Tinnitus, dizziness?
Hello, Director Wu.
For long-term dizziness and occasional vertigo, aside from neurology and otolaryngology, which other specialties can I consult?
1.
If dizziness is caused by blood pressure issues, what are the typical symptoms?
2.
In a stable mental and physical condition, I may suddenly feel dizzy while sitting and watching TV or doing other activities.
At this time, my mood is likely to worsen the symptoms (and my blood pressure tends to be elevated during these episodes).
3.
I have undergone two cranial ultrasounds in neurology, and the conclusion was that everything is fine.
However, I was prescribed Difenidol and a chronic prescription for Cerebrolysin.
Although I take them as directed, I still experience dizziness and occasional vertigo.
4.
Neurologists (three different doctors from different hospitals) insist that no further tests are necessary and often remind me to reduce the use of electronic devices and pay attention to my posture, as well as find ways to lose weight.
I understand that with a current BMI of 28, dizziness is not easy to resolve, especially the spinning sensation of vertigo.
Medication may only help prevent or alleviate symptoms, but I wonder if there are other methods to seek help?
Thank you, Director Wu, for taking the time to clarify these issues.
Mr. Zhang, 50~59 year old female. Ask Date: 2021/05/05
Dr. Wu Zongying reply Family Medicine
Hello: Dizziness may not always have a detectable cause.
Even with medication, improvement is not guaranteed.
In terms of diet, it is advisable to avoid consuming high-concentration or strongly flavored soups, as they may affect the inner ear's semicircular canals and lead to dizziness.
Reply Date: 2021/05/05
More Info
Managing dizziness can be a complex issue, especially when it persists over a long period and is not solely attributed to neurological or ENT (ear, nose, and throat) conditions. While you have already consulted specialists in these fields, there are several other medical avenues you might explore to address your symptoms effectively.
1. Cardiovascular Evaluation
Given that you mentioned blood pressure issues, it’s crucial to consider a cardiovascular evaluation. Dizziness can often be linked to fluctuations in blood pressure, particularly orthostatic hypotension, where blood pressure drops significantly when standing up. Symptoms may include lightheadedness, fainting, or a feeling of being off-balance. A cardiologist can perform tests such as an echocardiogram or a Holter monitor to assess your heart's function and rhythm, which might reveal underlying issues contributing to your dizziness.
2. Endocrinology Consultation
Hormonal imbalances can also lead to dizziness. Conditions such as thyroid dysfunction (hypothyroidism or hyperthyroidism) or adrenal insufficiency can manifest as dizziness or lightheadedness. An endocrinologist can evaluate your hormone levels and determine if any imbalances might be contributing to your symptoms.
3. Psychological Assessment
You mentioned that your mood might influence your dizziness. Anxiety and panic disorders can lead to episodes of dizziness or a sensation of unreality. A psychologist or psychiatrist can help assess whether anxiety is a contributing factor and may suggest cognitive-behavioral therapy (CBT) or medication to help manage anxiety symptoms, which could, in turn, alleviate your dizziness.
4. Physical Therapy
Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy designed to alleviate dizziness and balance issues. A physical therapist trained in vestibular disorders can provide exercises that help your brain adapt to the changes in balance and reduce dizziness. This approach is particularly effective for patients experiencing vestibular migraines or benign paroxysmal positional vertigo (BPPV).
5. Lifestyle Modifications
You mentioned a BMI of 28, which indicates being overweight. Weight management can significantly impact overall health and may help alleviate dizziness. Incorporating regular physical activity, a balanced diet, and adequate hydration can improve your cardiovascular health and potentially reduce dizziness. Additionally, reducing screen time and taking breaks from 3C devices (computer, communication, and consumer electronics) can help minimize visual strain, which may contribute to dizziness.
6. Alternative Therapies
Some patients find relief through alternative therapies such as acupuncture or chiropractic care. While scientific evidence may vary, these therapies can sometimes provide symptomatic relief for chronic dizziness.
Conclusion
In summary, while you have already consulted neurology and ENT specialists, consider seeking evaluations from cardiology, endocrinology, psychology, and physical therapy. Each of these fields can provide insights into potential underlying causes of your dizziness and offer treatment options that may not have been previously explored. Remember to maintain open communication with your healthcare providers about your symptoms and any changes you experience. Managing dizziness often requires a multidisciplinary approach, and finding the right combination of treatments can lead to significant improvements in your quality of life.
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