Re: dizziness

Posted By CCF Neurology MD:NT on December 16, 1998 at 22:14:54:

In Reply to: dizziness posted by Tommy on December 13, 1998 at 21:00:11:






Hello,
I am a 26 yr old male with a history of high cholestrol.  Two months ago,  I experienced an episode of near syncope followed by a couple of days of lightheadedness.  I have had a full cardiac workup including echocardiogram w/stress test and 30 day event monitor.  Everything has turned up negative.  In fact,  I am probably in good physical shape as I have been an avid weightlifter for 12 years.
However,  I have continued to experience days of lightheadedness and another episode of near syncope although nowhere near as pronounced as the first.  The lightheadedness has me extremely worried as it is persistent throughout the day.  
My question is this:  what should I do next in terms of diagnosing any illness or ruling anything serious out?  My internal medicine doctor doesn't seem to think much of it,  prescribing Paxil for anxiety.  I imaging that I will have to ask to have any further testing done.
Thanks,
Tommy




Dear Tommy:
Your description does not appear to resemble true vertigo, which is a symptom of inner ear or neurological disease. It more resembles pre-syncope, or near fainting. This due to low blood presure, frequenly from a lowered blood volume - such as from diarrhea, poor fluid intake, excessive sweating, etc. It is less frequently from a cardiac problem, or from a disorder of autonomic nerves causing a loss of tone of blood vessels.
I would trust a competent internist to manage your case. A neurological consultation may be indicated if symptoms persist, and an autonomic disorder is a serious diagnostic consideration.
Good luck!