[40F] Experiencing severe dizziness and associated symptoms

Patient Description

A 40-year-old female reports waking up around 4 am with severe dizziness, to the point of being unable to walk or see clearly. The dizziness is continuous and is alleviated when lying on the left side. Accompanying symptoms include a headache and nausea with a propensity to vomit. The patient has a significant medical history, including multiple blood clots in her leg and lungs, one in her brain, and has undergone a full hysterectomy, cholecystectomy, appendectomy, and removal of a large tumor. She is currently on Eliquis 5 mg for the brain blood clot, diagnosed about 7 months ago, with no recent changes to her medication regimen. No new weakness, numbness in the face, or changes in speech were reported, but she does experience numbness in her hands and feels hot and sweaty. No known drug allergies. No other medications, over-the-counter drugs, supplements, or herbal remedies reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, it's possible that you could be experiencing one of the following:

  • Vertigo: This condition is characterized by a sensation of spinning or feeling off-balance. It can be caused by issues in the inner ear or brain. Vertigo often leads to dizziness, a loss of balance, and sometimes nausea and vomiting.

    • Treatment typically involves medications to relieve symptoms and physical therapy maneuvers to help resolve the underlying issue.
  • Migraine: Migraines can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Some people may experience auras — sensations that precede the headache, such as tingling in the limbs or slight loss of vision.

    • Treatment usually involves medications to relieve symptoms and prevent future attacks.
  • Side effects of Eliquis: Dizziness and nausea are known side effects of this medication. However, given your history of blood clots, it's important to continue taking this medication as prescribed unless directed otherwise by your doctor.

    • If you suspect that your symptoms may be related to your medication, it's important to discuss this with your doctor. They can help determine whether a different medication might be more suitable for you.

Given your history of blood clots and current treatment with Eliquis, it's also important to consider the possibility of a clot affecting your brain. This could potentially lead to a stroke, which is a medical emergency. However, you've not reported any typical symptoms of a stroke, such as sudden weakness or numbness on one side of the body, difficulty speaking, or facial drooping.

What you can do

Given the severity and persistence of your symptoms, it's important to seek medical attention immediately. You should not attempt to drive yourself to the hospital. Instead, call an ambulance or have someone else take you.

In the meantime, try to stay as comfortable as possible. If lying on your left side helps alleviate your symptoms, continue to do so. Try to stay hydrated and avoid any sudden movements that might exacerbate your dizziness.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Sudden, severe headache
  • Difficulty speaking or understanding speech
  • Sudden weakness or numbness on one side of your body
  • Sudden loss of vision or blurred vision in one or both eyes
  • Sudden trouble walking or loss of balance

Please remember that while I strive to provide accurate and helpful information, I'm not a doctor. It's important to consult with a healthcare professional who can provide a formal diagnosis and appropriate treatment options.

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9 mo ago


People Also Ask


What are the common causes of vertigo and how is it treated?

Vertigo is often caused by issues in the inner ear, such as benign paroxysmal positional vertigo (BPPV), Meniere's disease, or vestibular neuritis. It can also be related to problems in the brain. Treatment may include medications to relieve symptoms and physical therapy maneuvers to address the underlying cause.


Can migraines cause dizziness and what are the typical symptoms?

Yes, migraines can cause dizziness. They are typically characterized by severe throbbing pain or a pulsing sensation on one side of the head, accompanied by nausea, vomiting, and sensitivity to light and sound. Some people may also experience auras, which are sensory disturbances that occur before the headache.


What are the side effects of Eliquis and should I be concerned about dizziness?

Eliquis can cause side effects such as dizziness and nausea. While these symptoms can be concerning, it's important to continue taking the medication as prescribed due to its role in preventing blood clots. If you suspect your symptoms are related to Eliquis, discuss this with your doctor to explore alternative options.


What are the warning signs of a stroke and when should I seek emergency care?

Warning signs of a stroke include sudden severe headache, difficulty speaking or understanding speech, sudden weakness or numbness on one side of the body, sudden loss of vision or blurred vision, and sudden trouble walking or loss of balance. If you experience any of these symptoms, seek emergency medical care immediately.

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