several factors. Muscle strain from recent physical activity, such as weight training, could explain some of the discomfort. However, if the weakness persists and is accompanied by other neurological symptoms (like numbness or tingling), it could indicate a more serious issue, such as nerve compression or a neurological disorder. It’s essential to differentiate between muscular pain and potential nerve-related issues, as the latter may require different management.

Given the complexity of your symptoms, it’s advisable to maintain open communication with your healthcare providers. If you feel that your concerns are not being adequately addressed, seeking a second opinion from a neurologist may provide further insights. They can conduct a thorough neurological examination and may recommend additional tests, such as nerve conduction studies or electromyography (EMG), to assess nerve function and muscle response.

In the meantime, consider keeping a symptom diary. Document when your symptoms occur, their duration, and any potential triggers. This information can be invaluable for your healthcare team in diagnosing your condition. Additionally, managing stress through relaxation techniques, gentle exercise, and proper hydration may help alleviate some of your symptoms.

Lastly, while it’s natural to worry about serious conditions like cancer, it’s essential to focus on the information you have and the steps you are taking to investigate your health. Many symptoms can be attributed to benign causes, and early intervention often leads to better outcomes. Stay proactive about your health, and don’t hesitate to advocate for yourself in medical settings. Your well-being is paramount, and thorough investigation is the key to finding answers.

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