Unexplained Dizziness: Causes and Solutions

Dizziness of unknown origin?

I have been experiencing dizziness for about 4.5 days.
Initially, it was severe enough to cause vomiting.
Two days ago, I visited an otolaryngologist, which provided some relief.
However, I still feel dizzy when walking or turning my head, and I often feel sleepy.
What could be the cause and what are the possible solutions?

Li Tongxue, 10~19 year old female. Ask Date: 2015/09/12

Dr. Jiang Junyi reply Neurology

Based on your description, the symptoms are more consistent with positional vertigo, occurring when turning the head, tilting the head back, or rising from a lying position.
This is likely caused by otoliths dislodging into the posterior semicircular canal.
As for the drowsiness, it may be a side effect of the medications used to treat vertigo, which can have a sedative effect on the nervous system.
I recommend discussing your condition and treatment options with a neurologist or an otolaryngologist.
Wishing you good health and peace.

Reply Date: 2015/09/12

More Info

Unexplained dizziness can be a perplexing and distressing symptom, and it is essential to understand its potential causes and solutions. Dizziness can manifest in various forms, including lightheadedness, vertigo (a spinning sensation), and imbalance. Given your symptoms of dizziness lasting for about 4.5 days, initially severe enough to induce vomiting, and now accompanied by a desire to sleep and feelings of unsteadiness while walking or turning your head, it is crucial to consider several underlying causes.

1. Vestibular Disorders: One of the most common causes of dizziness is a vestibular disorder, which affects the inner ear's balance system. Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or labyrinthitis can lead to dizziness and vertigo. These conditions may arise after a viral infection or due to changes in head position.

2. Neurological Causes: Dizziness can also stem from neurological issues, including migraines, transient ischemic attacks (TIAs), or even more severe conditions like strokes. If dizziness is accompanied by other neurological symptoms such as weakness, numbness, or difficulty speaking, it is vital to seek immediate medical attention.

3. Cardiovascular Issues: Orthostatic hypotension, where blood pressure drops significantly upon standing, can cause dizziness. This condition can be exacerbated by dehydration, medications, or underlying heart conditions. Monitoring blood pressure and hydration status is essential.

4. Anxiety and Stress: Psychological factors can also contribute to dizziness. Anxiety disorders can manifest physically, leading to feelings of dizziness or lightheadedness. Stress management techniques and counseling may be beneficial in such cases.

5. Medication Side Effects: If you are taking any medications, it is essential to review them with your healthcare provider, as some medications can cause dizziness as a side effect.

6. Dehydration and Nutritional Deficiencies: Insufficient fluid intake or deficiencies in essential nutrients (like vitamin B12 or iron) can lead to dizziness. Ensuring adequate hydration and a balanced diet is crucial.

Solutions and Next Steps
- Medical Evaluation: Since your symptoms have persisted for several days and have caused significant discomfort, it is advisable to follow up with a healthcare provider. They may recommend further evaluations, such as blood tests, imaging studies (like MRI or CT scans), or vestibular function tests, to determine the underlying cause of your dizziness.

- Vestibular Rehabilitation: If a vestibular disorder is diagnosed, vestibular rehabilitation therapy (VRT) can help improve balance and reduce dizziness through specific exercises.

- Hydration and Nutrition: Ensure you are drinking enough fluids and consuming a balanced diet rich in vitamins and minerals. If you suspect dehydration, increase your fluid intake gradually.

- Rest and Sleep: Given your desire to sleep, ensure you are getting adequate rest. Fatigue can exacerbate feelings of dizziness.

- Avoid Triggers: If certain movements or positions worsen your dizziness, try to avoid them until you have a clearer understanding of your condition.

- Follow-Up: Keep a symptom diary noting when dizziness occurs, its severity, and any associated symptoms. This information can be valuable for your healthcare provider in diagnosing the issue.

In conclusion, while dizziness can arise from various causes, a thorough evaluation by a healthcare professional is crucial to determine the underlying issue and appropriate treatment. Do not hesitate to seek medical attention, especially if your symptoms worsen or new symptoms develop.

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