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Hello There! I Have Been Struggling With Chronic Dizziness For

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Posted on Sun, 8 Dec 2019
Question: Hello there!

I have been struggling with chronic dizziness for a few months now. I have a near constant feeling of rocking, as if on a boat, and when I go out and walk around in the city or go into stores, the feeling gets worse. And my head often feels full and foggy. It's never a spinning sensation, its always a rocking / swaying /pulling feeling like i'm being thrown around on a boat. It's also worse after stress. Like if I have an argument, I'll be fine during the argument but a little while after, the feeling gets worse. And usually I wake up and do not have the feeling until I first get out of bed. And it gets better as the days goes on after peaking late morning or early afternoon.

I had been under tremendous pressure from April-Oct so, my stress was very, very high for months as well as my anxiety (panic disorder, OCD and GAD). I had many other sensations of anxiety and stress but most of them have disappeared. Only this dizziness remains, and sometimes I have some light insomnia and limited symptom panic attacks, but nothing overwhelming.

Earlier this year, I had an MRI of my brain and an MRI w/ contrast of my auditory canals. It was all fine. I also had a few vestibular tests: "hearing test is normal and the balance test, VNG, was grossly normal". I also had heart tests, EKG, full blood workup... everything has always been normal except slightly high inflammation markers. And I had a nystagmus in my right eye.

The dizziness has gotten worse this past month as my stress has passed and I've had time to calm down. It used to go away awhile after anything stressful or anxiety provoking but now it's around most of the day and at its worst, it makes me a little uncoordinated when I try to walk. I'm sensitive to loud noises, bright lights and any stress.

Any idea what it could be? I heard of a thing called "Chronic Subjective Dizziness" but, I'm not sure. I guess I am anxious still, but mostly about this sensation because it can be hard to go about my day feeling so unsteady.

Are there any other tests to do? Any idea what it might be?
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Follow up: Dr. Dr. Rajat Basak (0 minute later)
Hello there!

I have been struggling with chronic dizziness for a few months now. I have a near constant feeling of rocking, as if on a boat, and when I go out and walk around in the city or go into stores, the feeling gets worse. And my head often feels full and foggy. It's never a spinning sensation, its always a rocking / swaying /pulling feeling like i'm being thrown around on a boat. It's also worse after stress. Like if I have an argument, I'll be fine during the argument but a little while after, the feeling gets worse. And usually I wake up and do not have the feeling until I first get out of bed. And it gets better as the days goes on after peaking late morning or early afternoon.

I had been under tremendous pressure from April-Oct so, my stress was very, very high for months as well as my anxiety (panic disorder, OCD and GAD). I had many other sensations of anxiety and stress but most of them have disappeared. Only this dizziness remains, and sometimes I have some light insomnia and limited symptom panic attacks, but nothing overwhelming.

Earlier this year, I had an MRI of my brain and an MRI w/ contrast of my auditory canals. It was all fine. I also had a few vestibular tests: "hearing test is normal and the balance test, VNG, was grossly normal". I also had heart tests, EKG, full blood workup... everything has always been normal except slightly high inflammation markers. And I had a nystagmus in my right eye.

The dizziness has gotten worse this past month as my stress has passed and I've had time to calm down. It used to go away awhile after anything stressful or anxiety provoking but now it's around most of the day and at its worst, it makes me a little uncoordinated when I try to walk. I'm sensitive to loud noises, bright lights and any stress.

Any idea what it could be? I heard of a thing called "Chronic Subjective Dizziness" but, I'm not sure. I guess I am anxious still, but mostly about this sensation because it can be hard to go about my day feeling so unsteady.

Are there any other tests to do? Any idea what it might be?
doctor
Answered by Dr. Dr. Rajat Basak (6 hours later)
Brief Answer:
Hii. You have done a lot of tests. Everything has come normal. I will focus

Detailed Answer:
Hii. You have done a lot of tests. Everything has come normal. I will focus you on some few things.Have you done Dix Hall pike or postural tests? If it came to be positive then there is a chance of having benign paroxysmal postural vertigo or BPPV. This is a condition when calcium crystals in balance system get dislodged from their position. Ent surgeon need to do some exercise to restore the calcium crystals to their position. Another diagnosis I like to focus is hypoactive labyrinth where the balance system gets less functioning due to viral infection or any other inflammation. You need Electronystagmogram to diagnose it. The treatment to this hypoactive labyrinth is to do vestibular rehabilitation exercise.This will not be detected in MRI brain. As MRI Brain has come to be normal so it's obvious that there are no tumor or lesion in the brain which can lead to giddiness. There is another condition where you can have the same symtoms is vertiginous migraine where you can have giddiness and sensitive to bright light, loud nose and stress. You may need to take some antimigraine drugs in that case. At the same time consult your medicine physcian and check your blood pressure, blood sugar, electrolytes as diabetes and hypertension can have similar problems. You need to do a ECG, echocardiogram to check your heart status also. You focus on the above diagnosis and ask your ent surgeon and medicine physician to consider these points and treat accordingly. Please review if you have any queries.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Dr. Rajat Basak (0 minute later)
Brief Answer:
Hii. You have done a lot of tests. Everything has come normal. I will focus

