Stiff neck, dizziness, nausea
by ForestCharm, Jan 23, 2010
Hello from the UK can anyone help me? For months now I have been suffering dizziness, nausea and drowsiness particularly in the mornings on waking up. It is seriously affecting my quality of life, I'm losing time from work and it's really worrying me and making me feel depressed. My doctor has not been much use and I don't have a diagnosis. I am now beginning to panic that I have a life-threatening illness. I am particularly bad this week having jarred my neck in bed - whole room started to spin round me and I was violently sick. Any comments gratefully received. Thank-you.
by Neuro ForumBlank, Jan 25, 2010
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.

I am not sure what you mean by the term dizziness. When some people use the term dizziness, they often mean vertigo, or room-spinning. Others mean a light-headed, whoozy feeling.

If by dizziness you mean vertigo (room-spinning), the causes could be either the inner ear or the brain. Inner ear causes of vertigo most commonly include benign positional vertigo (BPPV), which is due to small particle in the inner ear that moves out of place, and can be repositioned with simple head maneuvers. The symptoms often include vertigo that occurs with turning of the head, often while turning over in bed. Another cause, if your symptoms are associated with tinnitus (ear ringing) and hearing loss is called Meniere’s disease and can be treated with medications and sometimes surgery. And so on, several other causes from inner ear problems exist.

Vertigo can also 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. A normal MRI of the brain excludes multiple sclerosis. Thyroid problems can also lead to vertigo.

If by dizziness you mean light-headedness, causes could include low blood pressure such as due to dehydration or autonomic dysfunction, cardiac problems, and several other non-neurologic causes. Anemia can cause light-headedness as well.

If you awaken in the morning with a groggy feeling and feel your sleep has been unrefreshed, one possibility is obstructive sleep apnea. Symptoms include daytime sleepiness, unrefreshing sleep, morning headaches, frequent naps during the day. This is more common in overweight people who snore, but can occur in people of normal weight who do not snore. The risks of untreated sleep apnea, besides affecting day to day life and causing fatigue, include high blood pressure, heart problems, and even stroke. The diagnosis is made with a study called a polysomnogram (sleep study) and effective treatments such as CPAP are available.

Patients with dizziness due to neck pathology (cervicogenic dizziness) often complain of dizziness that is worse with particular head movements and when the head is maintained in one specific posture for prolonged periods. Neck pain and a headache in the occipital region (the back of the head above the neck) may be associated with the dizziness. The dizziness may last minutes to hours after assuming certain head positions. Imaging of the neck is often indicated, and treatment is usually with  neck physical therapy, unless a structural lesion that requires surgery is found on neck imaging.

Continued followup with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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Member Comments (2)
by ldhallett, Jan 23, 2010
You should probably see an ENT and be checked for Meniere's Disease.  Do you have any tinnitus?  Try eliminating salt from your diet and see if it helps.  When you're talking with someone on the phone, switch ears, do you hear them equally well or is the sound quality the same out of each ear?  Low tone hearing loss is common with Menieres.  I would avoid driving.

Good Luck.