Unexplained Neurological Symptoms: Dizziness and Weakness

Unknown etiology

Hello, after I sneezed (I have allergic rhinitis), I initially experienced dizziness and immediately sat down.
My hands felt weak, and I wanted to grab my phone to call for help, but I felt somewhat out of control.
There was a tingling sensation, sweating, and an urge to have a bowel movement (I also have constipation).
After a while (about 30 minutes), the symptoms became less pronounced, but I still felt something was off.
Two nights later, after turning my neck, I suddenly felt a strange sensation at the back of my head (a slight feeling that my balance was off, but I could still control it).
My right pinky and ring fingers suddenly felt slightly curled (like a cramp) with a tingling sensation, but I could still manage it.
I experienced chest tightness, felt like my breathing was not smooth, sweating, and an urge to have a bowel movement (I also went to the bathroom).
The symptoms were milder than during the sneezing episode.
After resting and sleeping, the next day I woke up with this feeling persisting throughout the day, particularly in the back of my head, neck, shoulders, and both hands, especially the right hand, which seemed to have a tingling sensation.
The dizziness also seemed to occur occasionally, and during these episodes, I would also feel the urge to have a bowel movement and sweating.
Based on these symptoms, please give me your advice.
Thank you.

Little JOHN, 30~39 year old female. Ask Date: 2010/08/30

Dr. Jiang Hezhou reply Neurology

1.
Severe sneezing may potentially trigger the Valsalva maneuver phenomenon, leading to insufficient venous return and related symptoms.
However, a face-to-face consultation and physical and neurological examinations are necessary to rule out other conditions!
2.
Symptoms may also be associated with cervical radiculopathy, acute spinal cord syndrome, ulnar nerve pathology, myofascial pain syndrome, or other functional disorders with associated dysfunction.
Nonetheless, other conditions must still be ruled out!
3.
It is advisable to seek medical evaluation and examination!

Reply Date: 2010/08/30

More Info

It sounds like you are experiencing a complex set of neurological symptoms that can be quite distressing. The symptoms you've described, including dizziness, weakness in your arms, a tingling sensation, sweating, and gastrointestinal urges, can be indicative of several underlying conditions. Let's break down your symptoms and discuss potential causes and next steps for evaluation and management.

Understanding Your Symptoms
1. Dizziness and Weakness: Dizziness can arise from various causes, including vestibular disorders (related to the inner ear), neurological issues (such as migraines or transient ischemic attacks), or even anxiety. The weakness in your arms, particularly if it is unilateral (affecting one side), could suggest a neurological event, such as a stroke or a transient ischemic attack (TIA).
2. Tingling Sensation: The tingling or "pins and needles" sensation you describe can be due to nerve compression or irritation, which might occur due to posture or muscle tension. It can also be associated with anxiety or panic attacks, where hyperventilation leads to changes in blood gas levels, causing tingling sensations.

3. Sweating and Gastrointestinal Symptoms: The sweating and urge to defecate could be related to autonomic nervous system responses, which can be triggered by stress, anxiety, or even certain neurological conditions. The fact that you have a history of constipation may also play a role, as straining can sometimes lead to vagal responses that cause dizziness and faintness.

4. Neck Movement and Symptoms: The peculiar sensations you experienced after turning your neck could indicate cervical spine issues, such as cervical spondylosis or nerve root compression. These conditions can lead to symptoms that radiate into the arms and can affect balance.

Next Steps for Evaluation
Given the complexity of your symptoms, it is essential to seek a thorough evaluation from a healthcare professional, preferably a neurologist. Here are some recommended steps:
1. Neurological Examination: A comprehensive neurological examination can help identify any focal neurological deficits that may indicate a more serious condition.

2. Imaging Studies: Depending on the findings from your examination, imaging studies such as an MRI or CT scan of the brain and cervical spine may be warranted to rule out structural abnormalities, such as herniated discs or lesions.

3. Blood Tests: Routine blood tests, including a complete blood count, metabolic panel, and thyroid function tests, can help identify any underlying metabolic or systemic issues.

4. Vestibular Assessment: If dizziness persists, a vestibular assessment may be necessary to evaluate the function of your inner ear and balance system.

5. Cardiovascular Evaluation: Given the symptoms of sweating and potential autonomic involvement, a cardiovascular evaluation may also be appropriate to rule out any heart-related issues.

Management Strategies
1. Lifestyle Modifications: Managing stress through relaxation techniques, regular exercise, and a balanced diet can help alleviate some symptoms.
2. Physical Therapy: If cervical spine issues are identified, physical therapy may be beneficial to strengthen neck muscles and improve posture.

3. Medication: Depending on the diagnosis, medications may be prescribed to manage symptoms, such as anti-anxiety medications or medications to address vestibular dysfunction.

4. Follow-Up: Regular follow-up with your healthcare provider is crucial to monitor your symptoms and adjust your treatment plan as necessary.

Conclusion
Your symptoms warrant careful evaluation to determine their underlying cause. While some of your symptoms may be related to anxiety or benign conditions, others could indicate more serious neurological issues. It is essential to consult with a healthcare professional who can guide you through the diagnostic process and develop an appropriate treatment plan. Remember, early intervention can often lead to better outcomes, so do not hesitate to seek help.

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