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Does Benign Paroxysmal Positional Vertigo Cause Sudden Dizziness, Unbalanced Drunken And Nauseous Feeling With Sweaty Palms ?

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Posted on Thu, 12 Apr 2012
Question: I am a 33 year old male.

It started on Friday, July 29 at 1pm. I started feeling a little woozy, like a drunk feeling and unbalanced all of a sudden. Not really dizzy but more unsteady and not being able to walk a straight line. I also felt nauseous and my palms were sweaty. It hit me out of no where. Saturday morning I woke up and felt the same so I went to the ER. On this morning my next was a little stiff so I thought maybe meningitis so I had better see a doc. The doc ran blood work and everything came back normal. She did some eye test where I follow here finger, walking test and I was very unbalanced. She looked in my eyes with the light etc. She ultimately said it was BPPV. She asked if I was coughing and if i had a recent cold in which I did like a week and half ago prior. I had a bad cold and was prescribed Z pack. But even today I am still coughing up some phlem. She said this could have been caused from that. I had no head aches or fever. Never vomitted but felt like I wanted to. I had no appetite on Friday night after it hit me. Still today I seem unbalanced and unsteady. The room is moving a little but not completely spinning.

Was wondering your thoughts on this all of a sudden, dizzy, unbalanced, drunken feeling.

Should I make an appointment with a Otolaryngologist?
doctor
Answered by Dr. Naveen Kumar Nanjasetty (24 hours later)
Hi,

Thanks for the query

Dizziness could be of various etiologies, such as hypoglycemia (low blood sugar), hypotension (low Blood pressure), related to cardiac, spine, neurology, ENT, ophthalmology, etc. With a thorough history and after performing certain investigations the actual cause can be found out.

As you have already mentioned that you have undergone certain hematological investigations and taken medications for the acute episode of dizziness, certain causes of dizziness has already been ruled out. Hence, it seems to be you are suffering from either Vestibular Neuronitis or Benign Paroxysmal Positional Vertigo (BBPV).

It would be very helpful if you can provide answers to the following questions to rule the above two causes:
1.     For how long does the episode of dizziness last for?
2.     Are there any associated symptoms such as reduced hearing or noise in the ear?
3.     Is there episodes of dizziness on rolling over the bed or turning and flexing of the neck?
4.     What makes you relieve from the symptoms?
5.     Do you have any neck pain?

I will be looking forward for your reply.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (4 hours later)
The dizziness hit me out of no where on Friday July 29 afternoon. It has been lasting most of the day. Its a feeling out being out of it. The room is not spinning but more like a drunk feeling and not being very balanced. Its a unsteadiness. But if I sit still with my head stationary I am not unsteady or dizzy.

I have not lost any hearing and there is no ringing in the ears.

When I turn my head its like the room has to catch up to where my eyes are going. So it takes a second to focus. Its not immediate.

My neck is stiff more then normal but not really painful.

The doctor did blood work and said everything is normal. She asked if I had recently had a cold in which I did like a week and half ago but it was not an ear infection. So not sure if that was the cause of this now.

I want to be sure I do not have something life threatening like a brain tumor or something. I have not lost sensation anywhere or anything. Have not had a fever or any headaches. My hands have been sweaty and been very nauseous.

Hope that answers some of your questions. If it matters I did have a head CT in Dec of 2008 and that was completely clear but was that was some time ago.

I was just wondering how something like this can just happen out of the blue.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (8 hours later)
Hi,

Thanks for the details.

Now the things are much clear:
1. Vestibular neuronitis (inflammation of the vestibular nerve) – is ruled out as there is no dizziness induced on gaze.
2. Labyrinthitis (inflammation of the labyrinth following flu) – is ruled out because there is no associated hearing loss or tinnitus (noise in the ear).
3. Meniere’s disease - is also ruled out as there are no associated symptoms of reduced hearing or tinnitus (noise in the ear) and vomiting.
4. BPPV – is induced on rolling over the bed and turning of the head on both the sides and the dizziness usually last for few seconds to minutes, hence BPPV is also ruled out.

