HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Pregnant With Dizziness. EKG, X- Ray, Blood Pressure, Urine And Blood Test Normal

default
Posted on Wed, 4 Jul 2012
Question: my finace is about five weeks pregnant and she is experiancing extreme dizziness that has almost made her completely bed ridden for the last four days. It started about two weeks ago with just some mild dizzy spells and then they would go away for a while, but now she only feels good in the morning until around noon or 1pm and then she is basically stuck in the couch or in bed and even then she is almost constantly dizzy with it getting worse for a few minutes and it gets worse as the day goes on and when she lays down for bed she has trouble falling asleep becasue the room is spinning so fast. we went to the er yesterday and they did blood work, ekg, chest x-rays, urine sample, and had her hooked up to a heart monitor and blood pressure machine for almost four hours and could not find anything wrong
doctor
Answered by Dr. Aashish Raghu (36 minutes later)
Hi there.

Thanks for the query.

You have provided with good information and I appreciate it. In order to guide you appropriately, I will need a few more details regarding your problem, so please answer the following questions in as much detail as possible.

Did your fiance have similar episodes of dizziness in the past ?

Does she have any seizures or convulsions ?

Is there headache, nausea, vomiting, vision problems ?

It appears that your fiance is having possible vertigo where there is sensation of room spinning around, extreme dizziness, sometimes nausea, ringing sensation in the ears etc.

There could be many possible causes of vertigo like Benign positional vertigo (BPV), hormonal changes, blood sugar fluctuations, blood pressure changes, etc. Dilantin is also known to cause vertigo as a side effect.

It is advisable for her to avoid getting up very quickly, prefer lying down with lower limbs at a higher level than the rest of the body at horizontal level, eat well balanced diet and drink enough water. Avoid much salt in diet. Keep head on flat level and avoid sudden head movements. Avoid loud noise or lights as well.

It is advisable to consult her Doctor to get her a thorough checkup to find the cause of vertigo. It is not good practice to use Dilantin in pregnancy, there may be some birth defects because of it's use. Other safer anti-epileptic drugs can be used in pregnancy. Also get her tested for the health of the baby as well to ensure safety.

Kindly respond to the above queries.

I hope I have answered your queries. I will be available to answer your follow up queries.

Wishing good health.

Regards,



Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Aashish Raghu (2 hours later)
She has always had dizziness, i have known her for over five years and she would just all of a sudden get really dizzy, but it would only last for less than thirty seconds and this was only like once a day or once every couple days. One doctor put her an over the counter motion sickness pill and this seemed to help with the dizziness. She started to have seizures when she was like 10 or eleven and she had a few up until she was like 14 then none until about a year ago and this is when they diagnosed her with epilepsy and put her on dilantin the same dose she is on now. When she was first put on the dilantin she was not getting the dizzy spells until about three months ago and then it came back like it always was before. then about two weeks ago she started to get dizzy more fequently than normal and then on thursday she was feeling really sick to her stomach a dizzy even more frequently but it still would always only last a couple mins and go away. then friday we went to see her mid wife which was her gyno. and they confirmed the pregnancy and drew some blood and she got so dizzy she felt like she was gonna black out and ever since she cannot stand for much longer than a few minutes before she feels like she is gonna passout, but this only happens in the afternoon and continues to get worse and worse throughout the day. Her face is actually starting to get red and sore looking becasue of how much she keeps a cool wash cloth on her face. It really doesnt matter how she sits or lays it is the same way. She still has not had any siezures or convulsions since all of this began, just the last one a year ago. She has not experianced any headaches really, she says she has had a few very mild ones that only lasted ten or fifteen minutes, there is some nausea but she has not thrown up yet, one thing that she always complains about is when she gets dizzy she feels like her ears need to pop like when you travel through the mountains and they feel wierd from the difference in altitude. on sunday we went to the er becasue when the dizzy spells got bad she felt her heart racing, tightness in her chest, and a few of her fingers tingled like they went to sleep. any they did tons of tests on her all sorts of blood work, urine sample, chest x-ray, and ekg. About the dilantin her family doctor says the same thing you did about the medication and pregnancy, but her neurologist says it is the safest medicine to be pregnant on. What other medications would you recomend because we are going to see her family doctor on weds. this week and we will ask him how he feels about those meds for her during pregnancy.
doctor
Answered by Dr. Aashish Raghu (7 hours later)
Hi there.

