Feels like a head rush

[addy520]

there are times when i am laying down or sitting upright and i feel like i have a head rush. sometimes it will last for a few minutes and sometimes it will last for longer. evertime i stand up i feel as though i might passout. i currently am 27years old and have been diagnosed with connective tissue disease associated with systemic lupus. my mother has had lupus, ra and ms for the last 8 yrs. she thinks i need to get tested for ms. could it be ms or just a bad case of lupus?

[Lama Chahine, MD]

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 your doctor.

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

The symptoms of a head rush when you stand from a seated position postural or orthostatic, meaning they are related to changes in position. Normally, there are specific blood pressure and heart rate responses that an individual mounts in response to changes in posture. Often, these include a small drop in blood pressure and an increase in heart rate when one assumes a standing posture. Eventually after standing for a few seconds, the body gets used to the change and there should not be symptoms. In individuals with a problem somewhere within the autonomic nervous system (the part of the nervous system that controls blood pressure, heart rate, and other functions), the appropriate blood pressure and heart rate response may not occur in response to changes in posture, such as in what is medically termed orthostatic hypotension, with autonomic failure. However the most common cause is dehydration; other causes include medications.

One way of assessing the autonomic nervous system is with a test called a tilt table test. If autonomic dysfunction is diagnosed, there are treatments available to help prevent the blood pressure from inappropriately dropping with changes in posture.

Multiple sclerosis would not typically present with isolated autonomic symptoms (other neurologic symptoms would be expected); also, MS is not hereditary. However, given your history of rheumatologic disorder, this may be affecting the small nerves of your body, what is called small fiber neuropathy, which can involve the autonomic nervous system. However, more commonly, something as simple as dehydration can lead to orthostatic symptoms. I recommend you discuss your symptoms with your rheumatologist, with referral for tilt table testing or referral for other testing or to another specialist as felt indicated by your rheumatologist.

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

[londyn61]

A related discussion, thyroid disease, POTS, vagal nerve damage, tachacardia was started.