Detailed Answer:
Hii. You have done a lot of tests. Everything has come normal. I will focus you on some few things.Have you done Dix Hall pike or postural tests? If it came to be positive then there is a chance of having benign paroxysmal postural vertigo or BPPV. This is a condition when calcium crystals in balance system get dislodged from their position. Ent surgeon need to do some exercise to restore the calcium crystals to their position. Another diagnosis I like to focus is hypoactive labyrinth where the balance system gets less functioning due to viral infection or any other inflammation. You need Electronystagmogram to diagnose it. The treatment to this hypoactive labyrinth is to do vestibular rehabilitation exercise.This will not be detected in MRI brain. As MRI Brain has come to be normal so it's obvious that there are no tumor or lesion in the brain which can lead to giddiness. There is another condition where you can have the same symtoms is vertiginous migraine where you can have giddiness and sensitive to bright light, loud nose and stress. You may need to take some antimigraine drugs in that case. At the same time consult your medicine physcian and check your blood pressure, blood sugar, electrolytes as diabetes and hypertension can have similar problems. You need to do a ECG, echocardiogram to check your heart status also. You focus on the above diagnosis and ask your ent surgeon and medicine physician to consider these points and treat accordingly. Please review if you have any queries.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Rajat Basak (11 hours later)
hi. i have had an echocardiogram earlier this year and an ekg and they were both normal.

my blood pressurevis sometimes slightly high but that always coincides with anxiety / stress. its normal when im calm.

default
Follow up: Dr. Dr. Rajat Basak (0 minute later)
hi. i have had an echocardiogram earlier this year and an ekg and they were both normal.

my blood pressurevis sometimes slightly high but that always coincides with anxiety / stress. its normal when im calm.

doctor
Answered by Dr. Dr. Rajat Basak (3 hours later)
Brief Answer:
Hii. I think you check your blood pressure twice daily and make a chart for

Detailed Answer:
Hii. I think you check your blood pressure twice daily and make a chart for 1 month. You can get an idea if you are having hypertension or not. If your body is more than 150/100 then you need to start medicine by a physician. You have to control your stress and mark your stress zones and factors. Avoid stress and all sort of ocd and everything. You have to find out why you are having stress and try to solve those problems. Focus more on work, exercise, gym and not on your stress. At the end of day you have to stay healthy and give your best in your field. Do a ENG and sort out if you are not having any sort of weakness of your balance system behind the ear. As you are having right side nystagmus you have to rule out few vestibular disease like meniers disease, BPPV, vertiginous migraine. Consult a proper ent surgeron with good experience in vestibular disease. Do an ENG, dixhallpike test, electrocochleogram to rule out hypoactive labyrinth, BPPV, meniers disease. Treatment will be according to diagnosis. You can do vestibular rehabilitation exercise. Please review if you have any queries.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Rajat Basak (0 minute later)
Brief Answer:
Hii. I think you check your blood pressure twice daily and make a chart for

Detailed Answer:
Hii. I think you check your blood pressure twice daily and make a chart for 1 month. You can get an idea if you are having hypertension or not. If your body is more than 150/100 then you need to start medicine by a physician. You have to control your stress and mark your stress zones and factors. Avoid stress and all sort of ocd and everything. You have to find out why you are having stress and try to solve those problems. Focus more on work, exercise, gym and not on your stress. At the end of day you have to stay healthy and give your best in your field. Do a ENG and sort out if you are not having any sort of weakness of your balance system behind the ear. As you are having right side nystagmus you have to rule out few vestibular disease like meniers disease, BPPV, vertiginous migraine. Consult a proper ent surgeron with good experience in vestibular disease. Do an ENG, dixhallpike test, electrocochleogram to rule out hypoactive labyrinth, BPPV, meniers disease. Treatment will be according to diagnosis. You can do vestibular rehabilitation exercise. Please review if you have any queries.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Rajat Basak

ENT Specialist

Practicing since :2011

Answered : 801 Questions

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Hello There! I Have Been Struggling With Chronic Dizziness For

Hello there! I have been struggling with chronic dizziness for a few months now. I have a near constant feeling of rocking, as if on a boat, and when I go out and walk around in the city or go into stores, the feeling gets worse. And my head often feels full and foggy. It's never a spinning sensation, its always a rocking / swaying /pulling feeling like i'm being thrown around on a boat. It's also worse after stress. Like if I have an argument, I'll be fine during the argument but a little while after, the feeling gets worse. And usually I wake up and do not have the feeling until I first get out of bed. And it gets better as the days goes on after peaking late morning or early afternoon. I had been under tremendous pressure from April-Oct so, my stress was very, very high for months as well as my anxiety (panic disorder, OCD and GAD). I had many other sensations of anxiety and stress but most of them have disappeared. Only this dizziness remains, and sometimes I have some light insomnia and limited symptom panic attacks, but nothing overwhelming. Earlier this year, I had an MRI of my brain and an MRI w/ contrast of my auditory canals. It was all fine. I also had a few vestibular tests: "hearing test is normal and the balance test, VNG, was grossly normal". I also had heart tests, EKG, full blood workup... everything has always been normal except slightly high inflammation markers. And I had a nystagmus in my right eye. The dizziness has gotten worse this past month as my stress has passed and I've had time to calm down. It used to go away awhile after anything stressful or anxiety provoking but now it's around most of the day and at its worst, it makes me a little uncoordinated when I try to walk. I'm sensitive to loud noises, bright lights and any stress. Any idea what it could be? I heard of a thing called "Chronic Subjective Dizziness" but, I'm not sure. I guess I am anxious still, but mostly about this sensation because it can be hard to go about my day feeling so unsteady. Are there any other tests to do? Any idea what it might be?