Persistent Dizziness: When to Seek Neurological Evaluation - Neurology

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Persistent dizziness can be a concerning symptom, especially when it has changed in character or intensity over time. Given your history of a head injury eight years ago, along with the recent onset of significant dizziness and neurological symptoms such as numbness in your right hand and foot, it is crucial to seek a thorough neurological evaluation.


When to Seek Neurological Evaluation
You should consider seeing a neurologist if you experience any of the following symptoms:
1. Persistent Dizziness: If your dizziness has lasted for more than a month and is not responding to treatment, it warrants further investigation.

2. Neurological Symptoms: The new onset of numbness in your right hand and foot is particularly concerning. This could indicate a neurological issue that needs to be evaluated.

3. Changes in Symptoms: Any change in the nature of your dizziness, such as it becoming more severe or associated with other symptoms like headaches, visual disturbances, or difficulty with coordination, should prompt a visit to a specialist.

4. Balance Issues: If you are experiencing difficulties with balance or coordination, especially if you feel like the environment is moving or you feel heavy-headed, these are red flags that should not be ignored.


Possible Causes of Your Symptoms
Your symptoms could be indicative of several conditions, including:
- Post-Concussion Syndrome: Given your history of head trauma, it’s possible that you are experiencing lingering effects from that injury, which can manifest as dizziness, headaches, and cognitive difficulties.

- Vestibular Disorders: Conditions affecting the inner ear can lead to dizziness and balance issues. These may not always be related to head trauma but can be exacerbated by it.

- Cervical Spine Issues: Sometimes, neck problems can lead to dizziness, especially if there is nerve involvement or if the blood flow to the brain is compromised.

- Neurological Disorders: Conditions such as multiple sclerosis or other demyelinating diseases could present with your symptoms, particularly the numbness and dizziness.


Recommended Steps
1. Schedule an Appointment with a Neurologist: Given your symptoms, it’s advisable to see a neurologist who can perform a comprehensive evaluation. They may conduct a physical examination, neurological tests, and possibly imaging studies such as an MRI or CT scan to assess for any structural issues in the brain or spine.


2. Consider a Vestibular Evaluation: If the neurologist suspects a vestibular disorder, they may refer you to an otolaryngologist (ENT specialist) or a vestibular rehabilitation therapist for further assessment.

3. Document Your Symptoms: Keep a detailed record of your symptoms, including when they occur, their duration, and any associated factors (like changes in position or activity). This information can be invaluable for your healthcare provider.

4. Avoid High-Risk Activities: Until you have been evaluated, it may be wise to avoid activities that could put you at risk of falls or injury, especially if you are experiencing significant dizziness.


Conclusion
In summary, your persistent dizziness, especially in conjunction with new neurological symptoms, is a valid reason to seek a neurological evaluation. Early diagnosis and intervention can be crucial in managing any underlying conditions effectively. Do not hesitate to reach out to a healthcare professional to discuss your symptoms and get the appropriate care.