Presyncopal Lightheadedness

[Dan111]

Hi there,  I was diagnosed with bickerstaffs brainstem and limbic encephalitis after having contracted it while studying in central China in 2005.  Today,  things are thankfully greatly improved but the difference between getting back into life and not,  it seems,  is presyncopal lightheadedness, which has been a painfully slowly improving symptom over the past three years.
  I've become an extremely active person since falling ill as,  I believe this symptom is related to blood flow to the brain and therefor being in better cardiovascular condition should improve the problem,  which it has but the main lingering symptom of this lightheadedness has been fear and apprehension - crossing roads seems like playing Russian roullette right now.
  Are there any medications (preferably non prescription but prescription would be nice also) which are known of to improve the circulation of blood to the brain with minimal to no side effects (like fatigue)?  While on the subject,  I also have a lingering slight astigmatism of the eyes which can also be a trigger at times (used be I'd see two of everything,  now is only a problem when I look left/right)

Any help appreciated,
                               Daniel

[Dan111]

I'm greatly concerned by this.  I've had the idea of being more proactive and seeking glasses to help my eyes focus better and perhaps improve things but on the other hand I'm apprehensive as I see doing this as a bandaid for the brain more or less and I'm concerned that the degree of natural compensation or improvement will be less as my brain and eyes become dependent on the use of prescription glasses.  
  Basically I spent the first year terrified of going blind,  the second terrified of stroke (which is was I thought presyncopal lightheadedness was the beginnings of initially) and now in the third to fourth year I find myself asking "what if the doctors were wrong last year and I do get well?  They said I wouldn't improve but I have"
  I'm pretty much hell bent on recovery and at present I average 5-8 hours physical and mental rehab 6 days per week (was 8 per day but that was silly and caused more problems than it fixed).
  Right now I feel on the verge of a recovery I was told I'd never make and this lightheadedness is about the single biggest obstacle remaining.  Throughout the course of the last three years I've found that :

-exhaling as I begin to cross the road (and not inhaling as I begin)
-not thinking too much about the potential for an episode and just doing it
-being fitter
-getting into a rigid routine of exercise and mental stimulation
-being positive minded

all seem to help prevent it but on some days it's simply not possible and I have an episode as a result which is utterly depressing for some time thereafter.  
  Essentially my two biggest fears to overcome about this are :
1) it might result in a stroke
2) I might get hit by a car

  but there's no easy way around it - do it and eventually improve or don't and remain the same - I see corrective glasses as potentially an admission of the latter - do you know of any neurological circulatory medications which may help,  or balance assisting (non prescription)?

[DrNoopurMD]

Also please get an eye exam done as you may need corrective glasses.

[DrNoopurMD]

Hi,

How are you?
As you rightly mentioned presyncopal lightheadedness is due to insufficient blood flow to the brain. This can be due to a cardiovascular condition or postural hypotension. Postural hypotension occurs when the blood pressure suddenly falls when standing from a sitting posture.
Other cause can be hyperventilation, rapid shallow breathing can cause presyncopal lightheadedness.
Please discuss these possibilities with your treating doctor as the treatment will depend on the underlying cause. Meanwhile please eat a balanced meal and maintain your flyid intake at all times. Take care!