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Family Medicine  (Expert Forum)
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Dizziness
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.

Dizziness

by jhaverfi, Aug 01, 2005 12:00AM

I have been experiencing dizzyness(not spinning), light headedness, fainting, loss of feeling in arms, heart palpatations, I periodically have a cough and some chest pain and have had general miserable feelings for 8 weeks.  I have been into ER 3 times-I thought I was having a heart attack. The 1st 2 times they said I had Benign Positional Vertigo, but have seen an ENT and he said definitely not and referred me to a cardiologist and neurologist.  The 3rd trip to ER was because I lost feeling in my arms and hands and passed out and was kept overnight and had tests run.

I have seen an ENT, Family Doctor, Cardiologist, Pulminary specialist, and a Neurologist.  I have had a shearing test, tress test echo; EKG, EEG, MRI on my head; CT on my chest/lungs; extensive blood workup (thyroid, white blood cell count, sugar, etc).  All tests came back negative and show that I am in excellent health except for the stress test which showed that I have PAC's periodically.  I am on a beta- blocker for that and have a follow-up visit to my cardiologist.  My Cardiologist says that the PACs would not be causing my extreme dizziness.

My question is that all specialists say I am healthy and they can't help me. BUT - I currently miss 1 -2 days/week of work where I feel so dizzy and sick that I can't get out of bed and certainly can't drive.  My sick feelings are kind of like having a hangover.    

I need to know what kind of specialist to go to next or who can I get to help me continue to investigate and find a solution to my illness?  Are there other tests you would recommend that I have performed?  I cannot live like this - I can't function.

by Kevin Pho, MD, Aug 02, 2005 12:00AM
You have clearly had a comprehensive evaluation, including multiple specialists.  Normally the ENT and neurologist would be the consultants that would help with dizziness.  If there was a silver lining, it's that if there was a serious disease present, it would have been caught with the testing you have undergone.

At this time, you can consider a physical therapy consult.  They deal with dizziness and can consider various maneuvers (i.e. Epley maneuver) that can help the vertigo symptoms you are experiencing.

This option can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com
Member Comments (2)

by jhaverfi, Aug 02, 2005 12:00AM
Yes, I have tried what you recommend.  The ENT did try the Epley manuever and says that I do not have vertigo.  I don't spin and have no nausea.  My dizzyness is more like that of just before you pass out and trouble focusing.  

I just followed up with my general doctor today and she is stumped.  We did more blood workup and she gave me sleeping pills to see if getting more hours of sleep per night will help.  I am hesitant to think this will since when I am unable to get out of bed a couple days a week, I sleep and it does not seem to help.

I have made an appointment with an endocrinologist, but they can't fit me in for 8 weeks.  Am desparate and at this point will try anything.  Is there some other specialist that may be able to help?  Could they have misread my MRI and should I ask for another read?  This really feels like it is in my head.

Thanks

by VictoriaLM, Oct 17, 2005 12:00AM
WOW! I am new to this site but came upon in trying to research my own symptoms. I was in awe when I read your comment...I am going through the EXACT same thing...only before I passed out I had a heart twitch but although I am only 20 years old I would compare the symptoms to that of a heart attack. (which is what I thought I was having) Have been to the ER SEVERAL times,I've been to the family doctor and just last week finished an excercise test, ECG, Echo, and wore a holter monitor for the second time for my new cardiologist.

They tell me everything is fine! the first time I wore the holter they told me I experienced a second-degree heart block which was not current the time of any of my symptoms...( this was all before my cardiologist tests) Since then they have not found anything and say I'm fine!

I still experience severe dizziness, and as you explained it best, the dizziness is compared to the faint feeling you get right before you pass out. I know because this all began after the first time I passed out (it was only once...and once when I was 12...Not sure if its related)

Well I just thought I'd let you know your know your not the only one going through this wierd experience. I Hope that one of us can get a lead as to finding out what this is...Even if it's not the same illness it'll give us something to look in to.

Its horrible that all doctors ad tests come back to believe I am a young and healthy individual. They laugh in my face when I am getting these heart tests done because I am so young...I also have a heart murmer which can either be nothing or threatening....we are not sure as to which one I have. They could not find it in the echo test but the doctor could hear it. So if you hear anything please LET ME KNOW! Or if you can recomend anything that may help in treatment...or even a diagnosis.
Well Best of LUCK!!!!
If you have any further questions feel free to email me at VL_MARCHESANO***@****
Bye for now!
-Victoria

by Carly13, Aug 06, 2008 08:29PM
A related discussion, dizziness answer was started.
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