[40F] Experiencing constant dizziness and head pressure

Patient Description

A 40-year-old female has been suffering from constant dizziness and a heavy sensation in the head for the past four years. She rates her dizziness as a 9 out of 10 and the pressure in her head as a 10 out of 10, particularly behind the eyes and in the lower back of the head. The symptoms are not affected by changes in position and are constant throughout the day, although stress exacerbates the condition. The patient has also experienced headaches, blurry vision, and difficulty communicating. Despite no confirmed seizures, she is on Oxycarbazepine (350mg twice a day) and takes Vitamin C supplements. No known allergies, no use of alcohol, tobacco, or recreational drugs, and no significant past medical or family history of neurological conditions have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possibilities that could explain your symptoms:

  • Chronic Migraines: Migraines are severe headaches that can cause a pulsing sensation or throbbing pain, usually on one side of the head. They can also cause nausea, vomiting, and extreme sensitivity to light and sound. Migraines can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment typically involves medications to help reduce the frequency and severity of migraines. These could include pain-relieving medications, preventive medications, or medications to help manage any associated symptoms.
  • Vertigo: This is a sensation of feeling off balance and experiencing a dizzy spell. Vertigo is often caused by an issue in the inner ear or brain.

    • Treatment of vertigo depends on the cause and severity of the symptoms. It may include medications, physical therapy maneuvers, or other types of therapy.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.

    • Treatment of CFS focuses on symptom relief. This may include medications to control pain, sleep disorders, other symptoms, or therapy to help you cope with the disorder.
  • Anxiety Disorders: Chronic stress or anxiety can cause a variety of physical symptoms, including dizziness, headaches, and fatigue.

    • Treatment typically involves a combination of psychotherapy, behavioral therapy, and medication.

It's important to note that these are just possibilities, and the exact cause of your symptoms can only be determined by a healthcare professional.

What you can do

Given the chronic nature and severity of your symptoms, it's important to continue seeking medical attention. Here are some steps you can take:

  1. Continue to take your prescribed medication as directed by your doctor.
  2. Try to identify and avoid any potential triggers for your symptoms, such as stress.
  3. Maintain a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep. These can help manage some of your symptoms and improve your overall health.
  4. Consider seeking mental health support. Chronic physical symptoms can often be exacerbated by stress, anxiety, and other mental health issues. A mental health professional can provide strategies to help manage these aspects.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache or a headache that is accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • A sudden, severe headache that's different from past headaches
  • A headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Please remember that while I strive to provide accurate information, I'm not a doctor and my advice should not replace a consultation with a healthcare professional.

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9 mo ago


People Also Ask


What are the common causes of constant dizziness and a heavy sensation in the head?

Constant dizziness and a heavy sensation in the head can be caused by various conditions such as chronic migraines, vertigo, chronic fatigue syndrome, or anxiety disorders. It's important to consult a healthcare professional for an accurate diagnosis.


How can stress exacerbate symptoms like dizziness and headaches?

Stress can exacerbate symptoms like dizziness and headaches by triggering the body's stress response, which can lead to muscle tension, changes in blood flow, and increased sensitivity to pain. Managing stress through relaxation techniques and therapy can help alleviate these symptoms.


What are the potential side effects of taking Oxycarbazepine for dizziness?

Oxycarbazepine is an anticonvulsant medication that can cause side effects such as dizziness, drowsiness, nausea, and headaches. It's important to discuss any side effects with a healthcare provider to ensure the medication is appropriate for your condition.


How can chronic migraines be differentiated from other types of headaches?

Chronic migraines are typically characterized by severe, throbbing pain on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound. They can last for hours to days and may be preceded by an aura. Differentiating them from other headaches involves assessing the frequency, duration, and associated symptoms, often requiring a healthcare professional's evaluation.


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