[21M] With imbalance and tinnitus post-head trauma

Patient Description

A 21-year-old male has been experiencing a sensation of imbalance for approximately two weeks, which began following an incident where he was punched in the head multiple times. The imbalance is exacerbated by standing for prolonged periods or viewing moving images on screens. Additionally, the patient reports a high-pitched ringing in the right ear, which is not noticeable when there is background noise such as a TV show or conversation. The patient has a history of anxiety diagnosed a few months ago and a previous concussion approximately eight years ago. He denies any changes in vision or hearing, aside from the tinnitus, and has not experienced nausea or vomiting. Occasionally, he feels tired but has not noticed significant changes in sleep patterns. No imaging tests have been conducted since the recent head injury. The patient is not currently on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  • Post-Concussion Syndrome: This condition can occur after a head injury, even if the initial concussion was mild. Symptoms can include dizziness, ringing in the ears (tinnitus), and balance issues. Anxiety and fatigue are also common. It's important to follow up with a healthcare provider to assess your symptoms and determine the best course of action.

    • Treatment typically involves rest and avoiding activities that could worsen symptoms. A healthcare provider may recommend physical therapy or vestibular rehabilitation to help with balance issues.

  • Labyrinthitis or Vestibular Neuritis: These are inner ear disorders that can cause dizziness, balance problems, and ringing in the ears. They often occur after a viral infection but can also be related to head trauma.

    • Treatment may include medications to reduce dizziness and nausea, as well as exercises to improve balance.

  • Anxiety-Related Dizziness: Anxiety can sometimes manifest with physical symptoms, including dizziness and a sense of imbalance. The stress from the head injury and ongoing symptoms might be contributing to this.

    • Treatment for anxiety-related symptoms often involves therapy, stress management techniques, and sometimes medication.

What you can do

  1. Consult a Healthcare Provider: It's important to see a doctor to evaluate your symptoms, especially given your recent head injury. They may recommend imaging tests or refer you to a specialist, such as a neurologist or an ENT (ear, nose, and throat) doctor.

  2. Rest and Avoid Triggers: Try to rest and avoid activities that worsen your symptoms, such as watching fast-moving images on screens.

  3. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share this information with your healthcare provider. This can help in identifying patterns and triggers.

  4. Manage Anxiety: Consider techniques such as deep breathing exercises, meditation, or yoga to help manage anxiety. If anxiety continues to be a significant issue, discussing it with a mental health professional might be beneficial.

What you should look out for

Seek medical attention if you experience any of the following:

  • Worsening symptoms or new symptoms, such as severe headaches, confusion, or changes in vision.
  • Persistent or severe dizziness that affects your ability to perform daily activities.
  • Any signs of infection, such as fever or ear pain.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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10 d ago

People Also Ask

What is post-concussion syndrome and how is it treated?

Post-concussion syndrome is a complex disorder with symptoms such as headaches, dizziness, and ringing in the ears that persist after a concussion. Treatment typically involves rest, avoiding activities that worsen symptoms, and sometimes physical therapy or vestibular rehabilitation to help with balance issues.

Can anxiety cause physical symptoms like dizziness and imbalance?

Yes, anxiety can manifest with physical symptoms, including dizziness and a sense of imbalance. Stress from a head injury and ongoing symptoms can contribute to this. Treatment often involves therapy, stress management techniques, and sometimes medication.

What are labyrinthitis and vestibular neuritis, and how do they relate to head trauma?

Labyrinthitis and vestibular neuritis are inner ear disorders that can cause dizziness, balance problems, and ringing in the ears. They often occur after a viral infection but can also be related to head trauma. Treatment may include medications to reduce dizziness and exercises to improve balance.

When should I seek medical attention for dizziness and balance issues after a head injury?

You should seek medical attention if you experience worsening symptoms, new symptoms like severe headaches or confusion, persistent dizziness affecting daily activities, or signs of infection such as fever or ear pain.

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