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Neurology (Expert Forum)
chronic lightheadedness
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chronic lightheadedness
by wbonnell, Jul 02, 2002 12:00AM
I'm a previously healthy, 28 year old male. Last December I had a bad head cold (runny nose and sore throat) that lasted approximately 5 days. Then one day I woke up extremely dizzy lightheaded accompanied by an acute frontal headache and slight fatigue. The dizziness was so acute that I missed an entire week of work and visited my family doctor twice. He ran CBC, thyroid, and blood sugar tests which all came back normal. Unfortunately, he was clueless and completely unhelpful not even referring me to an ENT or neurologist (I had to do that on my own).
The symptoms gradually improved to the point where the dizziness and headaches sort of plateaued to a livable level but are almost always present. However, when I wake in the morning, I usually feel fine, but as the day progresses, so do the symptoms. Interestingly, the dizziness and the headache often appear independently. The lightheadedness is more frequent and acute, while the headaches tend to be mild frontal or sore left eye.
Other prominent symptoms: fatigue, stiff and sore neck, buzzing or vibrating when I talk, "brain fog", difficulty speaking late in the afternoon when I am fatigued, ringing in the ears, muscle twitching, sudden allergy to Ibuprofen, and extremely dry and flaky skin on cheeks and nose.
Tests which have come back normal include: CT of brain, MRI w/ contrast, echocardiogram, hearing, ENT evaluation, and neurological exam. Stress levels are low, and I don't feel depressed. Neurologists and Internist don't have any good suggestions.
Any ideas?
The symptoms gradually improved to the point where the dizziness and headaches sort of plateaued to a livable level but are almost always present. However, when I wake in the morning, I usually feel fine, but as the day progresses, so do the symptoms. Interestingly, the dizziness and the headache often appear independently. The lightheadedness is more frequent and acute, while the headaches tend to be mild frontal or sore left eye.
Other prominent symptoms: fatigue, stiff and sore neck, buzzing or vibrating when I talk, "brain fog", difficulty speaking late in the afternoon when I am fatigued, ringing in the ears, muscle twitching, sudden allergy to Ibuprofen, and extremely dry and flaky skin on cheeks and nose.
Tests which have come back normal include: CT of brain, MRI w/ contrast, echocardiogram, hearing, ENT evaluation, and neurological exam. Stress levels are low, and I don't feel depressed. Neurologists and Internist don't have any good suggestions.
Any ideas?
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jul 06, 2002 12:00AM
Sorry to hear about your symptoms, glad the workup to date has been normal. In the setting of a preceding respiratory infection (cold), the acute attack of dizziness which kept you at home for a week was probably a vestibular neuronitis or neuropathy. As in your case it does get better in a matter of days and then resolves after several weeks. Medications such as meclizine and possibly a scopolamine patch may help and vestibular therapy (special type of physical therapy for dizzy patients) has improved symptoms in a number of our patients. Meniere's disease is also a possibility with your report of ringing in the ears. This goes away with time and is trated with meclizine. What's concerning about your case however, is the other symptoms that you;re reporting such as the stiff neck and "brain fog". A chronic meningitis needs to be considered. Consider going to a major academic or clinical center for a second opinion. A spinal tap may be necessary for further evaluation depending on the neuro exam findings. Good luck.
I also found that valium helps sometimes, but makes me feel very tired and sleepy. Good luck and if you find a solution please give me an e-mail: ***@**** and I will do the same for ya.
http://neuro-mancer.mgh.harvard.edu/cgi-bin/Ultimate.cgi
I have "episodes" 1 to 5 times a week, and they are more acute when I'm fatigued. I haven't compiled a daily log, but I have NOT noticed any correlation between sleepwalking episodes and my stated symptoms the following day.
Anyway, is this something to pursue further or is it a red herring? I don't have any major respiratory symptoms (the occasional runny nose notwithstanding) though over the same time period my 18-month old baby has had one respiratory illness after another. He was a very healthy baby prior to this. However, my wife and 7-year old seem unaffected.
And if it is a mold allergy, why do I feel fine first thing in the morning and worsen as the day progresses when I am typically away from my house at work?