I Had Alot Of Stress Last Year And Was Diagnosed

Brief Answer:
Vertigo is typically understood by neurologists to be sense of MOVEMENT

Detailed Answer:
Good MORNING from XXXXXXX OH...a bit East of FIGHTING IRISH COUNTRY......someone who would like a clarification on a definition, huh? I like that.....it's great that you are questioning the actual terminology given to your symptoms and your condition because it demonstrates an active thought process on your part where you want to be sure that the medical term being supplied to you accurately describes what you're feeling. That way, you can be certain (if confirmed) that other doctors and health care providers will understand EXACTLY what you're talking about or what you're experiencing without having to go through the task of describing everything from scratch...which can sometimes be difficult if it's been awhile since you've recounted the storyline....right?

Anyways, I like the way you think.......

So let's dive into some medical jargon and defintions of what things mean....and how that correlsponds to what patient perceptions may way of the same or similar terms...

Let's start at the top young lady....You say you were having problems of "almost fainting" and so were told that you were describing vertigo?

So, when someone tells me they feel like (or have felt like) fainting....my impression of what the person is describing is an inability or difficulty for stayin' on their feet in the upright position to the point of losing consciousness. I suppose some people may want to refer to that feeling as DIZZY as well, right?

So, to me, I have a better word to describe that sort of dizziness. I would call it PRE-SYNCOPE. The reason it is "PRE-" is simply based upon your statement of "ALMOST" fainting.....so if it's an ALMOST faint but somehow you manage to push through and stay upright and conscious....I would call it PRE-SYNCOPE. If you actually would go down despite your best efforts to stay up and aware of your surroundings then, I would call that a FAINTING SPELL...or in medical lingo.....SYNCOPE.

However, I personally, would not describe one of my patients as being VERTIGINOUS if in fact, they were having PRE-SYNCOPAL episodes. And here's why---

In my world the word VERTIGO means some type of perceived movement which is often described as a spinning or whirling sensation by a patient. It has nothing to do with maintaining a state of ALERTNESS or CONSCIOUS STATUS which SYNCOPE and PRE-SYNCOPE have EVERYTHING to do with as far medical terminology and meaning are concerned.

And so, "ALMOST FAINTING"- PRE-SYNCOPAL, DIZZY, or LIGHTHEADED

"VERTIGO"- Sensation or perception of BODILY MOVEMENT/SPINNING when none is occurring.

Now, GOOD BALANCE or in your case, " LACK of good balance" or "walking as if drunk" would be referred in my lingo as having DYSEQUILIBRIUM or IMBALANCE. I would not call this vertigo. I would not call it dizziness, however, many patients in fact, consider the sensation of dizziness as being tied intimately to their sense of balance so I am aware that needs to be thought of when someone tells me they feel "DIZZY."

But THE STATE of DYSEQUILIBRIUM or not having good balance, or not being able to safely NEGOTIATE STAIRS is not what I would consider VERTIGO. The reason I tend to separate and not mix these terms up is because sometimes when discussing symptoms in a patient, the more precision that can be brought to the sensations under discussion the more likely I might be to be able and LOCALIZE some part of the NEUR-AXIS (brain or spinal cord) that is more likely involved. Make sense?

There is no real LABORATORY or PHYSICAL TESTS that can DETECT the feeling of VERTIGO, DIZZINESS, DYSEQUILIBRIUM but there are tests that can be DONE on people who state they are all those things. See the difference...so I'm not quite sure which of those you were trying to state.

There is such a thing as VERTIGO TESTING which would theoretically take a person who is already experiencing these symptoms and see what their ability to balance would be on a balance plate, or how well they would be able to walk a straight line, and other things. There are also ways to check eye movements which are almost always affected when a person is feeling uncontrollable VERTIGO or DIZZINESS.

