Dizziness and Pressure: Neurological Insights and Solutions

Dizziness and a feeling of heaviness in the head?

Hello Doctor: I have been experiencing dizziness, a feeling of pressure in my head, and nausea for almost three weeks.
After visiting an ENT specialist and taking medication, I haven't vomited in the past few days, but I still feel a bit dizzy and pressure in my head.
I experience pain on both sides of my head, and my ears also feel slightly painful.
I feel heavy-headed and light-bodied, and looking at my phone causes some dizziness.
I'm unsure if the dizziness is due to nasal congestion or something else, and I have some difficulty breathing.
I tend to get anxious and nervous easily.
Thank you, Doctor, for answering my questions.

Ling, 20~29 year old female. Ask Date: 2022/03/14

Dr. Jiang Junyi reply Neurology

Dear Miss Ling,
You mentioned that "my head still feels a bit dizzy and swollen, with pain on both sides, and my ears also hurt a little.
I feel heavy-headed and light-bodied, and looking at my phone causes some dizziness...
After visiting the ENT and taking medication, I haven't vomited these past few days." Your symptoms may suggest Meniere's disease.
The primary cause is excessive accumulation of endolymph in the inner ear, which compresses the vestibular and cochlear systems.
Common symptoms include:
1.
Paroxysmal vertigo (lasting from 20 minutes to 24 hours), often accompanied by nausea and vomiting.
2.
Sensorineural hearing loss, which fluctuates in severity but typically first affects low-frequency hearing.
3.
Low-frequency tinnitus, often accompanied by a feeling of fullness.
Initial daily treatment recommendations include:
1.
Reducing intake of sodium (salt), caffeine, nicotine, and alcohol.
2.
During acute symptoms, anti-anxiety medications, antihistamines, and antiemetics can help alleviate symptoms.
3.
Diuretics may also be used; sometimes the feeling of dizziness can be a side effect of medication.
I recommend that you consult with an ENT specialist and a neurologist for further evaluation and treatment.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2022/03/14

More Info

Dizziness and a sensation of pressure in the head can be distressing symptoms that may arise from various underlying causes, including neurological, vestibular, or even psychological factors. Based on your description, it seems that you have been experiencing these symptoms for about three weeks, which is significant enough to warrant further investigation.

Firstly, it's important to understand that dizziness can manifest in different forms, including a spinning sensation (vertigo), lightheadedness, or a feeling of being off-balance. The accompanying symptoms you mentioned, such as headaches, ear pain, and difficulty breathing, can provide clues to the underlying issue. Given that you have already consulted an ear, nose, and throat (ENT) specialist and received medication, it suggests that there may be a vestibular component to your dizziness, possibly related to inner ear issues.

One common cause of dizziness is vestibular neuritis or labyrinthitis, which can occur after a viral infection and lead to inflammation of the inner ear structures responsible for balance. This condition can cause vertigo, imbalance, and sometimes associated headaches. Another possibility is benign paroxysmal positional vertigo (BPPV), where small crystals in the inner ear become dislodged, leading to brief episodes of vertigo triggered by changes in head position.

Your mention of nasal congestion and difficulty breathing could also indicate that sinus issues are contributing to your symptoms. Sinusitis can lead to pressure in the head and may cause referred pain to the ears and face, as well as dizziness. If you have a history of allergies or respiratory issues, this could further complicate your symptoms.

Additionally, anxiety and stress can significantly impact physical health, leading to symptoms such as dizziness, headaches, and a sensation of pressure in the head. Anxiety can cause hyperventilation, which may lead to feelings of lightheadedness and difficulty concentrating. If you are prone to anxiety, it may be beneficial to explore relaxation techniques or cognitive-behavioral strategies to manage your stress levels.

Given the complexity of your symptoms, it would be advisable to follow up with a healthcare provider who can conduct a thorough evaluation. This may include a neurological examination, imaging studies such as an MRI or CT scan to rule out any structural issues, and possibly vestibular testing to assess your balance function. If your symptoms persist or worsen, seeking a second opinion or consulting a neurologist may be beneficial.

In the meantime, consider keeping a symptom diary to track when your dizziness occurs, its duration, and any associated factors such as stress levels, dietary habits, or sleep patterns. This information can be invaluable for your healthcare provider in determining the most appropriate course of action.

In summary, dizziness and head pressure can stem from various causes, including vestibular disorders, sinus issues, and anxiety. A comprehensive evaluation by a healthcare professional is essential to identify the underlying cause and develop an effective treatment plan. Meanwhile, managing stress and anxiety through relaxation techniques may help alleviate some of your symptoms.

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