Falling Feeling While Being Awake

Hi,
I'm a 21 year old female
For about a year now since last August I've been feeling like I'm going to pass out, but I've never passed out or had loss of consciousness. I've also been dizzy as well, except the the room isn't spinning, it feels more like the feeling you get when you're falling asleep and it feels like you're falling down.  This falling feeling happens to me when I'm completely awake. I'm usually standing up or walking and then it'll just hit me out of no where. I have a lot of headaches as well, they're located usually in the back of my head and in the front. It's like a dull achy pain and sometimes a throbbing one. I've only been having this headaches for about a month. And as of lately It's been getting worse. I have a headache and have the falling feeling 24/7. It's to the point where I can't drive or do things, No one has a clue as to why it's happening. I went to the emergency room and they did a cbc and ct scan and everything came out normal. I know it's not dehydration or stress because I drink a lot of water, I eat regularly and healthy, and for the past month I've been trying to relax and cut out everything that could be stressful that maybe could be causing this but it's only been getting worse. I don't have any medical problems other than hypothyroidism, but that's even normal and has been normal for the past 11 years. My dizziness and headaches don't get better with rest, it seems like it never gets better. Thank you for your time and I hope someone can give me any ideas as to what this can be.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Dizziness can mean multiple things. Some describe dizziness as spinning sensation, others lightheadedness or imbalance. The most common cause of dizziness is benign paroxysmal positional vertigo (BPPV). However, you describe more lightheadedness feeling, rather than a spinning sensation. (BPPV is classically a spinning sensation that is worse with turning head or rolling over in bed).

Dizziness can be due to problems in the brain. The most common is a benign tumor called a schwanoma (also called acoustic neuroma). This is diagnosed by MRI of the brain. Multiple sclerosis can cause vertigo, but often, other symptoms are present as well, such as numbness, weakness, vision changes, etc. A normal MRI of the brain excludes multiple sclerosis. Thyroid problems can also lead to dizziness.

Your symptoms may be consistent with a variant of migraine called basilar migraine. Basically this is marked by several hours of dizziness associated with nausea, light-sensitivity, and sometimes other symptoms. Headache may or may not be present. The treatment is different from that used to treat other migraine types; the treatment in this case is a type of medication called calcium channel blocker, such as verapamil, which is actually used to treat blood pressure but works in type of basilar migraine as well.

Lastly, low blood pressure, such as from, dehydration or autonomic dysfunction, cardiac problems, and several other non-neurologic causes can cause lightheadedness. Anemia can cause light-headedness as well.

I would suggest you follow up with your primary physician. If a source cannot be found after thorough blood workup (which would include a thyroid panel and glucose testing), an MRI of the brain with and without contrast may be necessary.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[gumball23]

Thank you so much for getting back to me!!!! It helped a lot. Right now I'm in the process of getting an mri, but everything else was ruled out. I also went to see an ENT today and he didn't seem to find anything either.