Dizziness: Causes and When to Seek Medical Help

Possible Causes of Dizziness

Hello, Doctor.
I've been feeling unwell recently and would appreciate any advice you could offer.
Symptoms: For the past 20 days, I have frequently experienced dizziness, numbness in my hands, and a feeling of pressure in the back of my head.
It feels as if there is a constant, ongoing shaking or tremor.
The dizziness began about a week before the earthquake in Hualien, coinciding with my midterm preparations.
Initially, I thought it was due to the aftershocks, but later I considered that it might be due to insufficient rest.
However, the symptoms have persisted this week, which has raised my concern.
The timing of the symptoms varies daily; sometimes I wake up with them, while other times they occur in the afternoon or evening.
I'm not sure if it's related to fatigue, as I feel I have been resting adequately.
However, when I experience more severe dizziness, I tend to lie down, and after a while, I feel somewhat better.
The severity of the symptoms allows me to read, do homework, and walk, but the dizziness is quite bothersome, making it difficult to study effectively, which also discourages me from going out.

Lifestyle:
- I currently have some academic pressure, but I expect it to significantly decrease in about 10 days.
I believe I manage my stress fairly well, as I have maintained a similar lifestyle last semester, so I'm unclear about the relationship between my current symptoms and stress.

- I am not pregnant, not on my menstrual period, have not traveled abroad, and do not have pets.

- My daily routine is quite normal.
I used to exercise, but I've been hesitant to do so since the dizziness began.

- I do not have a blood pressure monitor, but I do not feel that my blood pressure is low.
My questions:
1.
Are there any indicators I can observe at home to learn more about my health?
2.
Based on the principle of "avoid seeing a doctor unless necessary," what symptoms or situations should prompt me to seek medical attention? Given my situation, which specialty should I consult? I apologize for taking up your time, and thank you for reading this message.

Chen Tongxue, 20~29 year old female. Ask Date: 2024/04/20

Dr. Jiang Junyi reply Neurology

Hello Ms.
Chen,
You mentioned experiencing symptoms such as dizziness, numbness in your hands, and a feeling of pressure at the back of your head.
After experiencing more severe dizziness, you tend to lie down, which provides some relief.
You are still able to read, do homework, and walk.
Your symptoms may need to rule out issues like anemia or dehydration, as lying down can alleviate them.
Increasing your fluid and electrolyte intake may help improve your symptoms.
Other potential causes could include autonomic dysfunction or inner ear imbalance, which may contribute to your physical symptoms.

Blood tests should be conducted to identify possible complications such as anemia, hyperthyroidism/hypothyroidism, diabetes, recurrent vestibular neuritis, autoimmune diseases, neurosyphilis, and central nervous system disorders.
You asked, "Are there any indicators I can observe at home to learn more about my health?" Monitoring your blood pressure with a sphygmomanometer could be beneficial.
Additionally, you might consider wearing a smartwatch with blood oxygen monitoring capabilities, such as the Apple S6, to track heart rate variability and blood oxygen levels.
Regarding your question about when to see a doctor based on the standard of "avoiding the doctor if possible," it would be advisable to seek medical attention if you observe concerning symptoms or conditions.
Given your situation, I recommend consulting a neurologist for further evaluation and treatment.
Thank you for your inquiry, and feel free to reach out for further discussion.
Wishing you good health, safety, and happiness.
Dr.
Jiang, Department of Neurology, Tzu Chi Hospital

Reply Date: 2024/04/20

More Info

Dizziness can be a perplexing symptom, and understanding its potential causes is crucial for determining when to seek medical help. Based on your description, it seems that you've been experiencing persistent dizziness, hand numbness, and a sensation of pressure in the back of your head for the past 20 days. These symptoms can be distressing, especially when they interfere with your daily activities, such as studying and going out.

Possible Causes of Dizziness
1. Vestibular Disorders: Conditions affecting the inner ear, such as benign paroxysmal positional vertigo (BPPV) or vestibular neuritis, can lead to dizziness. These conditions often present with a spinning sensation and may be triggered by changes in head position.

2. Anxiety and Stress: Given that you mentioned academic pressure, anxiety could be a contributing factor. Stress can manifest physically, leading to symptoms like dizziness, headaches, and even numbness in the extremities.

3. Cervical Issues: Tension or strain in the neck muscles can lead to dizziness and headaches. Poor posture, especially during study sessions, can exacerbate this.

4. Circulatory Issues: Although you feel your blood pressure is normal, fluctuations can occur, especially with stress or dehydration, leading to dizziness.

5. Neurological Concerns: While less common, persistent dizziness can sometimes indicate a neurological issue. Symptoms such as numbness and pressure in the head warrant further investigation.

When to Seek Medical Help
You should consider seeking medical attention if you experience any of the following:
- Severe Dizziness: If your dizziness becomes so intense that you cannot perform daily activities or if it leads to falls.

- Neurological Symptoms: If you experience additional symptoms such as severe headaches, vision changes, difficulty speaking, or weakness in limbs.

- Persistent Symptoms: If your dizziness does not improve or worsens over time, despite rest and stress management.

- Accompanying Symptoms: If you develop new symptoms such as chest pain, shortness of breath, or severe nausea.

Self-Monitoring at Home
While waiting to see a healthcare provider, you can monitor your symptoms at home:
1. Keep a Symptom Diary: Note when your dizziness occurs, its severity, and any accompanying symptoms. This can help identify triggers or patterns.

2. Hydration: Ensure you are drinking enough fluids, as dehydration can contribute to dizziness.

3. Rest and Relaxation: Practice stress-reduction techniques, such as deep breathing, meditation, or gentle stretching exercises.

4. Posture Awareness: Pay attention to your posture while studying or using devices. Ensure your workspace is ergonomically set up to reduce neck strain.

Which Specialist to Consult
Given your symptoms, starting with a visit to a primary care physician would be advisable. They can perform an initial evaluation and may refer you to a specialist, such as a neurologist or an ear, nose, and throat (ENT) specialist, depending on their findings.
In conclusion, while dizziness can stem from various causes, understanding your symptoms and knowing when to seek help is essential. Keep track of your symptoms, manage your stress, and don’t hesitate to reach out to a healthcare provider if your condition does not improve or worsens. Your health is paramount, and addressing these symptoms early can lead to better outcomes.

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