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Been Suffering From Vertigo, Weakness And Restlessness. How To Proceed With Treatment?
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Thank you for your query.
1. Does she have history of any illness - ear / neck related problems or head injury? Any headaches or migraine? Any hyperacidity or recent cold?
2. I will be able to guide you better about the possible cause if you can provide me more details of her dizziness like:
a. The exact moment when it all started,
b. How often and how long do the episodes last? Is it continuous?
c. Any other associated symptoms, such as nausea, vomiting or sweating?
d. I need to know if her hearing is normal. Does it fluctuate? Does she get any sounds (tinnitus) or fullness in the ear?
e. Is the dizziness true vertigo (spinning of the surrounding) or only unsteadiness.
f. Is the dizziness only when there is change of position (such as lie down or sit up)? Can she walk without support? Does she get dizzy when she turns in bed or look up while climbing stairs?
g. Is her vision clear or blurred? Is there any tendency to blackout?
3. It is also important to consult a neurologist to rule out neurological degenerations that can cause such symptoms. (MRI scans may not be enough to pick these conditions).
Awaiting your reply.
Regards
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She does not have any other illness. This started last year in summers around May 2011. She feels her head is heavy and complains of dizziness. At times it last for 3-4 days at a stretch but off and on. She does not have symptoms like nausea , vomiting etc. Her hearing is absolutely normal. She can walk without support and feels dizzy or tendency to black out while climbing stairs,turns in the bed, gets out from the bed & when she gets up if she had been sitting on the floor for a while.Visions is normal. Feels very restless and head becomes heavy. Getting out in the sun has been a prime concern since last year and she feels it aggravates in the sun more than anything else. She is extremely uncomfortable sitting at the back seat in the car & also feels sick when driving little fast.
Let know know if you require more details. Hope this will be helpful.
Regards, XXXXXXX
Thank you for writing back.
1. From your description, it is not Meniere's Disease. Her vertigo is most likely to be due to the following:
a. BPPV (Benign Paroxysmal Positional Vertigo). However a tendency to black out or dizziness on the move is rare.
b. Orthostatic hypotension (Postural Hypotension) (tendency to blackout).
c. Anemia (Low Hemoglobin) (tendency to black out).
d. Motion Sickness (dizziness in a car/ high speed).
2. Since she has photosensitivity, a Neurologist's opinion is required. Sinusitis should also be ruled out.
3. You should get Cervical spine X-rays to rule out cervical spine spondylosis. An MRI Scan will help rule out any neurological condition.
4. There are many tests such as ENG (ElectroNystagmoGraphy), testing for nystagmus (abnormal eye movements during an attack of vertigo) and many features such as direction of and fatiguablity of nystagmus. These can only be observed in a patient.
5. Kindly let me know the results of your tests. This will help in suggesting further treatment. BPPV can especially be cured.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
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