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Undiagnosed Dizzyness
Patient is a 35 y/o Caucasian male 142lbs, non-smoke non-drink no Rx, military member returned from sea with the following symptoms:
Last month at sea: no noticeable issues, regulated meals and workout routine
Past 7 days: returned home for vacation with family, 10 hour time change, unregulated meal times, no exercise. He has eaten two meals a day since his return and a snack around 10pm. His sleep routine begins around 11pm and he spontaneously wakes at 4am.
Yesterday was the first difference: patient went to bed at 11pm and claims his dreams consisted of two severe episodes of spinning to the point of feeling nauseous. He woke to an alarm at 730am. Most of the morning was spent sitting on the couch. At 1045am, he ate half of his first meal of the day and rejected the rest claiming he wasn't hungry anymore.
At 11am, he leaned over to kiss his wife and fell over. He claims he didn't know he was falling until he saw the ground moving, after which he claims feeling the same dizzy spell he felt in his dream. He returned to the couch and sat for a few minutes. Leaning his head to the left, he felt dizzy again. Returning his head upright, the spell faded. He sat until 1230pm when he decided to take a nap. He claims his dreams were full of worry about fainting. At 215pm, he woke and stretched while still laying down. He said he felt the same dizzy spell and his head lulled to the right on its own. The rest of the afternoon was spent worrying and resting.
He is visibly shaken at the incident. His resting pulse was 86 and BP was within normal range. I diagnosed it as a singular episode of orthostatic hypotension based on his sedition and lack of regulated sleep and eating habits since his return. I didn't want to call it vertigo because he didn't experience the moving sensation until after collapse. At patient's request, I did not perform a sit/stand test nor a tilt-table test.
I appreciate any opinions you provide.
Last month at sea: no noticeable issues, regulated meals and workout routine
Past 7 days: returned home for vacation with family, 10 hour time change, unregulated meal times, no exercise. He has eaten two meals a day since his return and a snack around 10pm. His sleep routine begins around 11pm and he spontaneously wakes at 4am.
Yesterday was the first difference: patient went to bed at 11pm and claims his dreams consisted of two severe episodes of spinning to the point of feeling nauseous. He woke to an alarm at 730am. Most of the morning was spent sitting on the couch. At 1045am, he ate half of his first meal of the day and rejected the rest claiming he wasn't hungry anymore.
At 11am, he leaned over to kiss his wife and fell over. He claims he didn't know he was falling until he saw the ground moving, after which he claims feeling the same dizzy spell he felt in his dream. He returned to the couch and sat for a few minutes. Leaning his head to the left, he felt dizzy again. Returning his head upright, the spell faded. He sat until 1230pm when he decided to take a nap. He claims his dreams were full of worry about fainting. At 215pm, he woke and stretched while still laying down. He said he felt the same dizzy spell and his head lulled to the right on its own. The rest of the afternoon was spent worrying and resting.
He is visibly shaken at the incident. His resting pulse was 86 and BP was within normal range. I diagnosed it as a singular episode of orthostatic hypotension based on his sedition and lack of regulated sleep and eating habits since his return. I didn't want to call it vertigo because he didn't experience the moving sensation until after collapse. At patient's request, I did not perform a sit/stand test nor a tilt-table test.
I appreciate any opinions you provide.
MEDICAL PROFESSIONAL
Hi
Welcome to the MedHelp forum!
Time lag, extreme exhaustion and a build up of acidity due to not eating properly can all cause this. Something to combat acidity and to overcome dizziness should be given, along with a mild tranuilizer. If this does not help then the patient should first be referred for tests to rule out orthostatic hypotension, and to an ENT specialist to rule out eat causes as tilting head to one side precipitates the attack more. If all this is ruled out, then cervical spondylosis should be ruled out. Hope this helps. Take care!
Welcome to the MedHelp forum!
Time lag, extreme exhaustion and a build up of acidity due to not eating properly can all cause this. Something to combat acidity and to overcome dizziness should be given, along with a mild tranuilizer. If this does not help then the patient should first be referred for tests to rule out orthostatic hypotension, and to an ENT specialist to rule out eat causes as tilting head to one side precipitates the attack more. If all this is ruled out, then cervical spondylosis should be ruled out. Hope this helps. Take care!
It sounds like his inner ear has been involved, specifically his semi-circular canals. Was a hearing test performed? Salt can also build-up fluids in the inner ear if his eating has increased the amount of salt intake, poor schedule and complete change of life since he was abroad.
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