Persistent Dizziness and Headaches: When to Seek Help

Initially, there was dizziness, which progressed to dizziness and headache after a few days?

Hello Doctor, I have never experienced dizziness or headaches before! At the beginning of January this year, I suddenly felt a bit dizzy while reading (not the spinning type) and it lasted for about 3 to 4 days without improvement.
Later, I started to feel a tight pain in the area between my eyebrows.
I visited a family physician, who prescribed muscle relaxants and painkillers, but they were not very effective.
Eventually, I also began to feel tight pain at the top of my head and the back of my head (sometimes it feels like a specific area of my head is being pressed down, with a heavy sensation).
When it gets severe, even swallowing makes the top of my head hurt! The areas affected are (the area between my eyebrows), (the top of my head), and (the back of my head).
In mid-January, I went to a neurologist for an EEG and a CT scan of my brain, both of which were normal.
Therefore, the doctor concluded that it was due to tension and stress (the only stress I have now is hoping to recover quickly) caused by muscle soreness, and advised me to apply heat to my neck.
The doctor also prescribed medication for anxiety (because I told the doctor that since the dizziness and headaches started, I have been sleeping poorly, having vivid dreams, and waking up frequently).
After taking the medication, my sleep improved somewhat, but the dizziness and headaches have not shown significant improvement! From January until now, the tightness and dizziness (which feels like swaying, and sometimes a sensation of floating or almost falling) have not resolved.
Now, even looking at things feels very taxing; I constantly feel like my vision is scattered.
Out of 24 hours, I only feel somewhat okay when I am sleeping; being awake is very uncomfortable! The dizziness while walking feels more severe, but sitting or lying down is manageable! The tight pain has been persistent! I would like to ask the doctor if the tests I have undergone can completely rule out any brain-related diseases (no bleeding, no growths), or could this be caused by neurological issues? If brain-related problems are ruled out, what direction should I seek for treatment? I apologize for the lengthy explanation.

Xūyào yī zhǎn míngdēng, 20~29 year old female. Ask Date: 2010/03/23

Dr. Lin Zijing reply Neurology

Head pain is primarily felt in the walls of blood vessels, scalp nerves, and muscles.
Brain imaging studies can only rule out certain conditions (such as larger tumors or bleeding) but cannot diagnose the cause of headaches.
Most headaches are classified as tension-type headaches or vascular headaches, which are not detectable through imaging.
Basic treatment, in addition to medication, requires adjustments in daily life, such as regular exercise, maintaining a normal routine, avoiding prolonged static postures, and incorporating neck and head muscle stretching and massage, all of which can help alleviate headache symptoms.

Reply Date: 2010/03/23

More Info

It sounds like you are experiencing a complex set of symptoms that have persisted for several months, including persistent headaches and dizziness. Given your history and the results of your previous medical evaluations, it is understandable that you are seeking clarity on your condition and the appropriate next steps for treatment.

From your description, it appears that you have undergone a thorough evaluation, including brain imaging (CT scans) and EEGs, which have returned normal results. This is a positive sign as it suggests that there are no significant structural abnormalities in your brain, such as tumors, bleeding, or other serious conditions. However, the persistence of your symptoms indicates that there may be other underlying factors contributing to your discomfort.

Your symptoms of tightness and pain in various areas of your head, combined with dizziness and difficulty focusing, could be indicative of tension-type headaches or possibly a form of migraine. Tension headaches are often associated with stress, anxiety, and muscle tension, particularly in the neck and shoulders. The tightness you describe may be a result of muscle strain or tension, which can lead to referred pain in the head.

Additionally, the dizziness you are experiencing could be related to vestibular issues or even anxiety, especially if it worsens with stress or when you are in certain positions. Anxiety can manifest physically, leading to symptoms such as dizziness, difficulty concentrating, and sleep disturbances, which you have also mentioned.

Given that you have already seen a neurologist and received treatment for anxiety, it may be beneficial to explore a multidisciplinary approach to your care. Here are some recommendations:
1. Follow-Up with a Specialist: If you have not already done so, consider following up with a headache specialist or a neurologist who specializes in headache disorders. They can provide a more focused evaluation and may suggest treatments specifically tailored to your type of headache.

2. Physical Therapy: Engaging in physical therapy can be beneficial, especially if muscle tension is contributing to your headaches. A physical therapist can work with you on exercises to improve posture, strengthen neck muscles, and reduce tension.

3. Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor in your symptoms, CBT can be an effective treatment. It helps individuals develop coping strategies and address the thought patterns that contribute to anxiety and stress.

4. Lifestyle Modifications: Ensure you are practicing good sleep hygiene, managing stress through relaxation techniques (such as yoga or meditation), and maintaining a balanced diet. Regular physical activity can also help alleviate tension and improve overall well-being.

5. Medication Review: Since you mentioned that the medications prescribed have not provided significant relief, it may be worth discussing this with your healthcare provider. They might consider adjusting your medication or trying alternative treatments.

6. Consider Alternative Therapies: Some patients find relief through complementary therapies such as acupuncture, massage therapy, or chiropractic care. These can help alleviate muscle tension and improve overall comfort.

In summary, while your initial evaluations have ruled out serious neurological conditions, the persistence of your symptoms suggests that further exploration into tension-type headaches, anxiety, and muscle tension may be warranted. A comprehensive approach that includes medical, physical, and psychological support may provide you with the relief you are seeking. Always consult with your healthcare provider before making any changes to your treatment plan.

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