Persistent Head Sensations: Dizziness, Pressure, and Sleep Issues

Q: Persistent Head Sensations: Dizziness, Pressure, and Sleep Issues

Hello, Ruid： The symptoms mentioned above are suggestive of balance dysfunction. <br>If appropriate rest and sleep do not improve the symptoms, it is recommended to visit a neurology outpatient clinic for evaluation.

Sensation of swaying, feeling of an earthquake, heaviness in the back left side of the head?

Hello Doctor, for the past two weeks, I have been experiencing a sensation of my head shaking throughout the day, whether I am sitting or standing.
Sometimes, I feel like there is an earthquake, a sudden feeling of falling, or a sensation as if I am on a boat.
This is especially pronounced when I am standing and looking down or bending over.
Walking feels slightly better, and I hardly notice it when riding a motorcycle.
When I sit and focus on a single point, I feel like my head is spinning.
Additionally, the area at the back of my left head and extending to my left neck feels very heavy and tight.
If I tilt my head to the left, I feel a tight and full sensation in the back of my head on the left side.
If I tilt my head to the right without exerting effort, it automatically turns back to the left.

For the past week, I have also felt a constant sensation of fullness or blockage in my left ear, along with a feeling of heaviness and slight pain in my left brain, and my left hand often feels somewhat weak.
The shaking sensation has occurred occasionally over the past year, with sudden feelings of earthquake or shaking, but it has not been as constant as it has been in the last two weeks.

About a month ago, I was sleeping every day, but during the day, I constantly felt the urge to yawn, with one yawn immediately followed by another, and often I couldn't yawn at all.
I have been struggling with severe insomnia for a long time, and going two days without sleep is common for me.
I wonder if this could be due to long-term sleep deprivation causing autonomic nervous system dysregulation, but I am also worried that it might indicate serious brain or neck issues, or even a stroke.

Additionally, for the past week, I have been taking half a tablet each of Flunarizine and Mirtazapine before bed to help with sleep.
I am unsure if these symptoms are related to the medications.
I apologize for the lengthy explanation, and thank you, Doctor.

Rui De, 20~29 year old female. Ask Date: 2022/10/06

Dr. Cai Zongzhang reply Neurology

Hello, Ruid: The symptoms mentioned above are suggestive of balance dysfunction.
If appropriate rest and sleep do not improve the symptoms, it is recommended to visit a neurology outpatient clinic for evaluation.

Reply Date: 2022/10/06

More Info

Dear Patient,
Thank you for sharing your detailed symptoms and concerns. It sounds like you are experiencing a complex set of issues that are affecting your daily life significantly. Based on your description, you are dealing with persistent sensations of dizziness, pressure in your head, and sleep disturbances, which can be quite distressing.

Firstly, the sensations of dizziness and the feeling of your head moving or shaking can be attributed to several potential causes. These may include vestibular disorders, which affect the inner ear and balance, or could be related to cervical spine issues, especially given your description of tightness and heaviness in the left side of your head and neck. The fact that you feel a pulling sensation when tilting your head could indicate muscle tension or even nerve involvement in the cervical region.

The pressure and discomfort in your left ear, along with the sensation of it being blocked, may suggest Eustachian tube dysfunction or even an inner ear issue, which can also contribute to feelings of dizziness. Additionally, the heaviness and tightness in your neck and head could be related to tension-type headaches, which are often exacerbated by stress, poor posture, or prolonged periods of inactivity.

Your mention of severe insomnia is particularly concerning. Chronic sleep deprivation can lead to a range of neurological symptoms, including cognitive impairment, mood disturbances, and increased sensitivity to pain. It can also exacerbate feelings of dizziness and disorientation. The medications you mentioned, such as "煩多閃" (which I assume is a sleep aid) and "美舒鬱" (likely an antidepressant), can have side effects that include dizziness and sedation, particularly if they are not well-tolerated or if there is an interaction between them.

Given the complexity of your symptoms, I recommend the following steps:
1. Neurological Evaluation: It is crucial to have a thorough neurological examination to rule out any serious conditions, such as a stroke or other neurological disorders. An MRI of the brain and cervical spine may be warranted based on your symptoms, especially considering the history of severe insomnia and the recent onset of these sensations.

2. Vestibular Assessment: A referral to an ENT specialist or a vestibular therapist may be beneficial to evaluate your balance and inner ear function. They can perform specific tests to determine if there is an underlying vestibular disorder contributing to your symptoms.

3. Sleep Study: Given your history of severe insomnia, a sleep study (polysomnography) could help identify any sleep disorders, such as sleep apnea, that may be affecting your overall health and contributing to your daytime symptoms.

4. Physical Therapy: If muscle tension or cervical spine issues are contributing to your symptoms, physical therapy may help alleviate some of the tightness and improve your posture, which can, in turn, reduce headaches and dizziness.

5. Medication Review: It may be beneficial to review your current medications with your prescribing physician to ensure they are appropriate for your symptoms and to discuss any potential side effects that may be contributing to your dizziness or fatigue.

6. Stress Management: Incorporating stress management techniques, such as mindfulness, yoga, or cognitive behavioral therapy, may help alleviate some of the anxiety and tension that could be exacerbating your symptoms.

In conclusion, while your symptoms are concerning, a comprehensive evaluation by a healthcare professional will be essential in determining the underlying causes and appropriate treatment. Please do not hesitate to seek immediate medical attention if your symptoms worsen or if you experience any new neurological signs, such as weakness, numbness, or changes in vision. Your health and well-being are of utmost importance.

Best wishes for your health and recovery.

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