[57F] Experiencing dizziness, nausea, vomiting, and tinnitus

Patient Description

A 57-year-old female presents with symptoms of lightheadedness, nausea, and vomiting, as well as ringing in the left ear. The lightheadedness has been occurring on and off for about 5 months and worsens with movement, typically lasting a few seconds. The severity of the dizziness is rated as an 8 out of 10. Nausea and vomiting have been present for a week, with vomiting occurring occasionally and not triggered by specific foods. The nausea is also rated as an 8 out of 10 in severity. The patient experiences a constant buzzing in the left ear that started 6 months ago, before the dizziness began, and the severity is rated as a 9 out of 10. The patient has a history of high blood pressure and anemia and is currently taking Losartan (50mg once daily) and Zofran (dosage unspecified, every 8 hours as needed). There is no history of head injury, loud noise exposure, sudden hearing loss, ear fullness, or severe headaches or neurological changes. There are no known allergies to medications.

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Arora's Assessment

What might be happening

Based on your symptoms, you may be experiencing:

  • Ménière's disease: This is a disorder of the inner ear that can lead to dizzy spells (vertigo) and hearing loss. In most cases, it affects only one ear. It can cause severe dizziness, a roaring sound in your ears (tinnitus), hearing loss that comes and goes, and ear pressure. The cause of Ménière's disease is unknown.

    • Treatment for Ménière's disease usually involves a combination of medications, lifestyle changes, and sometimes surgery.
  • Benign paroxysmal positional vertigo (BPPV): This is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning. BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in the position of your head.

    • Treatment for BPPV may include maneuvers in which your doctor moves your head into different positions to reset the balance in your inner ear.
  • Vestibular neuritis or labyrinthitis: Both are inflammations caused by a viral infection that result in dizziness and loss of balance. Vestibular neuritis is an inflammation of the vestibular nerve and can result in vertigo. Labyrinthitis is an inflammation of the inner ear and can cause dizziness, hearing loss, and a ringing sound in your ear. It's usually caused by a viral infection.

    • Treatment typically includes medications to control the inflammation and to relieve symptoms such as nausea and vomiting.

What you can do

  1. Schedule an appointment with your doctor: Given the duration and severity of your symptoms, it's important to get a formal evaluation. Your doctor can perform tests to better understand what's causing your symptoms and to rule out more serious conditions.

  2. Rest and hydrate: Make sure to get plenty of rest and stay hydrated, especially if you're experiencing vomiting.

  3. Avoid triggers: If certain movements or positions make your symptoms worse, try to avoid them as much as possible.

  4. Over-the-counter relief: Over-the-counter motion sickness medications may help relieve symptoms of dizziness and nausea. However, these should only be used as a temporary measure and not as a substitute for seeking medical attention.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

  • A new, severe headache
  • Fever
  • Double vision
  • Trouble speaking
  • Chest pain
  • Fainting
  • Ongoing vomiting
  • Severe weakness, numbness, or difficulty moving

Please remember that while I strive to provide accurate information, I'm not a doctor. It's important to consult with a healthcare professional who can provide advice based on a thorough examination.

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10 mo ago

People Also Ask


What is Ménière's disease and how is it treated?

Ménière's disease is a disorder of the inner ear that can cause episodes of vertigo, tinnitus, hearing loss, and ear pressure. It typically affects one ear. Treatment often involves medications to reduce symptoms, lifestyle changes, and sometimes surgery.


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

BPPV is characterized by brief episodes of dizziness triggered by changes in head position. Treatment often includes specific head maneuvers performed by a doctor to reposition the particles in the inner ear that cause the dizziness.


How can vestibular neuritis or labyrinthitis cause dizziness and what are the treatment options?

Vestibular neuritis and labyrinthitis are inflammations of the inner ear or vestibular nerve, often due to viral infections, leading to dizziness and balance issues. Treatment usually involves medications to control inflammation and relieve symptoms like nausea.


What should I do if I experience severe dizziness and nausea?

If you experience severe dizziness and nausea, it's important to rest, stay hydrated, and avoid movements that worsen symptoms. Over-the-counter motion sickness medications may provide temporary relief, but you should consult a doctor for a proper evaluation and treatment plan.


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