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What Causes Acute Onset Nausea, Vomiting, Dizziness And Weakness Despite Normal Reports?

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Posted on Thu, 9 Feb 2017
Question: I'm a physician with a perflexing pt. 48 y/o healthy female triathlete who has acute onset N/V, dizziness and weakness (motor intact but can't support her body wt. Occurred originally 2wks ago, neg neuro exam, nml CAT and MRI. Resolved in 24 hrs, now recurred 2 wks later. Any ideas?
doctor
Answered by Dr. Ishu Bishnoi (5 hours later)
Brief Answer:
Cause of the episode

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. This could be due to "transient ischemic attack" or s"syncopal attack".

If you are having history of diabetes, hypertension, hyperlipidemiam you must get

- Ultrasound doppler of neck vessels to rule out any atherosclerotic vessels.

TIA can later on cause stroke. You must rule out it. If it has been ruled out, kindly rule out syncopal attack. It can be due to dehydration, hypotension or vasovagal.

In all these illnesses, MRI or CT comes out to be normal.

Hope it will help you. If any doubt, do let me know. Thanks. Take care.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ishu Bishnoi (15 hours later)
Forgot to mention normal vitals. Only abnormal lab value was relatively low wbc count of 2900. Could this be a viral syndrome of some sort?
doctor
Answered by Dr. Ishu Bishnoi (5 hours later)
Brief Answer:
Low WBC

Detailed Answer:
Hi XXXX, welcome back.

The TLC 2900 is suggestive of low WBC count. It can be due to viral infection or drug induced leukopenia or false lab value. First of all, you should repeat the lab value.

If still the WBC count is low, please get the peripheral smear done. It will tell morphology and distribution of WBCs. If any abnormality, I'd suggest you to consult haematologist. Please let me know the report also.

The viral infection can cause the above mentioned symptoms. The viral infection will subside on its own with symptomatic treatment.

Hope it will help you.
Thanks.
Take care.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Ishu Bishnoi (18 minutes later)
Thanks
doctor
Answered by Dr. Ishu Bishnoi (12 hours later)
Brief Answer:
My pleasure

Detailed Answer:
Hi XXXX, thanks a lot for the appreciation.

If you need any help, do let me know.
Take care
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 901 Questions

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What Causes Acute Onset Nausea, Vomiting, Dizziness And Weakness Despite Normal Reports?

Brief Answer: Cause of the episode Detailed Answer: Hi XXXX, thanks for asking from HCM. I can understand your concern. This could be due to "transient ischemic attack" or s"syncopal attack". If you are having history of diabetes, hypertension, hyperlipidemiam you must get - Ultrasound doppler of neck vessels to rule out any atherosclerotic vessels. TIA can later on cause stroke. You must rule out it. If it has been ruled out, kindly rule out syncopal attack. It can be due to dehydration, hypotension or vasovagal. In all these illnesses, MRI or CT comes out to be normal. Hope it will help you. If any doubt, do let me know. Thanks. Take care.