[86M] Experiencing intermittent dizziness and difficulty focusing eyes

Patient Description

An 86-year-old male reports intermittent episodes of lightheadedness and difficulty focusing his eyes, where things seem to move slightly, over several days. These symptoms have occurred twice before. The dizziness is rated as 7 out of 10 in severity and improves when lying down. The patient has a medical history of bradycardia diagnosed 5 years ago and is currently on Warfarin and Sotalol. There are no known allergies or adverse reactions to medications. No specific movements or positions that exacerbate the symptoms were reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possible causes:

  • Vestibular neuritis or labyrinthitis: These are inner ear problems that can cause balance disturbances and dizziness. These conditions may also cause difficulty focusing the eyes.

    • Treatment typically involves medications to reduce inflammation and manage symptoms, such as steroids and medications to reduce dizziness.
  • Benign paroxysmal positional vertigo (BPPV): This condition causes brief episodes of mild to intense dizziness, usually triggered by specific changes in the position of your head. However, you mentioned that no specific movements or positions seem to make your dizziness worse.

    • Treatment usually involves a series of movements performed in a doctor's office to help dislodge the tiny calcium particles from the inner ear.
  • Medication side effects: Warfarin, Losartan, and Sotalol can all potentially cause dizziness and balance problems. It's also possible that the combination of these medications is contributing to your symptoms.

    • If this is the case, your doctor may need to adjust your medication regimen.
  • Cardiovascular issues: Given your history of bradycardia (slow heart rate), it's possible that your symptoms are related to your heart not pumping enough blood to your brain.

    • Treatment would depend on the specific heart condition causing your symptoms, but could include medication adjustments or a pacemaker.

What you can do

While I can't diagnose you, I would strongly recommend that you seek medical attention as soon as possible. Your symptoms could potentially indicate a serious condition that needs immediate treatment. In the meantime, try to avoid activities that could be dangerous if you were to become dizzy, such as driving or operating heavy machinery.

What you should look out for

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

  • A sudden, severe headache
  • A sudden, severe loss of balance or coordination
  • Difficulty walking
  • Fainting
  • Rapid or irregular heartbeat
  • Chest pain or shortness of breath
  • Sudden change in vision, speech, or ability to understand speech
  • Sudden, severe weakness or numbness in your face, arms, or legs

Remember, while I strive to provide accurate information, I'm not a doctor. Please seek care from a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

Top picked over-the-counter products for BPPV (Benign Paroxysmal Positional Vertigo)

People Also Ask


What are the common symptoms of vestibular neuritis or labyrinthitis?

Vestibular neuritis or labyrinthitis typically causes symptoms such as dizziness, vertigo, balance problems, nausea, and difficulty focusing the eyes. These symptoms are due to inflammation of the inner ear or the nerves connecting the inner ear to the brain.


How can medication side effects contribute to dizziness?

Medications like Warfarin, Losartan, and Sotalol can cause dizziness as a side effect by affecting blood pressure, heart rate, or blood flow to the brain. The combination of these medications might also increase the likelihood of experiencing dizziness.


What is benign paroxysmal positional vertigo (BPPV) and how is it treated?

Benign paroxysmal positional vertigo (BPPV) is a condition where small calcium particles in the inner ear become dislodged, causing brief episodes of dizziness triggered by changes in head position. Treatment often involves specific head movements, known as the Epley maneuver, to reposition these particles.


How can bradycardia affect balance and cause dizziness?

Bradycardia, a condition characterized by a slow heart rate, can lead to insufficient blood flow to the brain, resulting in symptoms like dizziness and balance issues. This is because the heart may not be pumping enough blood to meet the body's needs, especially during physical activity or sudden movements.


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