Dizziness upon opening the eyes?
Hello Doctor, I am inquiring about my mother's condition.
She is currently 65 years old.
Last night, she had a big argument with my younger brother, and afterwards, she experienced pain in one eye and slight dizziness.
Since her condition improved later, she did not seek medical attention.
However, this morning when she woke up, she unexpectedly felt dizzy as soon as she opened her eyes, making it necessary for her to keep her eyes closed while getting up to go to the bathroom.
She also feels a bit hungry and nauseous since she hasn't eaten breakfast yet.
My mother has autonomic nervous system issues and is taking Rivotril 2mg tablets, 40mg propranolol (Heart Care), and 2mg Trihexyphenidyl.
Doctor, which department do you recommend she should see first, or what measures can be taken to alleviate her condition before seeking medical care?
Lan, 30~39 year old female. Ask Date: 2016/01/15
Dr. Yang Shenggong reply Neurology
Hello Mr.
Lan: Your mother's primary symptoms include sudden onset of unilateral eye pain accompanied by dizziness, which may suggest several conditions: A.
If the dizziness is characterized by a spinning sensation, it may be due to posterior circulation insufficiency, potentially accompanied by symptoms such as: 1) transient binocular diplopia (seeing overlapping images), 2) unilateral weakness and numbness in the limbs, 3) difficulty swallowing, etc.
If these symptoms are present, please seek medical attention promptly.
B.
If the dizziness is not spinning and is accompanied by persistent binocular diplopia and eye pain, there may be an extraocular muscle disorder; please seek medical attention promptly.
C.
If dizziness is accompanied by persistent gait disturbances, there may be a risk of cerebellar stroke; please seek medical attention promptly.
D.
If dizziness is accompanied by unilateral tinnitus that synchronizes with the heartbeat, be cautious of vascular dissection; please seek medical attention promptly.
E.
Persistent blurred vision in one eye may indicate an intraocular condition, such as glaucoma or intraocular hemorrhage; please seek medical attention promptly.
If none of the above issues are present and symptoms improve without new symptoms or continuous worsening, and blood pressure remains normal, observation may be appropriate.
However, if there are still concerns or doubts, taking your mother to a medical facility for further evaluation and diagnosis should provide you with greater reassurance.
Dr.
Yang Sheng-gong, Neurology Department, Changhua Hospital.
Reply Date: 2016/01/15
More Info
Based on the symptoms you've described regarding your mother, it is crucial to approach her situation with caution, especially considering her age and existing medical conditions. The combination of eye pain, dizziness, and nausea can indicate several potential issues, some of which may require immediate medical attention.
Firstly, the fact that your mother experienced eye pain and dizziness after a stressful event (the argument) could suggest a few possibilities. Stress and anxiety can lead to tension headaches, which might cause dizziness and discomfort in the eyes. However, given her age and the presence of pre-existing conditions, it is essential to rule out more serious causes.
The symptoms of dizziness upon waking, especially when accompanied by nausea, could indicate several neurological or vestibular issues. Conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or even more serious concerns like a transient ischemic attack (TIA) or stroke should be considered. The fact that she has autonomic nervous system issues and is on medications like Rivotril (a benzodiazepine) and propranolol (a beta-blocker) adds complexity to her case. These medications can sometimes cause side effects like dizziness or exacerbate existing conditions.
Given these factors, I would recommend that your mother see a neurologist as her first point of contact. A neurologist can perform a thorough evaluation, including a neurological examination, to assess her symptoms and determine if any further imaging studies (like an MRI or CT scan) are necessary. They can also evaluate her current medications to ensure they are not contributing to her symptoms.
In the meantime, here are some steps you can take to help alleviate her symptoms until she can be seen by a healthcare professional:
1. Rest: Encourage her to rest in a quiet, dark room. Reducing sensory input can help alleviate dizziness and discomfort.
2. Hydration: Ensure she stays hydrated. Dehydration can worsen dizziness and nausea.
3. Positioning: If she experiences dizziness, advise her to change positions slowly. For example, when getting out of bed, she should sit on the edge for a moment before standing up.
4. Avoid Triggers: If certain movements or positions exacerbate her dizziness, she should avoid them until she can be evaluated.
5. Medication Review: If she has any over-the-counter medications or supplements, review these with her healthcare provider to ensure they do not interact negatively with her current prescriptions.
6. Emergency Signs: Be vigilant for any signs of a stroke, such as sudden weakness, confusion, difficulty speaking, or severe headache. If these occur, seek emergency medical attention immediately.
In summary, your mother's symptoms warrant a thorough evaluation by a neurologist to rule out any serious underlying conditions. While managing her symptoms at home, it is essential to monitor her closely and seek immediate care if her condition worsens.
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