Constant lightheadedness

[radam852]

Complaint: past week, recent constant lightheadedness, that resolves at some points during the day briefly but resumes.  It is not alleviated by lying down or other means, except maybe after a night's rest, it takes an hour or two to begin again.  There are no spinning sensations generally but a light dizziness.  On occasion it worses markedly and I feel as if I almost may faint, though never have.  Also I feel there may be some numbness on my forehead, but I can't be too certain.  It seems associated with mild pressure on the top of my head, almost like a headache and general pressure almost nasally around the sinuses.  All ocular tests are normal, hearing is normal.  BP normal.  Blood glucose levels during episodes are normal.  No changes in vision.  General weakness on occasion but no deficits noted specifically.  Slight feeling off balance when lightheaded.  At times exacerbated while focusing on objects or reading on the computer.  Difficult to concentrate and remain focused.

Possibly due to sinusitis?  Also have a cracked upper wisdom tooth, but no apparent abscess or infection, although I am not 100% certain, however there is no pain from the area, nor appreciable swelling.

I am interested in some differential diagnoses you may have for this lightheadedness.

Hx: I'm a 28 year old male, with IDDM for 17 years and rheumatoid arthritis for the past 10.  Current meds include humalog, lantus, micardis, methotrexate, mobic, prevacid, folic acid, and prn pain medication.  This lightheadness is not associated directly with blood glucose levels or pain medications.

[radam852]

I know many people have these symptoms, as a medical student I know that this most likely can be due to sinusitis, which results in a variety of symptoms including facial pain, tooth pain, headache, eye pain, dizziness, lightheadedness, vertigo, etc. due to sinus irritation, infection (bacterial, viral, or fungal).

However, I have very mild, if not any pain.  Sometimes knowing this much about disease causes me to turn into a hypochondriac.  I worry about it being an abscess from a tooth that moved to my brain (unlikely since I have no tooth pain) or even MS.  The MS worries me since my mother has it and I have two autoimmune diseases.  I've taken antibiotics for 3 days and the lightheadedness seems to have improved but not 100%.  However, now I tend to feel lots of muscle weakness and some pain in one of my eyes, but I have really no visual abnormalities or abn reflexes.  Hopefully some more insight could be provided to alleviate this or my fears regarding it.

[MInute Maid]

Oh, and I meant to suggest in the last post that possibly your light-headedness is coming from your neck.  I note you already have arthritis and I wonder if you might have some spondylitis?  The fact that you become dizzy after reading and working online suggests you may be holding your neck at an awkward angle and the discs might me impinging on a nerve.  Just a possibility.

[MInute Maid]

I have this too.  I keep getting a spinning sensation and I am pretty sure it is associated with my sinuses as I have a severe maxillary infection at the moment. The pressure is NOT painless, however, and it does feel like someone is blowing a balloon up inside my head.     I am on antibiotics at the  moment which is helping but it is a slow process.

[sirjoseph]

i have EXACTLY the same symptoms you do, mild dizziness, off balance, sometimes getting worse for several minutes but never true vertigo, i almost feel like passing out or something, painless pressure around my eyes and upper nose and directly on top of the head, like its inflating in there. so far i havent had any answers (ive posted about it before) except that it might be an ethmoid/sphenoid sinus infection. i also heard it could be allergies. im going to a clinic tomorrow and ill see what they say and i will let you know.