[29M] With severe dizziness and other symptoms post-assault

Patient Description

A 29-year-old male reports severe dizziness characterized by a spinning sensation, especially when standing up, lasting a few hours in the mornings. These symptoms began following an assault a few weeks ago. The patient also experiences lightheadedness, anxiety, nausea, hot flashes, and a fever of around 100°F. He reports intermittent ringing in his ears, occasional blurry vision, migraines, sensitivity to light, and difficulty with balance and coordination. There is no weakness or numbness in the arms or legs, changes in speech, or confusion and memory problems. The patient has been using meth since the incident and takes Tylenol and ibuprofen as needed. He has no allergies to medications, pre-existing conditions, or chronic illnesses, and is not taking any prescription medications, over-the-counter supplements, or vitamins.

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Arora's Assessment

What might be happening

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

  1. Post-Concussion Syndrome:

    • Given that you were jumped a few weeks ago, it's possible you sustained a concussion. Symptoms of post-concussion syndrome can include dizziness, headaches (like migraines), nausea, sensitivity to light, and balance issues. These symptoms can persist for weeks or even months after the initial injury.
    • Typical treatments include rest, avoiding activities that can worsen symptoms, and medications to manage specific symptoms like headaches and nausea.
  2. Vertigo:

    • The spinning sensation you described, especially when standing up, could be a form of vertigo. This can be caused by issues in the inner ear, such as benign paroxysmal positional vertigo (BPPV) or vestibular neuritis.
    • Treatment often involves specific head movements (Epley maneuver) to reposition inner ear crystals, medications to reduce dizziness, and sometimes physical therapy.
  3. Substance Use Effects:

    • The use of methamphetamine can exacerbate symptoms like dizziness, anxiety, and nausea. Meth can also affect your balance and coordination and may contribute to your hot flashes and temperature fluctuations.
    • Reducing or stopping meth use is crucial, and seeking help from a healthcare provider or addiction specialist can be beneficial.

What you can do

Dizziness and Vertigo:

  • Rest and Hydration: Ensure you are well-hydrated and get plenty of rest. Avoid sudden movements and try to move slowly when changing positions.
  • Epley Maneuver: If you suspect vertigo, you can try the Epley maneuver at home. There are many online resources and videos that can guide you through this.
  • Avoid Triggers: Identify and avoid any triggers that worsen your dizziness, such as bright lights or loud noises.

Headaches and Sensitivity to Light:

  • Pain Management: Continue using Tylenol and ibuprofen as needed, but ensure you do not exceed the recommended dosage.
  • Dark, Quiet Environment: Rest in a dark, quiet room when you have a headache. Use a cold compress on your forehead to help alleviate pain.

Nausea:

  • Small, Frequent Meals: Eat small, frequent meals to help manage nausea. Avoid spicy or greasy foods.
  • Ginger or Peppermint: Ginger tea or peppermint can help soothe nausea.

Substance Use:

  • Seek Help: Reducing or stopping meth use is crucial for your overall health. Consider seeking help from a healthcare provider or addiction specialist.
  • Support System: Reach out to friends, family, or support groups for assistance and encouragement.

General Health:

  • Monitor Symptoms: Keep track of your symptoms using the MDandMe journal. This can help you identify patterns and provide valuable information to your healthcare provider.
  • Stay Cool: Use a fan or cool compresses to manage hot flashes and temperature fluctuations.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Worsening Symptoms: If your dizziness, headaches, or other symptoms worsen or do not improve.
  • New Symptoms: If you develop new symptoms such as weakness, numbness, difficulty speaking, or confusion.
  • Severe Headache: If you experience a sudden, severe headache unlike any you've had before.
  • Fainting or Loss of Consciousness: If you faint or lose consciousness.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have any more questions or need further assistance, feel free to continue the conversation.

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4 mo ago


People Also Ask


What are the common symptoms of post-concussion syndrome?

Common symptoms of post-concussion syndrome include headaches, dizziness, nausea, sensitivity to light and noise, balance issues, and sometimes cognitive difficulties. These symptoms can persist for weeks or months after a concussion.


How can methamphetamine use affect dizziness and balance?

Methamphetamine use can exacerbate symptoms like dizziness, anxiety, and nausea. It can also affect balance and coordination, potentially worsening any pre-existing conditions related to dizziness or vertigo.


What is the Epley maneuver and how does it help with vertigo?

The Epley maneuver is a series of head movements designed to treat benign paroxysmal positional vertigo (BPPV) by repositioning crystals in the inner ear. This can help alleviate the spinning sensation associated with vertigo.


When should someone with dizziness and headaches seek medical attention?

Medical attention should be sought if dizziness and headaches worsen, do not improve, or are accompanied by new symptoms such as weakness, numbness, difficulty speaking, confusion, a sudden severe headache, or loss of consciousness.


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