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Suggest Remedy For Severe Dizziness In A Person With Gout
Question: Have a husband in bed now with severe dizziness. He's had it for about 4 hours now and he also has gout. He is on no meds. We are away from home. How can I help him?
Brief Answer:
Is the dizziness light headedness or room spinning?
Detailed Answer:
Hello and welcome,
Can you please tell me - is he feeling light headed like he might faint if gets up, or is he having sensation of room spinning when he turns his head? These are both called dizziness but are of different causes and require different treatment.
Also, is the gout active right now?
Does he have a fever or any other symptoms?
Weakness? Nausea? Visual changes?
Did this come on abruptly?
Is the dizziness light headedness or room spinning?
Detailed Answer:
Hello and welcome,
Can you please tell me - is he feeling light headed like he might faint if gets up, or is he having sensation of room spinning when he turns his head? These are both called dizziness but are of different causes and require different treatment.
Also, is the gout active right now?
Does he have a fever or any other symptoms?
Weakness? Nausea? Visual changes?
Did this come on abruptly?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He says room is spinning, gets worse when he turns his head, felt like he would faint, gout not active now, has nausea, eyes were blurring, couldn't focus well, vision is clearer now. Symptoms came on suddenly after looking through binoculars, slight headache still, left eye feels like it has pressure behind it.Worst symptom now is still the dizziness. He describes it as like feeling extremely drunk or on a rough boat ride (he has had no alcohol and is on no drugs or meds).
Brief Answer:
Most likely Benign Positional Paroxysmal Vertigo.
Detailed Answer:
From your description, the most likely and most common cause of these symptoms is Benign Paroxysmal Positional Vertigo (BPPV). This happens to many people and there are different maneuvers of the head that can cause it to resolve. The oldest, and most standard of these maneuvers that doctors will do on their patients in the office is the Epley maneuver. But I have had patients get relief on their own at home by doing the maneuvers shown in the you tube video at the following link:
https://www.youtube.com/watch?v=1VWyPgfMuvM
I've said that BPPV is the most common cause. But without the advantage of examining your husband (such as a neurological physical exam), there are limitations to on-line practice of medicine, so I will include some more concerning things to look for and when you should definitely have him seen in the ER: facial drooping, arm weakness, slurred speech. These are signs of a TIA or stroke. Blurred vision can be a concern for a stroke if it persists, but with BPPV, there can be blurred vision from nystagmus (eyes batting side to side or up and down rapidly). This is not part of having a stroke.
Doctors commonly prescribe an antihistamine called Antivert or Scopolamine to help with the nausea/motion sickness from the dizziness, but I haven't found these to work especially well. They are useful if the nausea is severe.
Please let me know if this maneuver helps.
If things get worse, do consider taking him in to the ER.
Most likely Benign Positional Paroxysmal Vertigo.
Detailed Answer:
From your description, the most likely and most common cause of these symptoms is Benign Paroxysmal Positional Vertigo (BPPV). This happens to many people and there are different maneuvers of the head that can cause it to resolve. The oldest, and most standard of these maneuvers that doctors will do on their patients in the office is the Epley maneuver. But I have had patients get relief on their own at home by doing the maneuvers shown in the you tube video at the following link:
https://www.youtube.com/watch?v=1VWyPgfMuvM
I've said that BPPV is the most common cause. But without the advantage of examining your husband (such as a neurological physical exam), there are limitations to on-line practice of medicine, so I will include some more concerning things to look for and when you should definitely have him seen in the ER: facial drooping, arm weakness, slurred speech. These are signs of a TIA or stroke. Blurred vision can be a concern for a stroke if it persists, but with BPPV, there can be blurred vision from nystagmus (eyes batting side to side or up and down rapidly). This is not part of having a stroke.
Doctors commonly prescribe an antihistamine called Antivert or Scopolamine to help with the nausea/motion sickness from the dizziness, but I haven't found these to work especially well. They are useful if the nausea is severe.
Please let me know if this maneuver helps.
If things get worse, do consider taking him in to the ER.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Tried the maneuvers 3 times - not very helpful, although he says the spinning is not as bad as it was earlier. He immediately vomited when he initially got out of bed but says the nausea is better when he lies down. Also looked up the Epley maneuvers online and he tried them once but seems exhausted now. We'll try the Epley again in 15 mins. since he's much more comfortable at this point lying down. He does not exhibit any of the TIA/stroke/heart attack symptoms, fortunately, and says his vision is clear at this point. If he's still dizzy tomorrow I will insist that he let me take him to a doctor (didn't want to go the hospital initially, obviously). Thanks for the advice since we would probably be sitting in the ER all night at this point since the symptoms don't appear to be too serious now. XXXXXXX
Brief Answer:
One other thought:
Detailed Answer:
Hi XXXXXXX
I am glad he is not as bad as he was earlier. Possibly he will feel better after sleep. Make sure he is well hydrated and not overheated.
One other thought: You had mentioned that he had a slight headache and pressure behind one eye. Sometimes a migrainous episode can also have symptoms of vertigo. Just a thought, but it sounds like the headache was not a significant part of the problem.
Yes, do take him in to a doctor if the vertigo continues and also if he gets further headaches.
I hope you both have a good night.
One other thought:
Detailed Answer:
Hi XXXXXXX
I am glad he is not as bad as he was earlier. Possibly he will feel better after sleep. Make sure he is well hydrated and not overheated.
One other thought: You had mentioned that he had a slight headache and pressure behind one eye. Sometimes a migrainous episode can also have symptoms of vertigo. Just a thought, but it sounds like the headache was not a significant part of the problem.
Yes, do take him in to a doctor if the vertigo continues and also if he gets further headaches.
I hope you both have a good night.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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