Persistent Dizziness and Heavy Head: Possible Causes and Solutions

Persistent and irregular episodes of dizziness and lightheadedness (heaviness in the back of the head)?

Hello Doctor: I suddenly experienced dizziness symptoms over two years ago, particularly when looking at the computer screen, which lasted for about a month.
After seeing a doctor, I was told it might be due to excessive earwax, and after it was cleaned out, the symptoms indeed improved.
A year ago, the symptoms reappeared, and after visiting an otolaryngologist, the doctor found no abnormalities, and I eventually recovered on my own.
However, since then, these symptoms have become frequent, occurring sometimes every two weeks to a month, with varying intensity—sometimes mild and lasting a few days, other times lasting up to a month.
The sensation is not exactly the same as the initial dizziness; it feels more like lightheadedness, particularly with a heavy feeling at the back of my head, as if there is something uncomfortable inside my brain.
Lying down exacerbates the dizziness, giving a sensation of spinning (especially when lying flat; elevating my head helps).
Occasionally, it is accompanied by nausea and a feeling of wanting to vomit, somewhat similar to motion sickness, although the surrounding environment does not feel like it is spinning, and it does not severely impact my walking or daily life, but it is quite uncomfortable.
Additionally, sometimes the lightheadedness is accompanied by other conditions, such as developing pimples or styes, and I wonder if these are related.
Furthermore, I usually have sufficient sleep, but I experience nighttime teeth grinding and frequent hair loss; I am unsure if these are connected.
For the past six months, I have been repeatedly troubled by these symptoms, and I kindly ask for your clarification.
Thank you!

ant, 30~39 year old female. Ask Date: 2012/04/24

Dr. Gao Chunde reply Neurology

If there are no symptoms of ear fullness, tinnitus, or hearing loss, it is more likely to be benign paroxysmal positional vertigo (BPPV), albeit with a higher frequency of episodes.
However, some conditions that warrant attention include multiple sclerosis in young women, vestibular neuritis, or the presence of neurocompressive lesions.
If the symptoms are continuous or accompanied by other unusual new symptoms, I would still have concerns and recommend further evaluation for the patient.

Reply Date: 2012/04/24

More Info

Persistent dizziness and a heavy sensation in the head can be quite distressing and may stem from various underlying causes. Based on your description, it appears that you have experienced episodes of dizziness and a feeling of heaviness in the back of your head for over two years, with intermittent occurrences that can last from a few days to several weeks. This pattern suggests that your symptoms may not be solely related to a single cause, but rather a combination of factors.

One potential explanation for your symptoms could be related to vestibular disorders. The vestibular system, which is responsible for balance and spatial orientation, can be affected by various conditions. For instance, benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness that occurs when tiny calcium crystals in the inner ear become dislodged. This can lead to episodes of vertigo, especially when changing positions, such as lying down or turning over in bed. Given that you experience increased dizziness when lying flat, this could be a possibility worth exploring.

Another consideration is tension-type headaches or migraines, which can manifest with dizziness and a sensation of heaviness in the head. Stress, poor posture (especially from prolonged computer use), and inadequate hydration can exacerbate these types of headaches. Since you mentioned that your symptoms sometimes coincide with stress or other physical symptoms like acne or styes, it might be beneficial to evaluate your overall lifestyle, including stress management techniques, ergonomic adjustments at your workstation, and hydration levels.

Additionally, your history of earwax buildup leading to dizziness suggests that ear-related issues could be a recurring factor. While your ENT specialist found no abnormalities, it may be worthwhile to revisit this aspect, especially if you notice a correlation between ear symptoms and your dizziness.

The presence of other symptoms, such as night grinding (bruxism) and hair loss, could indicate underlying stress or anxiety, which can contribute to both physical and psychological symptoms. Stress can lead to muscle tension, particularly in the neck and shoulders, which may in turn affect your head and contribute to feelings of heaviness or dizziness.

Given the complexity of your symptoms, it is advisable to consult with a healthcare professional who can conduct a thorough evaluation. This may include a neurological examination, vestibular testing, and possibly imaging studies if deemed necessary. A multidisciplinary approach involving a neurologist, an ENT specialist, and possibly a psychologist or counselor could provide a comprehensive understanding of your condition.

In the meantime, consider implementing some self-care strategies. Regular physical activity, mindfulness practices such as yoga or meditation, and ensuring you maintain a healthy sleep routine can help manage stress and improve overall well-being. Additionally, staying hydrated and taking breaks from screen time may alleviate some of the symptoms you experience.

In summary, while your symptoms may be linked to various factors, a thorough evaluation by a healthcare professional is essential to determine the underlying cause and appropriate treatment. By addressing both the physical and psychological aspects of your health, you can work towards alleviating your persistent dizziness and head heaviness.

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