Thus, it is very unlikely that there is any ENT cause for this dizziness. As you have mentioned in your history that you are having stiffness of the neck also, it would be wise to consult a good Orthopedician to rule out Cervical Spondylitis. Cervical Spondylitis can give rise to Cervical Vertigo, which could probably be one of causes of your dizziness. Do not get disheartened, dizziness is one condition which is difficult to diagnosis and involves various specialties to arrive at a diagnosis.

Hope I have answered your query, if you have any more doubts you are welcome.

Regards
Dr. Naveen Kumar N.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (7 hours later)
Well I have had the urge to vomit just never did it. How long does something like this take to resolve. This has never happened and is quite scary.

I just wanted to be sure that I did not have some life threatening brain tumor or something. What about a hemorrhage or something like that? Would that cause dizziness and unsteadiness.

Thanks for your help.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)
Hi,

Thanks for writing back.

I do understand your apprehension, but the symptoms you have described do not seem to be related to the brain tumor or brain hemorrhage.

Brain tumor usually starts with neurological symptoms like weakness on any one side of the body or in the limbs, diminished vision, slurring of speech, etc. And in the case of cerebral hemorrhage there will sudden onset of intolerable headache, vomiting, unconsciousness, slurring of speech, etc.

Dizziness in your situation can remain for few more days, till you receive appropriate treatment. You need to consult an orthopedician regarding your cervical spine. If you are still not convinced, you can get a MRI of the brain and the spinal cord done to look for brain tumor or hemorrhage.

Wish you good health.

Regards
Dr. Naveen Kumar N.
Above answer was peer-reviewed by : Dr. Manju M
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (2 hours later)
I went to an internist today and she was going to giving me a steroid pack to take as she said it may be inflammation causing this. She said it could have been caused from the cold i had and could have hit me out of know where. She said if does not clear up at the end of the pack she will then send me to a specialist. She did say things like this generally clear up on there own especially if it is viral.
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Follow up: Dr. Naveen Kumar Nanjasetty (8 minutes later)
I forgot to add I think I had a herpes Zostra flare up about a week ago. Not sure this would have anything to do with it as well. Sometimes it gives me this real sensitive area about my right ear. Could that have did anything to my ear canal?
doctor
Answered by Dr. Naveen Kumar Nanjasetty (12 hours later)
Hi

Welcome back

This was an important link which you missed in your history, indeed Herpes virus can cause the inflammation of the vestibular nerve leading to vestibular neuritis. Any infection by a virus is usually self limiting.

In this case, the symptoms of dizziness do remain for few days or couple of weeks. More than steroid pack you will be benefited with labyrinthine sedatives such as Cinnarizine and Vitamin B-complex capsules.

The Cinnarizine calms down the labyrinthine system and hence suppress dizziness and vomiting (this is the same drug which is used for motion sickness also), while Vitamin B-Complex nourish the nerves and prevent further damage.

Apart from all these, I would still suggest you take an orthopedician opinion also.

Wish you good health

Regards
Dr. Naveen Kumar N.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Radhika
doctor
Answered by
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Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2540 Questions

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Does Benign Paroxysmal Positional Vertigo Cause Sudden Dizziness, Unbalanced Drunken And Nauseous Feeling With Sweaty Palms ?

Hi,

Thanks for the query

Dizziness could be of various etiologies, such as hypoglycemia (low blood sugar), hypotension (low Blood pressure), related to cardiac, spine, neurology, ENT, ophthalmology, etc. With a thorough history and after performing certain investigations the actual cause can be found out.

As you have already mentioned that you have undergone certain hematological investigations and taken medications for the acute episode of dizziness, certain causes of dizziness has already been ruled out. Hence, it seems to be you are suffering from either Vestibular Neuronitis or Benign Paroxysmal Positional Vertigo (BBPV).

It would be very helpful if you can provide answers to the following questions to rule the above two causes:
1.     For how long does the episode of dizziness last for?
2.     Are there any associated symptoms such as reduced hearing or noise in the ear?
3.     Is there episodes of dizziness on rolling over the bed or turning and flexing of the neck?
4.     What makes you relieve from the symptoms?
5.     Do you have any neck pain?

I will be looking forward for your reply.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon