Persistent Dizziness: When to Seek Further Medical Evaluation

Q: Persistent Dizziness: When to Seek Further Medical Evaluation

Hello, Miss： Based on your description of experiencing dizziness, it may be necessary to first consider symptoms caused by inner ear imbalance. <br>However, conditions such as anemia and autonomic nervous system dysfunction could also contribute to your symptoms. <br>It is essent

Persistent dizziness

Hello Doctor: One night while I was using the computer, I suddenly experienced a bout of dizziness.
I had similar episodes before, but they usually lasted only a few seconds and then went away.
This time, however, the dizziness persisted for a long time, so I thought I would take a nap and see if it improved.
Instead, I kept waking up feeling startled, which made me very anxious and unable to sleep well.
The next morning, I visited a family medicine clinic, and they diagnosed me with benign paroxysmal positional vertigo (BPPV).
Although I finished the medication and haven't experienced dizziness again, I still feel lightheaded.
Additionally, I have this strange sensation in my solar plexus when I'm anxious, which has led to a loss of appetite.
Should I return for a follow-up appointment, or should I go to a larger hospital for further evaluation?

W, 30~39 year old female. Ask Date: 2021/07/20

Dr. Jiang Junyi reply Neurology

Hello, Miss: Based on your description of experiencing dizziness, it may be necessary to first consider symptoms caused by inner ear imbalance.
However, conditions such as anemia and autonomic nervous system dysfunction could also contribute to your symptoms.
It is essential to rule out anemia or fluid deficiency that may lead to insufficient cerebral circulation.
You can improve your symptoms by replenishing fluids and electrolytes.
In addition to brain imaging and cervical ultrasound, blood tests can assist in evaluating dizziness.
Blood tests should include screening for possible complications (anemia, hyperthyroidism/hypothyroidism, diabetes, recurrent vestibular neuritis, autoimmune diseases, neurosyphilis, and central nervous system disorders).
I recommend discussing the examination and treatment with a neurologist.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to new preventive health measures before and after your medical visit.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health, safety, and happiness.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2021/07/20

More Info

Persistent dizziness can be a concerning symptom, especially when it disrupts your daily life and sleep. Based on your description, it seems that you experienced a significant episode of dizziness that lasted longer than usual, which has now transitioned into a persistent feeling of lightheadedness and anxiety. This situation warrants careful consideration and possibly further medical evaluation.

Dizziness can arise from various causes, including vestibular disorders (like benign paroxysmal positional vertigo, or BPPV), cardiovascular issues, neurological conditions, or even anxiety disorders. Since your initial diagnosis was ear stone disease (BPPV), it is essential to understand that while BPPV can cause episodes of dizziness, it typically resolves with specific maneuvers and may not lead to prolonged symptoms if treated appropriately. However, if you are still experiencing dizziness after treatment, it may indicate that the initial diagnosis was incomplete or that another underlying condition is contributing to your symptoms.

Given that you have also mentioned feelings of anxiety and a "tight" sensation in your stomach, it is crucial to consider the interplay between physical and psychological factors. Anxiety can exacerbate feelings of dizziness and create a cycle of discomfort that can affect your appetite and overall well-being. It is not uncommon for individuals experiencing persistent dizziness to develop anxiety about their symptoms, which can further complicate the clinical picture.

Here are some recommendations on when to seek further medical evaluation:
1. Persistent Symptoms: If your dizziness continues despite treatment and does not improve, it is essential to return to your healthcare provider. Persistent dizziness that lasts for weeks or longer should be evaluated to rule out other potential causes.

2. New or Worsening Symptoms: If you experience additional symptoms such as severe headaches, visual disturbances, weakness, numbness, difficulty speaking, or changes in consciousness, seek immediate medical attention. These could indicate a more serious condition, such as a stroke or other neurological issues.

3. Impact on Daily Life: If your dizziness is significantly affecting your ability to perform daily activities, work, or social interactions, it is crucial to discuss this with your doctor. Quality of life is an important factor in determining the need for further evaluation.

4. Anxiety and Mental Health: If you find that your anxiety is worsening or if you are struggling with sleep due to your symptoms, it may be beneficial to discuss these concerns with a mental health professional. They can provide strategies to manage anxiety, which may, in turn, help alleviate some of your physical symptoms.

5. Referral to a Specialist: If your primary care physician believes that your symptoms may be related to a vestibular disorder, they may refer you to an ear, nose, and throat (ENT) specialist or a neurologist for further evaluation. These specialists can conduct more specific tests to determine the underlying cause of your dizziness.

In conclusion, while it is essential to follow up with your healthcare provider regarding your persistent dizziness, it may also be beneficial to consider a comprehensive approach that includes both physical and mental health evaluations. If your symptoms continue or worsen, do not hesitate to seek further medical evaluation, as early intervention can lead to better outcomes.

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