[56M] Experiencing 'zaps' of dizziness when angry

Patient Description

A 56-year-old male reports moderate 'zaps' of dizziness described as a spinning sensation, occurring 3 to 5 times per week, each lasting less than a second. These episodes are triggered by feelings of anger, especially when encountering mean or insulting behavior, and are alleviated by deep breaths and distraction. The patient has been experiencing these feelings of anger for about a year. No associated chest pain, shortness of breath, sudden weakness, numbness, or changes in hearing or vision have been reported. The patient's medical history includes heartburn, acid reflux, asthma diagnosed 20 years ago, and Long Covid diagnosed 2 years ago. Current medications include atorvastatin 40MG, Pantoprazole 40mg, and Escitalopram 10MG. There are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Vestibular Migraine: This is a type of migraine that may or may not cause a headache, but can cause a variety of symptoms including dizziness, imbalance, and problems with vision. The dizziness can be triggered by stress or strong emotions, such as anger.

    • Treatment typically involves lifestyle changes to manage stress and potentially medication to prevent migraines or to take when you have an attack.
  • Benign Paroxysmal Positional Vertigo (BPPV): This condition causes brief episodes of mild to intense dizziness and is usually triggered by specific changes in the position of your head. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

    • Treatment typically involves a series of movements performed in a doctor's office to help dislodge the tiny calcium particles from the inner ear canal.
  • Psychogenic Dizziness: This is a type of dizziness that is thought to have a psychological cause. In your case, the fact that the dizziness is triggered by anger suggests that it could be psychogenic.

    • Treatment typically involves cognitive behavioral therapy (CBT) and other forms of psychotherapy.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Try to manage your stress and avoid triggers of anger. This could involve techniques such as deep breathing, meditation, or other forms of relaxation.
  2. Stay hydrated and maintain a healthy diet. Dehydration and low blood sugar can sometimes contribute to dizziness.
  3. Avoid sudden changes in position, especially when getting up from lying down or sitting.
  4. If your symptoms persist or worsen, consult with a healthcare provider. They may want to perform tests or refer you to a specialist to determine the cause of your dizziness.

What you should look out for

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

  • A severe headache or a headache that is different from your usual migraines
  • Difficulty speaking or understanding speech
  • Loss of vision or double vision
  • Loss of coordination or balance
  • Numbness or weakness in your face, arms, or legs, especially on one side of your body
  • Any other symptoms that are severe or concerning to you

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What is vestibular migraine and how is it treated?

Vestibular migraine is a type of migraine that can cause dizziness, imbalance, and vision problems, often triggered by stress or strong emotions. Treatment typically involves lifestyle changes to manage stress and possibly medication to prevent migraines or treat them during an attack.


What are the symptoms and treatment options for Benign Paroxysmal Positional Vertigo (BPPV)?

BPPV causes brief episodes of dizziness triggered by changes in head position. Treatment usually involves specific head movements performed by a doctor to help dislodge calcium particles from the inner ear canal.


Can stress or emotions like anger cause dizziness?

Yes, stress and strong emotions like anger can cause dizziness, which may be psychogenic in nature. This type of dizziness is thought to have a psychological cause.


What steps can I take to manage dizziness triggered by emotions?

To manage dizziness triggered by emotions, try stress management techniques such as deep breathing, meditation, or relaxation exercises. Staying hydrated and maintaining a healthy diet can also help, as well as avoiding sudden changes in position.


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