Persistent Dizziness and Nausea: When to Seek Neurological Help

Feeling nauseous all day, like being car sick?

Hello Dr.
Jiang, I started experiencing mild dizziness around January of this year, similar to motion sickness, accompanied by a feeling of nausea and frequent burping.
This would last for about one to two hours but did not affect my daily life.
However, since April, the duration of these episodes has increased, and for the past two weeks, I have been almost constantly in a state of dizziness, with a feeling of pressure in my head and back pain.
The persistent nausea is very uncomfortable.
Which specialty should I consult? Medical history: Meniere's disease, meningioma (underwent radiosurgery a year and a half ago), and hyperlipidemia for many years (currently taking Rosuvastatin).
Sandy

Sandy, 60~69 year old female. Ask Date: 2021/05/03

Dr. Jiang Junyi reply Neurology

Hello, based on your description, there are many potential causes for dizziness, such as anemia, autonomic nervous system dysfunction, and inner ear imbalance, which may contribute to your symptoms.
First, it is important to rule out anemia or fluid deficiency that could lead to insufficient cerebral circulation.
Symptoms can be improved by replenishing fluids and electrolytes.
In addition to magnetic resonance imaging (MRI), blood tests can assist in evaluating dizziness and headaches.
Blood tests may include screening for possible complications such as anemia, hyperthyroidism/hypothyroidism, diabetes, recurrent vestibular neuritis, autoimmune diseases, neurosyphilis, and central nervous system disorders.
I recommend discussing further evaluation and treatment with a neurologist.
Wishing you good health and peace.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2021/05/03

More Info

Hello Sandy,
Thank you for reaching out with your concerns regarding persistent dizziness and nausea. Based on your symptoms and medical history, it’s important to approach this situation with careful consideration.

When to Seek Neurological Help
Given that you have been experiencing dizziness and nausea since January, with a significant increase in the duration and intensity of these symptoms over the past few weeks, it is advisable to seek medical attention. Persistent dizziness, especially when it becomes more frequent or severe, can indicate an underlying neurological issue that requires evaluation.
You mentioned a history of Meniere's disease and a previous brain tumor (meningioma) that was treated with radiosurgery. Both of these conditions can contribute to dizziness and nausea. Meniere's disease is characterized by episodes of vertigo, tinnitus, and hearing loss, while a history of brain tumors can lead to various neurological symptoms depending on their location and any potential complications from treatment.

Recommended Specialists
In your case, it would be best to consult a neurologist or an otolaryngologist (ENT specialist) who specializes in balance disorders. A neurologist can evaluate for any potential neurological causes of your symptoms, while an ENT specialist can assess issues related to the inner ear, which is often involved in balance and dizziness.

Possible Diagnostic Tests
During your consultation, the doctor may recommend several diagnostic tests, including:
1. MRI or CT Scan: To rule out any structural issues in the brain, especially considering your history of a brain tumor.

2. Vestibular Testing: This may include tests like the caloric test or electronystagmography (ENG) to assess the function of your inner ear and balance system.

3. Blood Tests: To check for any metabolic or systemic issues that could contribute to your symptoms, such as thyroid function or electrolyte imbalances.

Symptoms to Monitor
While waiting for your appointment, it’s essential to monitor your symptoms closely. Pay attention to:
- The frequency and duration of dizziness episodes.

- Any associated symptoms such as headaches, visual disturbances, or changes in hearing.

- Any new symptoms that may arise, such as weakness, numbness, or difficulty speaking.

If you experience any of these alarming symptoms, seek immediate medical attention.

Management and Treatment
Once a diagnosis is made, treatment will depend on the underlying cause of your symptoms. For Meniere's disease, treatment options may include dietary changes (such as reducing salt intake), medications to manage symptoms, or in some cases, surgical interventions. If your dizziness is related to neurological issues, treatment may involve medications, physical therapy, or other interventions based on the specific diagnosis.

Conclusion
In summary, given your persistent symptoms of dizziness and nausea, along with your medical history, it is crucial to seek evaluation from a neurologist or an ENT specialist. Early diagnosis and intervention can significantly improve your quality of life and address any underlying issues effectively. Remember to keep track of your symptoms and communicate openly with your healthcare provider about any changes you notice.

Take care, and I hope you find relief soon.

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