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Dr. Andrew Rynne

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What causes dizziness,palpitations and nubness in foot?

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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

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Posted on Mon, 11 Aug 2014 in Brain and Spine
Question: Hello, I have been having periods of lightheadness and dizziness for a couple of years now. I have had a holter monitor that just showed some tachycardia, and I also had a echo of the heart that was normal and a normal MRI. Recently however in addition to the general lightheaded feeling, I will have surges of extreme lightheadedness and it will be difficult to talk or walk and sometimes I will get weakness or numbness, then it will get a little better, however I will not feel right for the rest of the day. I also have a lot of facial flushing on the bridge of my nose and cheeks. My cbc with differentials have all come back normal. I also would like to mention I will sometimes have upper back pressure. I literally can not do anything at this point because I feel so out of it, sometimes dizzy, and will also have intermittent foot numbness. The symptoms are worse when sitting and standing and my blood pressure can sometimes be a little low, but not always low when symptomatic. My heart-races when I stand and I just don't feel right... any suggestions? Is it possible that I could have some sort of an abdominal aneurysm?
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Answered by Dr. Shafi Ullah Khan 6 hours later
Brief Answer:
Needs management & clinical corrlation

Detailed Answer:
Thank you for asking
Vertigo has many causes some are peripheral and some are central.to rule out central causes a complete neurological assessment of cranial nerves 7 and 8 specially and cerebellum and looking for any underlying pathology like tumor infection trauma or multiple sclerosis. Migraines headaches also cause such vertigo.
Some peripheral causes are inner ear troubles like meniere disease or any inner ear infection or cardiac causes which have already been ruled out.
Now your vertigo is posture related and worse on sitting and standing position makes it worth assessment for BPPV benign paroxysmal positional vertigo. 20 % of us population presenting with vertigo has this etiology and also most likely in your case.
Some other rare possibilities are POTS postural ortho static tachycardia syndrome as you mentioned racing heart beat on standing. A reflex tachycardia classic for POTS and ganglion blockers help.
Also do t forget that a simple anemia anxiety and headaches and migraines can also cause these symptoms and I am getting suspicious that anxiety might have also role in your case too.
Nutshell , get vestibular functions assessed. You need a team if neurologist and otorhinilaryngologist for further management and narrowing down the cause.
I hope it helps. Take good care of yourself and don't forget to close the discussion please.
May the odds be ever in your favour.
Regards XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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