Persistent Dizziness, Headaches, and Unseen Tremors

Dizziness, headache, and unseen body tremors?

I would like to ask the doctor, I have been experiencing a sensation of dizziness for the past three months.
It is not a spinning sensation, nor does the visual field appear to be swirling; rather, it feels like being on a boat, with a sense of weightlessness that makes me feel dizzy and nauseous.
This occurs whether I am sitting at the computer, lying down while using my phone, or even when I lean against a wall when I am tired.
Sometimes, even while crossing the street, I experience this dizziness.
When lying down and looking at my phone, if I move my legs, the sensation becomes more pronounced (possibly due to oxygen deprivation).
At times, I also feel weak, and in the past week, I have had noticeable headaches, particularly pain located at the lower left side of my occiput, along with neck pain.
Additionally, there is discomfort in the upper left side of my head, and sometimes my eyes and nose feel uncomfortable as well.
When lying down, if I press on the left side of my head, it also hurts.
I also experience various other body pains that are not consistent.
In the mornings, I sometimes wake up with pain in my hands or feet, which feels like inflammatory pain.
I have a history of adenomyosis and iron deficiency anemia (I have been taking iron supplements for three months, with levels around 8), and I also have mild mitral valve prolapse.
My job as an engineer requires prolonged sitting at the computer, and sometimes just using the computer for a short time makes me feel extremely dizzy, with the screen appearing to move around, or when I turn my head to look at another monitor, I also feel dizzy.
Additionally, I have been experiencing body tremors for several months, which are not visible, so initially, I thought it was a psychological issue.
It wasn't until someone I sleep with mentioned that it felt like an earthquake that I realized it was my body shaking.
My personal sensation is akin to the vibration felt when a large truck passes beneath my feet or the minor tremors felt before an earthquake.
I commute by long-distance motorcycle, and the most intense vibrations are felt when I get off after my ride home (my heart also races).
I have been seeing a neurologist and have previously undergone nerve conduction studies.
The doctor mentioned sciatica but did not identify any other conditions, and my symptoms have been interpreted based on my hemoglobin levels.
However, I have been troubled by the issues mentioned above for a long time, which have even affected my quality of life.
I would like to consult a doctor to see if there are any other potential conditions that could be investigated.

Hong, 20~29 year old female. Ask Date: 2024/08/02

Dr. Jiang Junyi reply Neurology

Hello Ms.
Hong,
You mentioned, "Sometimes I wake up in the morning with pain in my hands and sometimes in my feet, and the pain feels like inflammation..." Due to the presence of widespread pain, fibromyalgia should be considered.
This is a complex clinical syndrome that may be related to an imbalance of neurotransmitters in the central nervous system.
The primary symptoms in patients include chronic widespread pain and tenderness, along with other systemic symptoms and comorbidities such as fatigue, insomnia, headaches, gastrointestinal symptoms, depression, and anxiety.
These distressing symptoms often affect the patient's quality of life and can lead to significant disability.
If there are multiple issues, the recommended approach is to seek a different physician for a new perspective on treatment.
It is advisable to find a nearby hospital with an emergency department to integrate medical information and understand the purpose and timing of each medication being used.

From my clinical perspective, bodily ailments are dynamic and require adjustments in medical treatment as the body changes.
However, Western medicine tends to categorize diseases for efficiency in management.
The holistic concept considers various symptoms of the body.
I suggest consulting a rheumatologist to discuss your concerns.
Thank you for your inquiry, and feel free to reach out for further discussion on related issues! Wishing you good health, peace, and joy.
Dr.
Jiang Junyi, Taoyuan Medical Center / Hualien Medical Center

Reply Date: 2024/08/02

More Info

Your symptoms of persistent dizziness, headaches, and the sensation of tremors can be quite distressing and may stem from a variety of underlying causes. Given your detailed description, it’s essential to consider several potential factors that could be contributing to your condition.

Firstly, the sensation of dizziness that you describe as feeling like being on a boat or experiencing a loss of weight can be indicative of vestibular disorders. These disorders affect the inner ear and brain areas that help control balance and eye movements. Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or even Meniere's disease could be potential culprits. Since you mentioned that the dizziness occurs regardless of your position (sitting, lying down, or standing), it may be worthwhile to consult an ear, nose, and throat (ENT) specialist for a thorough evaluation.

The headaches you are experiencing, particularly localized to the left posterior area of your head, could be tension-type headaches or migraines. Given your history of prolonged computer use, it’s also possible that muscle tension in your neck and shoulders is contributing to your headaches. Poor posture while working at a computer can lead to muscle strain, which can manifest as headaches and neck pain. Implementing ergonomic adjustments to your workstation and taking regular breaks to stretch may help alleviate some of these symptoms.

Your mention of feeling weak and experiencing pain in your limbs upon waking could be related to your underlying conditions, such as adenomyosis (uterine adenomyosis) and iron deficiency anemia. Anemia can lead to fatigue and weakness, and it’s crucial to ensure that your iron levels are adequately managed. Since you are already taking iron supplements, it may be beneficial to have your hemoglobin and ferritin levels rechecked to ensure they are improving.

The sensation of tremors that you describe, which others have noticed, could be a form of essential tremor or even a manifestation of anxiety. It’s not uncommon for stress and anxiety to produce physical symptoms, including tremors. Given your engineering background and the demands of prolonged computer work, stress management techniques such as mindfulness, yoga, or cognitive behavioral therapy may be beneficial.

Additionally, you mentioned having mitral valve prolapse, which can sometimes be associated with palpitations and anxiety. While it’s generally not a serious condition, it’s essential to monitor any cardiovascular symptoms you may experience, especially given your description of your heart racing after riding your motorcycle.

Since you have already consulted with a neurologist and undergone nerve conduction studies, it may be worthwhile to seek a second opinion or further evaluation from a different specialist, particularly if your symptoms persist or worsen. A comprehensive approach that includes a neurologist, an ENT specialist, and possibly a rheumatologist (to rule out any autoimmune conditions) could provide a more holistic understanding of your symptoms.

In summary, your symptoms could be multifactorial, involving vestibular issues, tension headaches, anemia, and possibly anxiety-related tremors. It’s crucial to continue working with your healthcare providers to explore these possibilities and develop a tailored treatment plan that addresses all aspects of your health. Regular follow-ups and open communication with your doctors will be key in managing your symptoms effectively and improving your quality of life.

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