Thanks for the reply.

Does your fiancé feel her heart racing or chest pain when she gets the dizzy episodes?

Is there any sweating during her dizzy episodes? Does she hear any ringing sensation in her ears?

According to latest classification, there are safer anti-convulsants in pregnancy like Levitiracetam, Lamotrigine which are Category C drugs. Phenytoin is Category D drug which is more harmful.

Feeling of black out coming on is possibly due to vertigo of BPV (Benign Positional Vertigo) cause. Other causes can also be considered as mentioned earlier.

Typically for Vertigo, Phenytoin is not given. It may just control the seizures but not recommended during pregnancy. Kindly do refer to the Category C medication as mentioned above and discuss them with her Neurologist. Medicines like Phenergan which are anti-histamines can reduce the acute symptoms by 70-80%. Kindly do discuss the various exercises and medication which can help her, with the Neurologist.

I hope I have answered your query.

Wishing speedy recovery.

Regards,




Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Aashish Raghu (5 hours later)
she only feels her heart racing and sometimes tightness in her chest making it hard to breathe during the episode. And she does get hot, but mostly it is just her face that is hot during the dizzzy spells, she has a blanket over the lower portion of her body for the majority of the day. I hear about how hot her head is all day long and constanly keep wetting her rag with cold water that she keeps on her face. The only thing is that she has trouble hearing, she alays says that her ears feel clogged like they need to pop, but no ringing
doctor
Answered by Dr. Aashish Raghu (39 minutes later)
Hi there.

Please answer a few more questions to assess her condition.

Do her lower limbs feel cooler than her upper limbs and face? Please do feel and report.

Does she get nosebleeds, shortness of breath, high blood pressure, leg cramps during exercise or walking?

According to this history, it appears to be a cardiovascular problem, with possibly associated autonomic disturbance which is causing the flushing of her face.

There are many causes for the same including Coarctation of aorta, Carcinoid syndrome, Paraneoplastic syndromes, histamine release conditions etc.

The popping sensation in the ear is a condition called Tinnitus which can be associated with a multitude of conditions including those mentioned earlier.

This requires further clinical examination and a battery of required tests to come to a correct diagnosis. Kindly do discuss with her Neurologist of the above mentioned causes which will help to decide best treatment for her.

I hope I have answered your query.

Wishing speedy recovery.

Regards,



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5482 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Pregnant With Dizziness. EKG, X- Ray, Blood Pressure, Urine And Blood Test Normal

Hi there.

Thanks for the query.

You have provided with good information and I appreciate it. In order to guide you appropriately, I will need a few more details regarding your problem, so please answer the following questions in as much detail as possible.

Did your fiance have similar episodes of dizziness in the past ?

Does she have any seizures or convulsions ?

Is there headache, nausea, vomiting, vision problems ?

It appears that your fiance is having possible vertigo where there is sensation of room spinning around, extreme dizziness, sometimes nausea, ringing sensation in the ears etc.

There could be many possible causes of vertigo like Benign positional vertigo (BPV), hormonal changes, blood sugar fluctuations, blood pressure changes, etc. Dilantin is also known to cause vertigo as a side effect.

It is advisable for her to avoid getting up very quickly, prefer lying down with lower limbs at a higher level than the rest of the body at horizontal level, eat well balanced diet and drink enough water. Avoid much salt in diet. Keep head on flat level and avoid sudden head movements. Avoid loud noise or lights as well.

It is advisable to consult her Doctor to get her a thorough checkup to find the cause of vertigo. It is not good practice to use Dilantin in pregnancy, there may be some birth defects because of it's use. Other safer anti-epileptic drugs can be used in pregnancy. Also get her tested for the health of the baby as well to ensure safety.

Kindly respond to the above queries.

I hope I have answered your queries. I will be available to answer your follow up queries.

Wishing good health.

Regards,