For faintness and vertigo my first choices to test anybody would be to obtain blood pressures in various postural formats (lying, standing, prolonged standing), and I would also obtain laboratories for blood work looking for thyroid gland abnormalities, testosterone levels,and Vit. D and B12 levels as well as a URINALYSIS (especially in anybody >60 years). I would also obtain an MRI/MRA of the brain and look for any abnormalities such as strokes, brain bleeds, or obstructions of fluid flow through the ventricular system. If the patient were complaining of TINNITUS or ringing in the ears....I would like on the MRI for any evidence of something called an ACOUSTIC NEUROMA or alternatively a SCHWANNOMA...mainly located in the Cerebellopontine angle of the brain.

So again, bottom line? I don't think I personally would refer to your symptoms directly as VERTIGO unless you had additional sensations or information to give me as to what you were feeling. And as far as tests and other ways to look at how these symptoms are affecting the person functionally I would do the tests and diagnostic measurements mentioned above.

If I've provided useful or helpful information to your questions could you do me the utmost of favors by CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information on your condition if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and let me know how things turned out.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope our discussion has aided in your understanding of a few concepts related to your concerns and given you a better direction as to which way things should go in order to get this problem solved as quickly and efficiently as possible.

Cheers young lady and wishin' you the best on this 1st day of the Week!

This query required 65 minutes of professional time to research, assimilate, and file a response.

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Brief Answer:
Thank you for additional information

Detailed Answer:
Many thanks for some additional information on your question about near faint/vertigo.

I also read that you are being evaluated for a possible lung infection that may turn out to be tuberculosis. As well you have included information on your use of several daily beers with clarification that true vertigo in the form of a spinning doesn't occur so much any more so much as a lack of balance that occurs.

Therefore, everything that I previously mentioned as being POSSIBLE causes of vertigo and fainting or NEAR fainting spells still holds but now perhaps a couple of things rise more to the top of what's got an increased likelihood and what doesn't when it comes to causes as to what's going on.

Certainly, any type of pulmonary infection becomes important as a consideration in any patient who feels faint or near faint since we are talking about potentially compromising O2 supply to the muscles and the brain. If a person has a TB infection then, the saturation of blood with oxygen can be significantly reduced and this will cause a number of problems including dizziness, faintness, possible sense of reduced equilibrium due to lack of oxygen to the brain.

Also, on the balance issue you could be suffering as well from the chronic effects of alcohol as it can affect sensors in the feet called PROPRIOCEPTORS as well as TACTILE receptors that allow the brain to know where the feet are on the ground, etc. Alcohol does cause what we call NEUROPATHY which over time does tend to affect these sensors in the feet. It can also affect the cerebellum which is a part of the brain most responsible for integrating incoming information from the feet/legs and elsewhere to help maintain our balance.

The MRI of the brain can definitely look for any evidence of cerebellar involvement that could explain your balance impairment and if found may be tied to the use of alcohol. Of course, the fix to that problem is to reduce (or preferably eliminate the alcohol).

I am not as concerned of your having suffered a STROKE from the given information and other consult that I've read on you having to do with the pulmonary infection but, I did also read you had been a smoker from about 15 years and that means that you could be suffering from one additional problem that we hadn't considered called WHITE MATTER DEGENERATION of the brain. Although this is actually a COMMON radiographic finding (even in people with no complaints of anything)....it is especially looked at as important when there are potential neurological symptoms of poor balance, dysequilibrium, fainting (or near as in this case) and other things.

So, the MRI is very sensitive to this pathology and based upon the upon that were found one might consider that as a contributing factor to your symptoms as well as everything else we talked about.

Once again, if I've provided you with helpful information would you consider CLOSING THE QUERY and adding a few positive words of feedback with a 5-star rating if you feel it is deserving? Please feel free to drop me a line at www.bit.ly/drdariushsaghafi and let me know how you are doing down the road.

You can always reach me at the above address for this and other questions. I wish you the best in all things and hope our discussion has aided in your understanding of a few concepts related to your concerns.

This query required 84 minutes of professional time to research, assimilate, and file a response.

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