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What Causes Severe Dizziness?

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Posted on Wed, 15 Mar 2017
Question: falling dowm and extremely dizzy, what can I do
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Answered by Dr. Dariush Saghafi (1 hour later)
Brief Answer:
I would discontinue the meclizine and look for cause of dizziness

Detailed Answer:
Thank you for your question.

Based upon your gender and age as well as the fact that you are on BP medication and meclizine I am concerned that you may be either suffering from an over-control of your BP which is common in patients complaining of dizziness....especially if of new onset.

Other things to consider to explain dizziness and falls would be dehydration, hypoglycemia if you are involved in a major plan of reducing your caloric intake for any reason or you have been working on changing your diet.

Another quick and dirty way to check your body's volume status and/or degree of blood pressure control by blood pressure medications that may be excessive and causing you to feel dizzy and falling is to request that a doctor or nurse take pressures we refer to as ORTHOSTATIC BLOOD PRESSURES. This is generally considered to be a set of 3 pressure readings taken in conjunction with heartrate while in different posturally dependent positions (lying, standing, and standing for 2 minutes). If BLOOD PRESSURES precipitously drop by more than 25-30 points in the systolic or (top) number or 10-15 points in the diastolic or (bottom) number and this is also accompanied by increases in heartrate of more than 12-15 beats per minute when going from a lying to standing and then, remain standing position then, these changes would be diagnostic of what is called ORTHOSTATIC HYPOTENSION which could be due to low circulating volume as well as OVERCONTROL of blood pressure by medication.

This would be correctable by drinking a lot of fluids, eating more scheduled meals, and then, looking at medications that can be reduced or eliminated that are too restrictive on the patient's blood pressure.

If on the other hand you are not suffering from ORTHOSTASIS at all and your dizziness is more of a SPINNING or VERTIGINOUS feeling that occurs whenever you change position then, you may be suffering from something called BENIGN POSITIONAL VERTIGO and to remedy this you should get consulted either by a neurologist, an ENT specialist, or a NEURO-OTOLOGIST since these are the folks who understand that MECLIZINE is not the way to treat the condition of BPPV and can actually make things worse in some people. Instead patients should be given a set of exercises to do referred to as the BRANDT-DAROFF exercises which usually need to be done 2-3x/day for a period of 2-4 weeks. Sometimes the cycle needs to be repeated but on other occasions one run is all that is necessary to set everything straight and get rid of the dizziness.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 52 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Causes Severe Dizziness?

Brief Answer: I would discontinue the meclizine and look for cause of dizziness Detailed Answer: Thank you for your question. Based upon your gender and age as well as the fact that you are on BP medication and meclizine I am concerned that you may be either suffering from an over-control of your BP which is common in patients complaining of dizziness....especially if of new onset. Other things to consider to explain dizziness and falls would be dehydration, hypoglycemia if you are involved in a major plan of reducing your caloric intake for any reason or you have been working on changing your diet. Another quick and dirty way to check your body's volume status and/or degree of blood pressure control by blood pressure medications that may be excessive and causing you to feel dizzy and falling is to request that a doctor or nurse take pressures we refer to as ORTHOSTATIC BLOOD PRESSURES. This is generally considered to be a set of 3 pressure readings taken in conjunction with heartrate while in different posturally dependent positions (lying, standing, and standing for 2 minutes). If BLOOD PRESSURES precipitously drop by more than 25-30 points in the systolic or (top) number or 10-15 points in the diastolic or (bottom) number and this is also accompanied by increases in heartrate of more than 12-15 beats per minute when going from a lying to standing and then, remain standing position then, these changes would be diagnostic of what is called ORTHOSTATIC HYPOTENSION which could be due to low circulating volume as well as OVERCONTROL of blood pressure by medication. This would be correctable by drinking a lot of fluids, eating more scheduled meals, and then, looking at medications that can be reduced or eliminated that are too restrictive on the patient's blood pressure. If on the other hand you are not suffering from ORTHOSTASIS at all and your dizziness is more of a SPINNING or VERTIGINOUS feeling that occurs whenever you change position then, you may be suffering from something called BENIGN POSITIONAL VERTIGO and to remedy this you should get consulted either by a neurologist, an ENT specialist, or a NEURO-OTOLOGIST since these are the folks who understand that MECLIZINE is not the way to treat the condition of BPPV and can actually make things worse in some people. Instead patients should be given a set of exercises to do referred to as the BRANDT-DAROFF exercises which usually need to be done 2-3x/day for a period of 2-4 weeks. Sometimes the cycle needs to be repeated but on other occasions one run is all that is necessary to set everything straight and get rid of the dizziness. If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 52 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.