Dizziness, Nausea, and Weakness: When to Seek Help

Dizziness, nausea, and weakness?

Hello Dr.
Hong, in the past week, I have been experiencing dizziness, headaches, and nausea (one day it was quite severe).
I also feel some weakness in my hands, and I have pain around my glabella and from the right side of my nose to the area around my right eye.
Maintaining my gaze to the right side increases the pain, and occasionally I experience tinnitus in my right ear.

1.
I would like to ask what possible issues this could be.
2.
Are there any specific diseases that I should be particularly concerned about?
3.
Should I see an otolaryngologist, an ophthalmologist, or another specialist?
Thank you for your assistance!

yk, 30~39 year old female. Ask Date: 2022/07/17

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, it is recommended to first check your blood pressure to see if it is elevated.
The higher likelihoods could be due to elevated intraocular pressure, inner ear inflammation, or migraines.
It is advisable to first consult an ophthalmologist, especially for an intraocular pressure examination.
If the ophthalmological evaluation is normal, you should then see an otolaryngologist to check for middle ear or inner ear inflammation.
If both the ophthalmology and otolaryngology evaluations are normal, you may ultimately need to consult a neurologist for further examination.
Thank you for your inquiry.

Reply Date: 2022/07/17

More Info

Hello, and thank you for reaching out with your concerns regarding your recent symptoms of dizziness, nausea, weakness, and localized pain. It’s important to address these symptoms promptly, as they can be indicative of various underlying health issues.

Possible Causes of Your Symptoms
1. Migraine: The combination of headache, nausea, and dizziness could suggest a migraine, particularly if the pain is unilateral (on one side of the head) and associated with visual disturbances or sensitivity to light and sound. Migraines can also cause aura symptoms, which may include visual changes or sensory disturbances.

2. Vestibular Disorders: Conditions affecting the inner ear, such as vestibular neuritis or Meniere's disease, can lead to dizziness, nausea, and ear ringing (tinnitus). These disorders often result in balance issues and may cause episodes of vertigo.

3. Sinusitis: Given the pain around your nasal bridge and eye, sinusitis could be a contributing factor. Inflammation of the sinuses can lead to pressure, headaches, and sometimes dizziness.

4. Neurological Issues: The symptoms you describe, particularly the localized pain and weakness, could also suggest a neurological issue. Conditions such as multiple sclerosis or transient ischemic attacks (TIAs) can present with similar symptoms, although they are less common.

5. Blood Pressure Fluctuations: Dizziness and weakness can also arise from changes in blood pressure, particularly if you have been dehydrated or have been experiencing stress or anxiety.

When to Seek Help
Given the range of potential causes, it is crucial to seek medical attention, especially since your symptoms have been persistent and severe. Here are some guidelines on when to seek help:
- Severe Symptoms: If you experience severe headache, sudden weakness, difficulty speaking, or changes in vision, you should seek immediate medical attention, as these could be signs of a stroke or other serious condition.

- Persistent Symptoms: If your dizziness, nausea, or pain persists for more than a few days or worsens, it is advisable to consult a healthcare provider.

- Associated Symptoms: If you develop additional symptoms such as fever, confusion, or loss of consciousness, seek emergency care.

Which Specialist to See
Based on your symptoms, you might consider starting with the following specialists:
1. Ear, Nose, and Throat (ENT) Specialist: Given your ear ringing and potential sinus involvement, an ENT can evaluate for vestibular disorders or sinus issues.

2. Neurologist: If your symptoms suggest a neurological cause, a neurologist can perform the necessary evaluations, including imaging studies if needed.

3. Primary Care Physician: Your primary care doctor can also be a good starting point. They can assess your symptoms, perform initial tests, and refer you to a specialist if necessary.

Conclusion
In summary, your symptoms warrant a thorough evaluation to determine the underlying cause. It is essential to monitor your symptoms closely and seek medical advice promptly. Early intervention can lead to better outcomes and management of any potential health issues. Please take care of yourself, and do not hesitate to reach out to a healthcare provider for further assistance.

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