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Feeling Dizziness, Anxious And Unbalanced. Took Ativan. Are These Anxiety Related?

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Posted on Wed, 7 Nov 2012
Question: I was having spells which started as slight dizzyness (although once or twice the dizzyness was more pronounced but I never fell over---just felt wobbly and shaky) and then feeling a little off balance and/or uncoordinated in my movements and anxious for a period of perhaps 20 minutes until the feeling passed. My girlfriend gave me an Ativan during one spell and it passed fairly quickly thereafter so it could be anxiety related I suppose. I am not sure if these spella are to do with blood sugar perhaps or anxiety or somethng more serious. I am a 47 year old white male, othewise quite fit but I have had higher than normal blood pressure since my early 20s. An MRI of my brain showed a few H2 hyperintense foci in the cerebral white matter. The largest is in the left frontal XXXXXXX white matter and measures 4 mm. I am curious what I should make of those findings and what my next steps or tests should be. Thank you. .
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Answered by Dr. Sudhir Kumar (2 hours later)
Hi,
Thank you for contacting Healthcare magic.

First of all, let me reassure you that you you are not suffering from any serious neurological problem.

The most likely possibility for your symptoms could be posterior circulation TIA (transient ischemic attack).

In this condition, the blood supply to the back of brain (cerebellum and brainstem) is reduced for a short time, resulting into symptoms such as dizziness, imbalance while walking, slurred speech, double vision, etc.

Regarding your MRI findings, they represent small areas of ischemia- lack of blood flow, and the most likely cause is hypertension (high blood pressure).

At this stage, you should do all the investigations to assess the risk factors for brain stroke/ischemia:
1. Fasting blood sugar,
2. Fasting lipid profile,
3. Fasting serum homocysteine
4. Echocardiogram of heart.

If any of the above reports are abnormal, that would require treatment. In addition, a small dose of aspirin would also be useful.

In summary, there is no need to worry, and you would be fine with treatment.

I hope it helps. Please get back if you have any further queries.
Best wishes,
Dr Sudhir Kumar MD (Medicine) DM (Neurology) XXXXXXX Consultant Neurologist
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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Feeling Dizziness, Anxious And Unbalanced. Took Ativan. Are These Anxiety Related?

Hi,
Thank you for contacting Healthcare magic.

First of all, let me reassure you that you you are not suffering from any serious neurological problem.

The most likely possibility for your symptoms could be posterior circulation TIA (transient ischemic attack).

In this condition, the blood supply to the back of brain (cerebellum and brainstem) is reduced for a short time, resulting into symptoms such as dizziness, imbalance while walking, slurred speech, double vision, etc.

Regarding your MRI findings, they represent small areas of ischemia- lack of blood flow, and the most likely cause is hypertension (high blood pressure).

At this stage, you should do all the investigations to assess the risk factors for brain stroke/ischemia:
1. Fasting blood sugar,
2. Fasting lipid profile,
3. Fasting serum homocysteine
4. Echocardiogram of heart.

If any of the above reports are abnormal, that would require treatment. In addition, a small dose of aspirin would also be useful.

In summary, there is no need to worry, and you would be fine with treatment.

I hope it helps. Please get back if you have any further queries.
Best wishes,
Dr Sudhir Kumar MD (Medicine) DM (Neurology) XXXXXXX Consultant Neurologist