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Feeling lightheaded. Table test positive for orthostatic hypotension. Guide

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I have been lightheaded for about five months now with a constant feeling like I'm going to pass out. I've been everywhere and all tests came back normal: CT scan of the head, blood tests: iron, b12, blood levels everything ok, tilt table test was positive for orthostatic hypotension but that's not it because it's not only when I stand up. I need to get this figured out asap it's controlling my life.

I forgot to mention that this came on in December randomly while I was sitting in class, I got really lightheaded and felt like I was going to pass out. About two weeks after that, my ears got plugged up and stayed plugged until I got ear tubes put in my ears in April. I am constantly feeling as if I'm going to pass out and I'm lightheaded. ENT said there is no infection or anything that could cause this and doesn't think it's ear-related because I don't have dizziness, just presyncope and lightheadedness.

Posted Thu, 13 Jun 2013 in Brain and Spine
Answered by Dr. Sandhya Manorenj 4 hours later

Thank you for the query.

I have gone through the details, based on your history and reports 2 things to be considered syncope versus seizure.

You need to consult cardiologist for ruling out syncope.You need ECG (Electrocardiography), 2DEcho and monitoring Blood pressure in standing and lying position to rule out orthostatic hypo tension. Sometimes may need holter monitoring too,discuss with the cardiologist.

If cardiac work up is negative, then EEG (Electroencephalography) is needed to rule out subclinical seizure phenomenon.Consult Neurologist for clinical examination and further plan.

Meantime have plenty of fluids, have Tab Tylenol 500 mg for headache and have antacids for acidity .

Please get back if you require any additional information.

Best wishes,

Dr Sandhya Manorenj

Hi Tech city Hyderabad
Above answer was peer-reviewed by
Follow-up: Feeling lightheaded. Table test positive for orthostatic hypotension. Guide 1 hour later
I forgot to mention that I went to a Cardiologist and the Cardiology work-up was negative. He referred me to a neurologist, however, I am unable to get into their office for a few months which is way too long. Is there anything else that this could possibly be since it's not heart-related? Thanks
Answered by Dr. Sandhya Manorenj 11 hours later
Yes, it is not related to heart, related to neuro alone.

Meantime you can get done EEG to rule out seizure phenomenon, with that you can consult neurophysician.

Since cardiac and ENT workup and blood test (I meant hemoglobin which when low also can produce these symptoms) are normal. Then everything depends on neurologist for clinical assessment and if required MRI brain to be done to rule out even minor lesion which can be missed by CT scan brain (such as affecting cerebellum, brainstem structures, small lesion of temporal lobe).

I apologize for the delay response.

Hope this will help you. Discuss with your treating doctor/neurologist about this protocol of evaluation and treatment.

Dr Sandhya Manorenj
Hi Tech City ,Hyderabad India

Above answer was peer-reviewed by
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