Persistent Dizziness Without Vertigo: Key Insights

Dizziness without vertigo?

I would like to ask the doctor, since last week I have been feeling lightheaded every day, but I do not experience vertigo.
When I close my eyes with my feet together, my body sways slightly.
I have never experienced anything like this before.
Although it hasn't been severe enough to cause me to fall or feel unsteady, the lightheadedness has persisted for a week and has not improved.
Could you please tell me what these symptoms might indicate? Thank you.

Mr. Zhang, 20~29 year old female. Ask Date: 2021/11/07

Dr. Jiang Junyi reply Neurology

Dear Mr.
Zhang,
You mentioned that when you stand with your feet together and close your eyes, your body sways slightly.
This may indicate that your proprioception is affected.
Conditions such as anemia, autonomic dysfunction, and inner ear imbalance could contribute to your symptoms.
First, it is important to rule out anemia or fluid deficiency that may lead to inadequate cerebral circulation.
You can improve your symptoms by replenishing fluids and electrolytes.

In addition to magnetic resonance imaging (MRI), blood tests can assist in evaluating dizziness and headaches.
These tests should include screening for possible complications such as anemia, hyperthyroidism/hypothyroidism, diabetes, recurrent vestibular neuritis, autoimmune diseases, neurosyphilis, and central nervous system disorders.
Generally, treatment for dizziness may include:
1.
Reducing intake of sodium (salt), caffeine, nicotine, and alcohol.
2.
For acute symptoms, physicians typically prescribe antihistamines, antiemetics, and anxiolytics to alleviate symptoms.
3.
Lifestyle modifications, such as avoiding sudden head movements and extreme postural changes.
4.
Supplementing with B vitamins and fluids, ensuring adequate rest to enhance the body's recovery capacity.
I recommend that you visit a neurology clinic for further evaluation and follow-up.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/11/07

More Info

Persistent dizziness without vertigo can be a perplexing symptom that warrants careful consideration. Dizziness is a common complaint and can arise from various underlying causes, ranging from benign to more serious conditions. In your case, the sensation of feeling "dizzy" without experiencing true vertigo (the sensation of spinning) can suggest several possibilities.

Firstly, it’s important to differentiate between dizziness and vertigo. Dizziness can manifest as a feeling of lightheadedness, unsteadiness, or a sensation of floating. In contrast, vertigo is characterized by a false sense of movement or spinning. Your description of feeling unsteady when standing with your eyes closed indicates a potential issue with balance, which could be related to several factors.

One common cause of persistent dizziness without vertigo is vestibular dysfunction. The vestibular system, located in the inner ear, plays a crucial role in maintaining balance and spatial orientation. If there is an issue with this system, such as vestibular neuritis or benign paroxysmal positional vertigo (BPPV), it can lead to feelings of dizziness. However, BPPV typically presents with episodes of vertigo triggered by specific head movements, which does not seem to be the case for you.

Another potential cause could be orthostatic hypotension, which occurs when there is a sudden drop in blood pressure upon standing. This can lead to lightheadedness or dizziness, especially if you have been sitting or lying down for an extended period. Dehydration, anemia, or certain medications can also contribute to this condition.

Additionally, anxiety and stress can manifest physically as dizziness. If you have been experiencing increased stress or anxiety, this could be a contributing factor. Psychological factors can sometimes lead to physical symptoms, including a sensation of dizziness.

Neurological conditions should also be considered, especially if the dizziness persists or is accompanied by other symptoms such as headaches, visual disturbances, or changes in coordination. Conditions such as migraines, multiple sclerosis, or even transient ischemic attacks (TIAs) can present with dizziness as a symptom.

Given that your dizziness has persisted for a week without improvement, it is advisable to seek medical evaluation. A healthcare provider will likely perform a thorough history and physical examination, focusing on your medical history, any associated symptoms, and any potential triggers for your dizziness. They may also recommend tests such as blood pressure measurements, blood tests, or imaging studies if necessary.

In summary, persistent dizziness without vertigo can stem from various causes, including vestibular dysfunction, orthostatic hypotension, anxiety, or neurological conditions. It is essential to consult a healthcare professional for a comprehensive evaluation to determine the underlying cause and appropriate management. Early intervention can help alleviate symptoms and improve your quality of life.

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