[29F] Experiencing chronic dizziness, racing heart, and visual disturbances

Patient Description

A 29-year-old female has been experiencing lightheadedness for the past 11 months, occurring about three times a week and lasting for 30 minutes to an hour. The lightheadedness comes on randomly, with or without movement, and not much seems to help until it passes. Additionally, she reports a racing heart occurring at least twice a day, fatigue, and blurred vision, which includes constant flashing lights and floaters. She also experiences constant headaches, described as a throbbing pressure in the front or back of her head, and overall body pain. Nausea is present, but vomiting is infrequent. The patient notes numbness and tingling in her face, neck, and down her arms. Her menstrual cycle has become more frequent, occurring every three weeks, with some excessive discharge. Her family history includes multiple sclerosis on her mother's side. Recent imaging tests revealed a mastoid effusion on the right ear, but were otherwise unremarkable. Current medications include Albuterol, Meclizine, Flonase, Benadryl/Zyrtec, Tylenol, and Ibuprofen. She is not on any birth control or hormone-related medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing. It's important to remember that these are just possibilities, and you should consult with a healthcare professional for a formal diagnosis.

  1. Vestibular Disorders: Given your dizziness, ringing in the ears, and blurred vision, you might be experiencing a vestibular disorder, such as vestibular migraine or Meniere's disease. These conditions can cause episodes of dizziness, hearing changes, and visual disturbances. Treatment often involves lifestyle changes, medications, and sometimes vestibular rehabilitation therapy.

  2. Migraine with Aura: Your headaches, visual disturbances, and nausea could be indicative of migraines with aura. Migraines can cause throbbing headaches, sensitivity to light, and visual changes. Treatment typically includes medications to relieve symptoms and prevent future attacks.

  3. Multiple Sclerosis (MS): Considering your family history and symptoms like numbness, tingling, and fatigue, MS could be a possibility. MS is a neurological condition that affects the central nervous system and can cause a wide range of symptoms. Diagnosis usually involves MRI scans and other tests, and treatment focuses on managing symptoms and slowing disease progression.

  4. Chronic Stress or Anxiety: Your symptoms could also be related to chronic stress or anxiety, which can manifest physically as dizziness, racing heart, and fatigue. Managing stress through therapy, relaxation techniques, and lifestyle changes can be beneficial.

What you can do

Vestibular Disorders:

  • Keep a journal of your symptoms, noting when they occur and any potential triggers. This can help your healthcare provider make a more accurate diagnosis.
  • Avoid caffeine, alcohol, and nicotine, as they can exacerbate symptoms.
  • Consider vestibular rehabilitation exercises, which a physical therapist can guide you through.

Migraines:

  • Identify and avoid migraine triggers, such as certain foods, stress, or lack of sleep.
  • Maintain a regular sleep schedule and stay hydrated.
  • Over-the-counter pain relievers like ibuprofen or acetaminophen can help, but consult your doctor for prescription options if needed.

Multiple Sclerosis:

  • If MS is a concern, it's important to see a neurologist for further evaluation and testing.
  • Keep track of your symptoms and any changes over time using the MDandMe journal.

Chronic Stress or Anxiety:

  • Practice stress-reduction techniques such as deep breathing, meditation, or yoga.
  • Consider speaking with a mental health professional for support and coping strategies.

What you should look out for

It's important to seek medical attention if you experience any of the following:

  • Sudden or severe worsening of symptoms
  • New neurological symptoms, such as weakness or difficulty speaking
  • Vision changes that are persistent or worsening
  • Any other concerning changes in your health

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a comprehensive evaluation and personalized treatment plan.

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1 mo ago

People Also Ask


What are the common symptoms of vestibular disorders?

Common symptoms of vestibular disorders include dizziness, vertigo, balance issues, ringing in the ears (tinnitus), and visual disturbances such as blurred vision or difficulty focusing.


How can migraines with aura be managed or treated?

Migraines with aura can be managed by identifying and avoiding triggers, maintaining a regular sleep schedule, staying hydrated, and using medications to relieve symptoms. Preventive medications may also be prescribed by a doctor.


What are the early signs of multiple sclerosis?

Early signs of multiple sclerosis can include numbness or tingling in the limbs, fatigue, vision problems, muscle weakness, and coordination difficulties. Diagnosis typically involves MRI scans and other neurological tests.


How can chronic stress or anxiety manifest physically?

Chronic stress or anxiety can manifest physically as dizziness, a racing heart, fatigue, headaches, muscle tension, and digestive issues. Managing stress through relaxation techniques and therapy can help alleviate these symptoms.


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