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progressing problems(dizziness now low grade headache)
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progressing problems(dizziness now low grade headache)

For about 3 years now I have been having a problem that has been getting worse.
It started with these sudden onset of a sensation that I was going to pass out, it would last a few second and go away, but I would get sweaty after and feel run down after. I had EKG, CT, holter test, exercise stress test. I've cut down on caffine, tried to increase sleep.
For lately this has progressed from an everyonce and a while sensation to one where I have a mild headache that moves around my head, dizziness, and sensations of me feeling like my head is going to drop to the ground. It happens at rest, watching movies, to times where I am walking about. I notice no changes in my heart rate, and sometimes I get sweaty. I also have noticed some changes in my visions where things will become fuzzy and I can see a person i'm focusing on but everything around them is very fuzzy.
I had a MRI in december when things where on and off. should I request another MRI since the issues are constant now. My dec one as clear, I also have had thyroid test and alot of blood and urine tests.
I do no drugs, drink one or two beers a week.

Any advise would be greatly appreciated. MY doctor is talking antidepressants but I don;t think it's anxiety or depression.
Thoughts Help!!
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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.

It sounds like you have many symptoms but a prominent one sounds to be like light-headedness/whooziness, or pre-syncope. Based on the description you provide, the more common causes are cardiovascular (arrhythmias, which should have been picked up by Holter though sometimes it may not have been) or vasovagal, which is an exaggeration of normal blood vessel and heart rate reflexes that normally occurs, this is a benign condition.

It sounds like your symptoms can occur at rest, and are not related to changes in posture. Therefore a less likely of a cause but still a possibility is a problem in the autonomic nervous system, the part of the nervous system that controls blood pressure, heart rate, and other functions. It is not located in one specific part of the brain or other body part but is rather made up of several different components: a region in the brainstem, certain receptors located on blood vessels and in the heart, and small nerves in our skin, among other areas. Dysfunction of the autonomic nervous system due to whatever cause can lead to a variety of symptoms including but not limited to orthostasis (which means symptoms or signs resulting from assuming an upright posture), light-headedness with drops in blood pressure when sitting up or standing up (this is an example of orthostasis), syncope (passing out), constipation, diarrhea, sweating abnormalities etc. If there is a problem in the small nerve fibers, what is medically termed a small fiber neuropathy, in addition to these symptoms, burning/tingling in the feet and hands or mild sensory loss may also occur. 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. In individuals with a problem somewhere within the autonomic nervous system, these responses are abnormal. Diagnosis of autonomic dysfunction includes a tilt table test and tests for peripheral neuropathy.

If you have a history of migraine headaches, the mild headaches you get associated with dizziness could be a variant of migraine called basilar migraine, 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.

Another MRI of the brain is likely unnecessary if there are no new neurologic symptoms even if there is symptoms worsening in frequency and intensity, but you should discuss this with your physicians.

Continued followup with your primary doctor and cardiologist is recommended, with possibly evaluation by a tilt table test if this has not yet been done. Based on the results of that, further neurologic evaluation may be warranted.

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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