Two Years of Dizziness: Unraveling the Mystery Behind Neurological Symptoms

Dizziness for two years with no identifiable cause?

About three years ago, I had to take a break from school due to panic attacks caused by dizziness.
During this time, I frequently visited the emergency room.
After being diagnosed two years ago, I suddenly experienced severe dizziness again, and treatments such as injections and medications were ineffective.
I consulted several hospitals, and both the neurology and otolaryngology departments found nothing abnormal, except for slightly elevated blood lipid levels.
After that, I saw a psychiatrist because the doctor believed my symptoms were psychologically induced, but I didn't agree with that perspective.
A few weeks ago, I experienced severe dizziness again and went to the emergency room, where the doctor noted that I had already undergone various tests.
Recently, my blood tests showed elevated lipid levels, approximately 252.
I asked the doctor if high lipid levels could cause dizziness, and he said no, but I found many online sources suggesting a connection.
Later, he prescribed me a medication called Cerebrolysin, which seemed to help a little, but I still feel uncomfortable.
I'm really at a loss and would like to ask if my prolonged dizziness could be related to my high lipid levels.

Chen, 10~19 year old female. Ask Date: 2024/01/11

Dr. Jiang Junyi reply Neurology

Dear Mr.
Chen,
You mentioned, "Could my dizziness be related to my long-standing high cholesterol?" Indeed, elevated cholesterol levels, particularly high LDL (low-density lipoprotein), can accelerate atherosclerosis.
High concentrations of LDL in the bloodstream can accumulate on the vessel walls, interacting with fibrinogen, platelets, and macrophages, leading to vascular atherosclerosis and obstruction.
Elevated LDL-C is considered a risk factor for vascular blockage.
Generally, an LDL-C level exceeding 130 mg/dL or an LDL-C/HDL-C ratio greater than 3.5 indicates a high-risk group for cardiovascular diseases such as coronary artery disease and stroke.
It is advisable to discuss with your physician about arranging a carotid ultrasound to assess your vascular health and blood flow status.

Thank you for your inquiry.
If you have further questions, feel free to discuss them.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2024/01/11

More Info

Dizziness can be a perplexing symptom, especially when it persists for an extended period, as you've described. Your situation involves a complex interplay of neurological, psychological, and possibly metabolic factors. Let's break down the potential causes and considerations regarding your dizziness and its relationship to elevated blood lipid levels.

Firstly, it's essential to understand that dizziness can stem from various sources, including vestibular disorders, neurological conditions, cardiovascular issues, and psychological factors. Given that you've undergone multiple evaluations by specialists in neurology and otolaryngology (ear, nose, and throat), and they found no significant abnormalities, we can explore other avenues.

1. Vestibular System: The vestibular system, which is responsible for balance, can be affected by various conditions. Benign Paroxysmal Positional Vertigo (BPPV) is one common cause of dizziness that can often be overlooked. It occurs when tiny calcium particles in the inner ear become dislodged, leading to episodes of vertigo. If you haven't been evaluated for this, it might be worth discussing with your healthcare provider.

2. Psychological Factors: Anxiety and panic disorders can manifest physically, leading to symptoms such as dizziness. Your history of panic attacks suggests that psychological factors could play a role in your symptoms. It's not uncommon for individuals with anxiety to experience dizziness, which can create a vicious cycle of fear and exacerbation of symptoms. Cognitive Behavioral Therapy (CBT) or other forms of psychotherapy may help address these underlying issues.

3. Metabolic Factors: Elevated blood lipid levels, particularly high cholesterol, are often associated with cardiovascular health. While your doctor indicated that high cholesterol is unlikely to directly cause dizziness, it can contribute to broader cardiovascular issues, such as atherosclerosis, which may affect blood flow to the brain. This reduced blood flow could potentially lead to dizziness, especially during physical exertion or changes in position. It’s crucial to manage your lipid levels through diet, exercise, and possibly medication, as recommended by your healthcare provider.

4. Medication Effects: You mentioned being prescribed a medication (likely a nootropic or cognitive enhancer) that seemed to help slightly. It's important to consider that medications can have varying effects on individuals. If you notice any side effects or if the medication does not seem to alleviate your symptoms, discussing this with your doctor is essential. They may need to adjust your treatment plan.

5. Further Investigations: If your symptoms persist despite treatment, further investigations may be warranted. This could include imaging studies like an MRI to rule out any structural abnormalities in the brain or inner ear. Additionally, a thorough cardiovascular evaluation might be beneficial to assess for any underlying issues that could contribute to your symptoms.

In conclusion, while high blood lipid levels may not be the direct cause of your dizziness, they could be part of a broader picture affecting your overall health. It's essential to maintain open communication with your healthcare providers, advocate for further evaluations if necessary, and consider a multidisciplinary approach that includes both physical and psychological assessments. Dizziness can be a multifaceted issue, and addressing it from various angles may lead to better management and relief of your symptoms.

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