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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes dizziness when I stand up from a lying position?

Answered by
Dr.
Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2426 Questions

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Posted on Wed, 8 Jun 2016 in General Health
Question: Dr. Saghafi,
Hello I'm the guy who sent you the wrong dosage for Indomethacin. I am on 25 MG twice a day, some relief of the cough headache with the exception of a bad sneezing spell which causes the usual frontal lobe pain that goes away quickly. The other issue I have with this different from the last occurrence is what I could best describe as feeling a bit disoriented when I am laying down and stand up, the room doesn't spin but there's a brief period of dizziness like vertigo, but not, there no nausea or anything like that.
Not sure whether to revisit the Neurologist or my ENT Doctor? (or both)
doctor
Answered by Dr. Dariush Saghafi 2 hours later
Brief Answer:
BPPV may be at play vs. blood pressure/orthostasis

Detailed Answer:
Good evening. Thanks for addressing your question to my attention and again thanks for your gracious feedback on the last question. I'm glad that the answer was of some value to you. Your current symptoms of feeling a bit disoriented upon lying down and standing up without vertigo but with "dizziness"....if not vertigo then, perhaps you can define what exactly you mean when you use the word "dizzy"....is a sense of fullness in the head, is it a sense of less than perfect balance, instability while walking or in the trunk while sitting up from a lying position? Bumping into walls while walking down the hall...as if one were inebriated? Or is it a lightheaded and disconnected feeling that you have? Whatever the case may be the story of feeling something odd upon changes in posture from lying to standing or vice versa always triggers the likely scenario of blood pressure changes as well as fluid shifts within the inner ear canals. If there is no true vertigo associated with these symptoms then, perhaps it is less likely that your symptoms are related to inner ear pathology which leaves blood pressure or symptoms of orthostatic hypotension next in the line of most likely culprits. If you are taking indomethacin we know that one of its side effects is that of lowering blood pressure and causing orthostasis and if these symptoms you're having can be correlated in terms of their initiation to when that medication was started then, blood pressure aberrations are potentially taking place.

Of course, my bias is to look for a NEUROLOGY COLLEAGUE to perform the standard Dix-Hallpike, Epley maneuvers, or head shaking maneuvers but ENT also knows these procedures very well.

But I do agree that no matter which specialist you get an appointment with, I believe that your diagnosis is linked to one of the things I mentioned.

All the best to you and please consider keep me in the loop when you do get a response...I'd be very curious to see what the final consensus was.

Please write back with further questions or comments to:


www.bit.ly/drdariushsaghafi
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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