Dizziness When Turning: Neurological Symptoms

Dizziness when turning?

Hello Doctor, for the past month, I have been feeling a bit dizzy and unsteady whenever I walk, especially when turning or looking back (it's not a spinning sensation).
I have tried walking in a straight line, standing on one foot, and performing the finger-to-nose test, and I feel quite stable during those tests.

1.
What could be the possible issue here?
2.
Can lack of sleep or anxiety contribute to the symptoms mentioned above?
Thank you, Doctor.

Mr. Huang, 20~29 year old female. Ask Date: 2022/01/24

Dr. Jiang Junyi reply Neurology

Hello Mr.
Huang,
You mentioned that "you have tried walking in a straight line or standing on one foot...
and also tried the finger-to-nose test, and personally feel quite stable." This observation suggests that it is less likely to be a cerebellar or brainstem lesion.
You also mentioned that "when turning or looking back...
you feel a bit dizzy and somewhat unsteady." It may be necessary to first consider Benign Paroxysmal Positional Vertigo (BPPV), which is characterized by brief episodes of dizziness related to changes in head position, such as bending over, tilting back, lying down, getting up, rolling over, or suddenly turning your head.
This may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and a feeling of weakness.
Regarding treatment:
1.
Reduce intake of sodium (salt), caffeine, nicotine, and alcohol.
2.
For acute symptoms, doctors typically prescribe antihistamines, antiemetics, and anxiolytics to alleviate symptoms.
3.
In terms of lifestyle habits, avoid sudden head movements and drastic changes in posture.
4.
Supplement with B vitamins and maintain hydration, ensure adequate rest, and enhance the body's recovery ability.
Please implement self-protection measures before and after medical visits, including cleaning and disinfecting, and adhere to new pandemic prevention practices.
Thank you for your inquiry, and feel free to discuss any related questions further!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Hospital

Reply Date: 2022/01/24

More Info

Dizziness, particularly when turning or changing head positions, can be a concerning symptom that may indicate various underlying conditions. Based on your description, it seems that you experience a sensation of dizziness or unsteadiness when you turn your head or look back, but you do not feel like the room is spinning (which is known as vertigo). This distinction is important as it can help narrow down potential causes.

1. Possible Causes of Dizziness When Turning:
- Vestibular Dysfunction: The vestibular system, located in the inner ear, is responsible for maintaining balance and spatial orientation. Conditions such as Benign Paroxysmal Positional Vertigo (BPPV) can cause dizziness when changing head positions. In BPPV, tiny calcium crystals in the inner ear become dislodged and affect balance.

- Cervical Vertigo: This type of dizziness can occur due to issues in the cervical spine, such as muscle tension or degenerative changes, which may affect blood flow or nerve function.

- Anxiety and Stress: Psychological factors can also contribute to dizziness. Anxiety can lead to hyperventilation, which may cause lightheadedness or feelings of unsteadiness. Additionally, chronic stress can lead to muscle tension, which may exacerbate feelings of dizziness.

- Dehydration or Poor Nutrition: Insufficient hydration or inadequate nutrition can lead to dizziness. If you have not been sleeping well or eating properly, this could contribute to your symptoms.

- Medication Side Effects: If you are taking any medications, it is essential to consider whether dizziness could be a side effect.

2. Impact of Sleep and Anxiety:
- Sleep Deprivation: Lack of sleep can significantly affect cognitive function and balance. It can lead to fatigue, decreased concentration, and increased sensitivity to stress, all of which can contribute to feelings of dizziness.

- Anxiety: Anxiety can manifest physically in various ways, including dizziness. When anxious, the body can enter a heightened state of arousal, leading to symptoms such as increased heart rate, shallow breathing, and muscle tension, which can all contribute to feelings of dizziness or unsteadiness.

Given these possibilities, it is crucial to approach your symptoms holistically. Here are some recommendations:
- Consult a Healthcare Professional: Since dizziness can stem from various causes, it is advisable to consult a healthcare provider, preferably a neurologist or an ear, nose, and throat (ENT) specialist. They may perform a thorough evaluation, including a physical examination and possibly imaging studies or vestibular testing.

- Keep a Symptom Diary: Documenting when your dizziness occurs, its duration, and any associated symptoms can help your healthcare provider understand your condition better.

- Manage Stress and Anxiety: If you suspect that anxiety or stress is contributing to your symptoms, consider stress management techniques such as mindfulness, yoga, or cognitive-behavioral therapy (CBT).

- Ensure Adequate Sleep and Nutrition: Prioritize good sleep hygiene and a balanced diet to support overall health and well-being.

In conclusion, dizziness when turning can arise from various factors, including vestibular dysfunction, anxiety, and lifestyle factors. A comprehensive evaluation by a healthcare professional is essential to determine the underlying cause and develop an appropriate treatment plan. Remember, addressing both physical and psychological aspects of your health is crucial for managing symptoms effectively.

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