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.