Persistent Dizziness: Should You Worry About Serious Conditions?

Dizziness has persisted for a long time?

Hello, Dr.
Jiang.
About two weeks ago, I experienced dizziness and instability one night.
I don't feel like the world is spinning, but the dizziness is quite mild and persists throughout the day.
I feel a bit unsteady while walking.
It's been two weeks now, and I've visited the clinic twice.
The first time, they said it was due to lack of sleep and inner ear imbalance.
Yesterday, they suggested it might be caused by fatigue, but if the medication doesn't improve my condition, I should see a neurologist at the hospital.
Could this possibly be a serious illness like a stroke?

Harry, 20~29 year old female. Ask Date: 2023/02/14

Dr. Jiang Junyi reply Neurology

Dear Mr.
Harry,
You are concerned about the possibility of a serious illness such as a stroke, correct? Your symptoms should first be considered in the context of vestibular neuritis.
Vestibular neuritis is associated with vertigo and primarily occurs in young adults, often following a viral infection after a cold that causes inflammation of the vestibular nerve.

For treatment, medications such as antihistamines for vertigo, prokinetic agents to promote gastrointestinal motility, and anxiolytics are usually helpful.
The addition of corticosteroids may enhance the treatment effect, but it is important to be aware of the potential side effects of corticosteroid use.
Given your age, the risk of having a stroke is extremely low.

It is important to be mindful of risk factors such as diabetes, followed by hypertension, smoking, and hyperlipidemia.
Prolonged exposure to these risk factors can lead to atherosclerosis, increasing the likelihood of cerebrovascular and cardiovascular diseases.

I recommend that you consult a neurologist to discuss further examination and treatment options.
Thank you for your inquiry, and feel free to reach out for further discussion.
Wishing you good health and peace,
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2023/02/14

More Info

Persistent dizziness can be a concerning symptom, and it’s understandable to worry about serious underlying conditions, especially when it persists for an extended period. However, it’s important to approach this issue with a clear understanding of potential causes and the appropriate steps to take.

Dizziness can arise from a variety of factors, and it is often categorized into two main types: peripheral and central dizziness. Peripheral dizziness is typically related to issues in the inner ear, such as vestibular disorders, while central dizziness may stem from neurological conditions affecting the brain. Given that you’ve experienced this sensation for two weeks, it’s crucial to consider both possibilities.

The initial assessments you received—suggesting that your dizziness may be due to lack of sleep or fatigue—are common explanations for mild, persistent dizziness. Sleep deprivation can significantly affect your overall health, leading to symptoms such as dizziness, fatigue, and difficulty concentrating. Similarly, fatigue can impair your body's ability to maintain balance and coordination, resulting in feelings of unsteadiness.

However, it’s wise to remain vigilant, especially since dizziness can sometimes be a symptom of more serious conditions, including stroke or transient ischemic attacks (TIAs). While the likelihood of these serious conditions increases with additional symptoms such as severe headache, vision changes, difficulty speaking, or weakness on one side of the body, it’s essential to consult a healthcare professional if you experience any of these alarming signs.

If your dizziness persists despite rest and medication, it is advisable to follow up with a neurologist, as suggested by your healthcare provider. A neurologist can conduct a thorough evaluation, which may include imaging studies like an MRI or CT scan, to rule out any serious neurological conditions. They may also assess your vestibular function through specialized tests to determine if the dizziness is related to inner ear problems.

In the meantime, consider implementing some lifestyle changes that may help alleviate your symptoms. Ensure you are getting adequate sleep, staying hydrated, and managing stress levels. Engaging in light physical activity, such as walking or gentle stretching, can also promote better circulation and balance. If you find that certain movements or positions exacerbate your dizziness, try to avoid them and move slowly when changing positions.

Lastly, it’s essential to communicate openly with your healthcare providers about your symptoms and any changes you experience. Keeping a symptom diary can be beneficial, noting when the dizziness occurs, its intensity, and any associated factors (like fatigue or stress). This information can help your doctor make a more accurate diagnosis and tailor a treatment plan that suits your needs.

In summary, while persistent dizziness can be concerning, it is often related to less serious causes such as fatigue or inner ear imbalances. However, it is crucial to remain proactive in seeking medical advice, especially if your symptoms do not improve or worsen. By staying informed and engaged in your healthcare, you can work towards finding relief and addressing any underlying issues effectively.

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