Dizziness
Hello Dr.
Huang: My mother is currently 75 years old and has been experiencing dizziness since she was in her thirties.
Her symptoms include a feeling of unsteadiness while walking.
She has consulted with an ear specialist and has taken many medications for dizziness, but nothing has worked.
She even underwent thyroid surgery due to her dizziness, but it was ineffective, and she has never returned to normal.
I kindly ask for your guidance on how to treat her dizziness, as it is truly distressing.
Thank you.
Zi Zi, 20~29 year old female. Ask Date: 2007/09/07
Dr. Huang Yongquan reply Neurology
Hello: In response to your question.
Based on your description, it seems that this condition has been occurring since your youth and continues to present with dizziness.
If the dizziness is intermittent and accompanied by nausea and vomiting, the most common issue is related to the vestibular nerve in the inner ear, such as benign paroxysmal positional vertigo (BPPV).
If there is tinnitus and hearing loss, it may indicate Meniere's disease.
The patient's description of feeling "floaty" in the legs, which is a non-rotational type of dizziness, primarily needs to be assessed for any positional correlation.
If there is a connection, it could be related to anemia or orthostatic hypotension.
If the dizziness is persistent and unrelated to movement, it is often associated with chronic conditions, insomnia, or autonomic nervous system dysregulation.
Most long-term dizziness symptoms, as described by this patient, do not respond well to medication; instead, some educational interventions may be more helpful.
It is important to maintain adequate sleep, engage in moderate exercise, and during acute episodes, avoid rapid head movements or bending down.
Finding a quiet environment to lie down or sit is advisable.
You may also consider obtaining some antiemetic or anti-vertigo medications from your physician.
There are many causes of dizziness, and most diagnoses rely on the patient's history and description, as there are not many tests that can definitively confirm a diagnosis.
If you have further questions, you may consult a neurologist or an otolaryngologist.
Reply Date: 2007/09/07
More Info
Chronic dizziness in seniors can be a complex issue, often stemming from a variety of underlying causes. Given your mother's history of dizziness since her thirties, it is essential to consider both common and less common causes of dizziness in older adults.
Common Causes of Chronic Dizziness in Seniors
1. Vestibular Disorders: The vestibular system, which helps control balance, can deteriorate with age. Conditions such as Benign Paroxysmal Positional Vertigo (BPPV) can cause episodes of dizziness, especially when changing head positions.
2. Cerebrovascular Issues: Reduced blood flow to the brain due to vascular conditions can lead to dizziness. This includes transient ischemic attacks (TIAs) or strokes, which may present with dizziness as a symptom.
3. Medication Side Effects: Many medications, especially those for hypertension, depression, or anxiety, can cause dizziness as a side effect. It’s crucial to review all medications with a healthcare provider to identify any potential culprits.
4. Inner Ear Problems: Conditions such as Meniere's disease or vestibular neuritis can lead to chronic dizziness. These conditions often require specific treatments or therapies.
5. Neurological Disorders: Diseases such as Parkinson's disease or multiple sclerosis can also manifest as dizziness due to their effects on the nervous system.
6. Dehydration and Nutritional Deficiencies: Older adults are at risk for dehydration and may also have deficiencies in essential vitamins and minerals, which can contribute to dizziness.
7. Anxiety and Depression: Psychological factors can also play a significant role in chronic dizziness. Anxiety can lead to a heightened perception of dizziness, while depression can contribute to a general sense of malaise.
Treatment Options
1. Comprehensive Evaluation: The first step in managing chronic dizziness is a thorough evaluation by a healthcare provider. This may include a physical examination, blood tests, imaging studies (like MRI or CT scans), and possibly referrals to specialists such as neurologists or otolaryngologists.
2. Vestibular Rehabilitation Therapy (VRT): If the dizziness is related to vestibular disorders, VRT can be beneficial. This therapy involves exercises designed to improve balance and reduce dizziness.
3. Medication Review: If medications are contributing to dizziness, your mother's healthcare provider may consider adjusting her prescriptions or switching to alternatives that have fewer side effects.
4. Hydration and Nutrition: Ensuring adequate hydration and addressing any nutritional deficiencies can help alleviate dizziness. A diet rich in fruits, vegetables, whole grains, and lean proteins is recommended.
5. Cognitive Behavioral Therapy (CBT): If anxiety or depression is a contributing factor, CBT can be effective in managing these conditions and may help reduce the perception of dizziness.
6. Lifestyle Modifications: Encouraging your mother to avoid sudden movements, stay hydrated, and engage in gentle physical activity can help manage her symptoms.
7. Follow-Up Care: Regular follow-up appointments with her healthcare provider are essential to monitor her condition and adjust treatment as necessary.
Conclusion
Chronic dizziness in seniors is a multifaceted issue that requires a comprehensive approach to diagnosis and treatment. Given your mother's long-standing symptoms, it is crucial to work closely with her healthcare provider to identify the underlying causes and develop an effective management plan. Encourage her to keep a diary of her symptoms, noting when they occur and any potential triggers, as this information can be invaluable for her healthcare team. With the right interventions, it is possible to improve her quality of life and reduce the impact of dizziness on her daily activities.
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