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What causes extreme dizziness and loss of balance?

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General & Family Physician
Practicing since : 2001
Answered : 14833 Questions
I am 66 years old and in reasonably good health. I don’t exercise (L) but know I should!
I have suffered from vertigo for 35 years. In 1981 and 84 I had a severe experience falling down and suffering extreme dizziness. Then in 2012 I had a bad fall resulting in a hematoma (on my brain? Or skull? Not sure how to phrase it). It was diagnosed with a CT scan. It resulted in Benign Paroxysmal Positional Vertigo. I continue to struggle with this and do the Epley maneuver. In addition my ENT doc has diagnosed Ophthalmic Migraines for which I take 25 mg of Topiramate 2x daily.
What bothers me the most is any activity where I need to move my head up and down. It creates a feeling of mild dizziness and imbalance.
I have lost some cognitive function. I have a Ph.D. in education and notice when I read a journal article it is harder to understand. I am VERY tired.
In addition I have osteoarthritis so the imbalance is a little more precarious.
Is there anything else I should be doing for the migraines? Should I see a neurologist or does this seem like a correct plan of care?
Posted Thu, 23 Nov 2017 in Ear, Nose and Throat Problems
Answered by Dr. Michelle Gibson James 50 minutes later
Brief Answer:
would be worthwhile to consider a neurologist

Detailed Answer:
HI, thanks for using healthcare magic

BPPV , benign paroxysmal positional vertigo, is one of the more causes of dizziness and vertigo.
As in your case, it varies with certain head positions.

It would be worthwhile to consider an evaluation by a neurologist.

This may require repeat imaging to make sure that there have been no changes since your last image in 2012.
Blood tests to make sure that there are no other causes for your fatigue will also be necessary eg complete blood count to rule out anemia, ESR and crp to check for underlying inflammation and thyroid function tests to rule out low levels of this hormone.

I hope this helps, feel free to ask any other questions
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