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Having Dizzy Spells. On Coverram For BP But Rises When Standing. CT Scan Showed Bone Spurs On Neck. Suggest?

Posted on Wed, 9 Oct 2013

Question: hi there I have been having dizzy spells (lighheadness) worse when standing or excerising for a period of 10 months now... my diabeties is controlled very well, I am on coverram for Blood pressure and it seems to be ok, all though it does rise when standing... I have had a stress test on heart all good... then I had a CT scan on brain, neck and back... I need to see a nurologist but with australia wait times i cant get in until mid dec... the CT scan found most was good but i had bone spurs between C4 and 5 on my neck... can this be causing my blood pressure to rise on standing and my dizzyness.. i really need to fix the problem i love to dance and we have preformaces come up and i am afraid to do them due my lightheadness i am suffering.

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Vertigo could be due to BPPV or bone spur related

Detailed Answer:
Hi,
Thank you for posting your query.

First of all, I would like to reassure you that your symptoms do not suggest any serious neurological illness.
The most likely cause for your dizzy spells could be benign positional paroxysmal vertigo (BPPV). In this condition, there is mild dysfunction in the middle ear, which improves with vestibular adaptation exercises, and over time on its own.
Bone spurs in the cervical region could also lead to dizzy spells. This also improves with physiotherapy and neck extension exercises.
Medications that could be of help are betahistine to relieve dizziness and piracetam, which is helpful in BPPV.
I hope it helps.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,

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

Follow up: Dr. Sudhir Kumar (28 minutes later)

thanks for this what are some vestibular adaptation exercises and what neck extention excerises what about chiropractic we dont have any physiotherepy anywhere near my town.

Answered by Dr. Sudhir Kumar (7 minutes later)

Brief Answer:
You can find them online

Detailed Answer:
Thank you for getting back.
Chiropracter and physiotherapist would be able to help in both vestibular as well as neck extension exercises. If they are not available, then some links online are:

For vestibular exercises

WWW.WWWW.WW
For neck exercises

WWW.WWWW.WW
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (11 hours later)

thanks for this i did some looking into the BPPV and I dont think its that the symptoms dont match its not vertigo the room does not spin its just the lightheadness feeling like i could faint... could be bone spurs but one thing i have noticed the last few days is my BP rising not much admittly but a bit 5-10 points upon standing the symptoms are similar to POTS can the bone spur cause changes in BP though?.

Answered by Dr. Sudhir Kumar (2 hours later)

Brief Answer:
POTS is a possibility

Detailed Answer:
Thank you for getting back.

POTS could be a possibility in your case. Typically, in this condition, the person has lightheadedness on getting up from supine or sitting position. Heart rate and pulse rises, however, BP usually falls. Rise in BP is uncommon. Sometimes, fainting also occurs. HUTT (head up tilt test) can be done under the guidance of a cardiac electrophysiologist to confirm the diagnosis.
Bone spurs are not related to POTS.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (16 minutes later)

I am thinking it more likley the bone spurs causing the problem i do get some pain in the neck and when i am feeling brethless and lightheaded a quick neck rub my myself seems to help a bit is neck excerises the only way to fix this problem or is there other ways?

Answered by Dr. Sudhir Kumar (6 minutes later)

Brief Answer:
Physiotherapy and neck exercises are the best way

Detailed Answer:
Thank you for getting back.

Physiotherapy, including neck exercises, neck traction, etc are the best and simplest ways of treating this condition.

In selected cases, where the symptoms do not resolve, after careful consideration by a neurosurgeon or spine surgeon, surgical excision of bone spurs can also be done.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (3 days later)

Hi there- I have been doing more research trying to find a cause and found cervicogenic headaches could the bone spurs be causing this and could it be causing my headaches/lightheadness and if you think so how can I treat it is it medication or chiro treatment or both or somehting else?.

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Cervicogenic headaches could be the cause

Detailed Answer:
Hi,
Thank you for getting back.

I agree that cervicogenic headaches could be a cause and can explain your symptoms of headache and light headedness. However, it should be noted that cervicogenic headaches are commonly caused by disc prolapse and pinched nerves in the neck. Also, it can occur in people with a lot of stress and tension, and excessive work on computers (10-12 hours per day).

Bone spurs usually do not cause cervicogenic headaches, but can be a cause in minority.

Treatment would include medications such as amitriptyline or dothiepin, physiotherapy and chiro treatment. In some cases, botox injections also help.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (56 minutes later)

thanks for that I do do excessive computer work I am a bookkeeper and I would do 10-12 hours a day on the computer I will bring this up with my GP when I see him next week. is there any way to test for it? to be sure its the cause of cause.

Answered by Dr. Sudhir Kumar (1 minute later)

Brief Answer:
It is a clinical diagnosis

Detailed Answer:
Thank you for getting back.

Your work and lifestyle could be contributing to your symptoms. It would be useful discussing this with your GP.

This is a clinical diagnosis and there are no tests to confirm the diagnosis.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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