Persistent Dizziness: Causes and Next Steps - Neurology

More Info

---

Persistent dizziness can be a challenging and frustrating condition to manage, especially when it has lasted for an extended period, as in your case of nearly two years. Your description of the dizziness—specifically that it occurs primarily when walking, accompanied by a sensation of unsteadiness and visual disturbances—provides some important clues for potential underlying causes.


Possible Causes of Your Dizziness
1. Vestibular Disorders: Given that your dizziness is more pronounced during movement, it may be related to vestibular dysfunction. Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or labyrinthitis can cause dizziness, particularly when changing positions or moving. However, these conditions often present with more intense spinning sensations.

2. Cervical Vertigo: You mentioned that a physician suggested poor circulation in the posterior cervical vessels. This can lead to cervical vertigo, where neck issues, such as cervical spondylosis or muscle tension, affect blood flow and nerve function, leading to dizziness. The straightening of your cervical spine could contribute to this, as it may affect the alignment and function of the cervical structures.

3. Neurological Issues: Although you have undergone MRI scans and blood tests that did not reveal any significant issues, it is important to consider that some neurological conditions may not always be apparent on initial imaging. Conditions like migraines can also present with dizziness without the classic headache.

4. Anxiety and Stress: Psychological factors can also play a significant role in dizziness. Anxiety can manifest physically, leading to sensations of dizziness or lightheadedness, particularly in situations that provoke stress or anxiety.

5. Medication Side Effects: If you have been prescribed medications, such as those for circulation, it is worth considering whether they might have side effects that contribute to your dizziness.


Next Steps for Evaluation
1. Further Neurological Assessment: If you have not already, consider a comprehensive evaluation by a neurologist who specializes in dizziness and balance disorders. They may recommend additional tests, such as vestibular function tests or a tilt table test, to assess your balance system more thoroughly.

2. Physical Therapy: Vestibular rehabilitation therapy (VRT) can be beneficial for individuals with dizziness. A physical therapist specialized in vestibular disorders can provide exercises to help improve balance and reduce dizziness.

3. Cervical Spine Evaluation: Since you have cervical spine issues, consulting with a spine specialist or a physical therapist who can assess your neck's alignment and function may be helpful. They can provide targeted exercises to strengthen neck muscles and improve posture.

4. Lifestyle Modifications: Keeping a diary of your dizziness episodes, including triggers and associated activities, can help identify patterns. Additionally, ensuring proper hydration, managing stress, and avoiding sudden movements may help mitigate symptoms.

5. Consider Psychological Factors: If anxiety or stress is suspected, speaking with a mental health professional may provide strategies to manage these feelings, which could, in turn, alleviate some of your dizziness.


Conclusion
Persistent dizziness can stem from various causes, and it often requires a multidisciplinary approach for effective management. Since you have already seen specialists and undergone several tests, it may be beneficial to revisit your healthcare providers with this comprehensive perspective. They can help guide you through further evaluations and potential treatments tailored to your specific situation. Remember, it’s essential to communicate openly about your symptoms and any changes you experience, as this will aid in finding the most effective management strategy for your dizziness.