The sensation of dizziness?
Dr.
Jiang, I have been feeling lightheaded while walking sometimes, and I need to hold onto something for a moment until it passes.
This has happened twice.
Additionally, when I am sitting, I sometimes feel a sudden jolt in my head.
Could this be due to fatigue, or is it caused by something else? Thank you.
I have had blood tests done, and my hemoglobin levels are normal, with a blood pressure reading of 122/80 and a heart rate of 74.
Mr. Chen, 30~39 year old female. Ask Date: 2015/09/08
Dr. Jiang Junyi reply Neurology
Based on your description: First, it is important to consider syncope, with the most common cause being reflex syncope due to excessive stimulation of the vagus nerve, which leads to bradycardia and decreased cardiac output.
Other causes may include changes in posture from lying to standing, sudden standing after squatting, certain medications causing hypotension, significant reductions in blood volume, peripheral vasodilation in hot environments, and peripheral neuropathy.
Cardiac syncope can occur due to arrhythmias, valvular heart disease, cardiac myxomas, acute myocardial infarction, or coronary artery spasm, all of which can lead to arrhythmias and decreased blood pressure.
Metabolic syncope can result from hypoglycemia or hyperventilation.
It is also important to differentiate syncope from seizures and vertigo.
It is recommended that you consult with a neurologist or cardiologist for further evaluation and treatment.
Wishing you good health and peace.
Reply Date: 2015/09/08
More Info
Dizziness can be a perplexing symptom, and understanding its causes is crucial for determining when to seek medical help. Based on your description, it seems you are experiencing episodes of dizziness while walking and occasionally when sitting. Given that your blood tests, including hemoglobin levels, are normal and your blood pressure is stable at 122/80 mmHg, it’s important to consider several potential causes of your dizziness.
Common Causes of Dizziness
1. Vestibular Disorders: The inner ear plays a crucial role in maintaining balance. Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease can lead to episodes of dizziness. If you notice that your dizziness is triggered by specific head movements, BPPV might be a possibility.
2. Orthostatic Hypotension: Although your blood pressure reading is normal while sitting, it’s possible that you may experience a drop in blood pressure when standing up quickly. This can cause dizziness and is often more pronounced in older adults or those who are dehydrated.
3. Cervical Issues: Sometimes, neck problems can lead to dizziness, especially if there is a pinched nerve or muscle tension affecting blood flow to the brain.
4. Neurological Conditions: While less common, neurological issues such as migraines, transient ischemic attacks (TIAs), or even more serious conditions like multiple sclerosis can present with dizziness. If you experience additional symptoms such as weakness, numbness, or changes in vision, it’s essential to seek immediate medical attention.
5. Anxiety and Stress: Psychological factors can also contribute to feelings of dizziness. Anxiety and panic attacks can manifest physically, leading to sensations of lightheadedness or dizziness.
When to Seek Help
You should consider seeking medical attention if:
- Your dizziness is recurrent and affects your daily activities.
- You experience additional symptoms such as severe headache, vision changes, hearing loss, or weakness.
- You have a history of heart disease or other significant medical conditions.
- You feel faint or have episodes of near-syncope (feeling like you might pass out).
- Your dizziness is accompanied by nausea or vomiting.
Next Steps
Given your current symptoms, it would be prudent to schedule an appointment with your healthcare provider. They may perform a thorough physical examination, including a neurological assessment, and possibly recommend further tests such as:
- Vestibular Function Tests: To evaluate the inner ear's role in balance.
- Imaging Studies: Such as an MRI or CT scan if a neurological cause is suspected.
- Blood Tests: To check for other underlying conditions, such as anemia or electrolyte imbalances.
Conclusion
While occasional dizziness can be benign, especially if it resolves quickly and does not recur frequently, it’s essential to pay attention to your body’s signals. Keeping a diary of your symptoms, including when they occur and any associated activities, can be helpful for your healthcare provider in diagnosing the issue. Remember, it’s always better to err on the side of caution when it comes to your health. If your symptoms persist or worsen, don’t hesitate to seek medical advice.
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