Dizziness: Insights from Neurology for Your Symptoms

About dizziness?

Hello Doctor, I started experiencing dizziness on July 10 of this year.
When I bend over, lower my head, raise it, or turn my head in the morning, it feels like my body is shaking as if there is an earthquake.
When I walk, it feels like my feet are bouncing off the floor, but I don't experience the sensation of the room spinning.
I feel very anxious because I had been doing exercises like weightlifting, sit-ups, and stretching.
Therefore, I initially suspected it might be due to cervical spine compression or injury.
I went to a nearby small orthopedic clinic for a lateral X-ray of my neck, and the doctor said the bones looked good and there were no issues.
He also mentioned that these exercises could not have caused such injuries and suggested that my anxiety might be influencing my symptoms.
He recommended that I see a psychiatrist or a neurologist.
A week later, I went to a large hospital's neurology department for an examination.
The doctor performed simple tests, such as having me touch my nose, grip his hand with strength, and walk in a straight line.
He also arranged for me to have an EEG, blood tests, and a CT scan, all of which came back normal.
I kept asking the doctor if there was an issue with my cervical spine, and he assured me that there was none.
Eventually, the neurologist referred me to a psychiatrist.
However, I feel helpless and often think negatively.
Sometimes I feel like crying, constantly worrying that there might be an issue with my neck.
My body has even started to experience sensations like tingling, chest tightness, involuntary muscle twitching, numbness in my hands and feet, and difficulty breathing.
Please give me some advice, thank you.

Jason, 20~29 year old female. Ask Date: 2012/09/18

Dr. Gao Chunde reply Neurology

On July 10, benign paroxysmal positional vertigo (BPPV) occurred.
Generally, rest for two to three days to a week will lead to recovery.
However, it is important to note that if there is excessive fatigue or irregular sleep patterns, it may recur.
Some patients may develop feelings of fear and anxiety due to the vertigo, which can sometimes escalate to panic disorder, health anxiety, or even depression, similar to your current situation.
In fact, the vertigo has resolved, but symptoms such as low mood, a crawling sensation, chest tightness, muscle twitching, peripheral numbness, and difficulty breathing may require assistance from a psychiatrist to help navigate through this gloom.

Reply Date: 2012/09/18

More Info

Understanding dizziness can be quite complex, especially when it is accompanied by a range of other symptoms. Based on your description, it seems that you have been experiencing dizziness since July 10, characterized by sensations that feel like your body is shaking or bouncing, rather than a true spinning sensation. This type of dizziness can be categorized as a form of non-vertiginous dizziness, which may stem from various underlying issues.

Given that you have already consulted with both orthopedic and neurological specialists, and have undergone several tests including X-rays, CT scans, and blood tests, it is reassuring that no significant structural abnormalities were found. The fact that your neck was assessed and deemed healthy is also a positive sign, as cervical spine issues can often contribute to dizziness and other neurological symptoms.

Your symptoms of anxiety, including feelings of tightness in the chest, muscle twitching, and a sensation of "ants crawling" on your skin, suggest that there may be a significant psychological component to your experience. Anxiety can manifest physically in many ways, including dizziness, muscle tension, and altered sensations, which can create a feedback loop of worry and physical symptoms. When the body is under stress, the autonomic nervous system can become dysregulated, leading to symptoms such as those you are experiencing.

It is important to address both the physical and psychological aspects of your symptoms. Here are some recommendations that may help:
1. Cognitive Behavioral Therapy (CBT): This form of therapy can be particularly effective for managing anxiety and its physical manifestations. A therapist can help you identify negative thought patterns and develop coping strategies.

2. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety and improve your overall sense of well-being. These techniques can also help you become more aware of your body and its sensations, which may reduce the fear associated with them.

3. Physical Activity: While you mentioned engaging in weightlifting and other exercises, it may be beneficial to incorporate gentler forms of movement, such as yoga or tai chi, which can promote relaxation and improve body awareness without putting undue strain on your body.

4. Regular Check-ins with Healthcare Providers: Continue to communicate with your healthcare providers about your symptoms. If you feel that your symptoms are worsening or not improving, it may be worth seeking a second opinion or exploring additional diagnostic tests.

5. Lifestyle Modifications: Ensure you are getting adequate sleep, maintaining a balanced diet, and staying hydrated. These factors can significantly impact both physical and mental health.

6. Medication: If your anxiety is significantly impacting your daily life, discussing medication options with a psychiatrist may be beneficial. Medications such as SSRIs or anxiolytics can help manage anxiety symptoms effectively.

7. Support Groups: Connecting with others who are experiencing similar symptoms can provide emotional support and practical advice on coping strategies.

In summary, while your physical tests have returned normal results, the interplay between anxiety and physical symptoms can be profound. Addressing both the psychological and physical aspects of your experience is crucial for recovery. It’s important to be patient with yourself as you navigate this process, and to seek support from healthcare professionals who can guide you through your symptoms. Remember, you are not alone in this, and with the right strategies and support, improvement is possible.

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