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What Causes Sudden Vertigo And Loss Of Balance?
Question: Hi,
I have been feeling strange. There are instances when I feel a little off balance (even though I am walking perfectly fine and never lose balance or get dizzy) I describe this feeling as "wobbly". It happens mostly when I am walking. Strange thing is that if I am sitting, jogging, or running, it never happens. It also happens when I lay down. Some people say things such as "my head is spinning", its not like that exactly because it lasts only for a split second, when I think of it, I can say I felt like my head spun or "moved" for a second there. I can also describe it as a quick head rush / light feeling. Therefore, I can be walking, then this feeling happens, and I continue walking or talking, texting etc - normally without being bothered by it. I notice it after it has happened because it only lasts a second or two. It's a strange sensation that feels like after you get hit in the back of the head, a brief buzzing sensation that comes and goes within a few seconds, ofcourse, not to that degree though. Also, it doesn't feel like anything around me has moved or that the world is spinning or that I am getting dizzy, it simply feels like the feeling is very isolated to the head. People who smoke describe a similar sensation as a "head rush". It is not very frequent and nothing I do makes it worse. I remember it started last year and I went to a doctor, she told me it's not anything to worry about and that the eye and the brain take information from your environment, and if there is some confusion or 'friction' in this process, some dizzy/light headed feeling can occur. It has gone on and off for this much time. I have recently noticed that I am very anxious and stressed, maybe I am simply noticing it more now.
In all this time, It has gone away and come back. I also get very stressed and anxious, im not sure if this has anything to do with the sensations though. The stress has effected me a lot and I don't feel happy anymore. I've had blood work done multiple times, doctor said "I'll get everything checked", urine tests 2 times, ECG, 24 hour urine test (when you collect urine, not sure if it was 24 or 48 hrs), doctor has done various exercises - pushing, pulling fingers etc, balance and memory tests, everything is fine. Vision is fine, no headaches or any other problems like that. I Asked my family doctor to send me for an MRI, he said that is not necessary at all and told me to just take a deep breath and relax. I was thinking of asking him to send me to a neurologist. He suggested mild BPPV (not sure if I spelt it right). Please note - this does not happen persistently. For example, there are instances of it, but it never comes, and stays for a certain time period and then goes away, only an instance here and there during the day when I am walking around. If I focus on it, I notice it. If I am busy or with my friends, I feel as if I don't notice it. It was a bit "worse" a little while ago as I was just very sick (fever - thats when it started), now it is much better I would say. Anxiety and stress I would say is through the roof, haven't felt this unhappy before.
Thank you for your time.
I have been feeling strange. There are instances when I feel a little off balance (even though I am walking perfectly fine and never lose balance or get dizzy) I describe this feeling as "wobbly". It happens mostly when I am walking. Strange thing is that if I am sitting, jogging, or running, it never happens. It also happens when I lay down. Some people say things such as "my head is spinning", its not like that exactly because it lasts only for a split second, when I think of it, I can say I felt like my head spun or "moved" for a second there. I can also describe it as a quick head rush / light feeling. Therefore, I can be walking, then this feeling happens, and I continue walking or talking, texting etc - normally without being bothered by it. I notice it after it has happened because it only lasts a second or two. It's a strange sensation that feels like after you get hit in the back of the head, a brief buzzing sensation that comes and goes within a few seconds, ofcourse, not to that degree though. Also, it doesn't feel like anything around me has moved or that the world is spinning or that I am getting dizzy, it simply feels like the feeling is very isolated to the head. People who smoke describe a similar sensation as a "head rush". It is not very frequent and nothing I do makes it worse. I remember it started last year and I went to a doctor, she told me it's not anything to worry about and that the eye and the brain take information from your environment, and if there is some confusion or 'friction' in this process, some dizzy/light headed feeling can occur. It has gone on and off for this much time. I have recently noticed that I am very anxious and stressed, maybe I am simply noticing it more now.
In all this time, It has gone away and come back. I also get very stressed and anxious, im not sure if this has anything to do with the sensations though. The stress has effected me a lot and I don't feel happy anymore. I've had blood work done multiple times, doctor said "I'll get everything checked", urine tests 2 times, ECG, 24 hour urine test (when you collect urine, not sure if it was 24 or 48 hrs), doctor has done various exercises - pushing, pulling fingers etc, balance and memory tests, everything is fine. Vision is fine, no headaches or any other problems like that. I Asked my family doctor to send me for an MRI, he said that is not necessary at all and told me to just take a deep breath and relax. I was thinking of asking him to send me to a neurologist. He suggested mild BPPV (not sure if I spelt it right). Please note - this does not happen persistently. For example, there are instances of it, but it never comes, and stays for a certain time period and then goes away, only an instance here and there during the day when I am walking around. If I focus on it, I notice it. If I am busy or with my friends, I feel as if I don't notice it. It was a bit "worse" a little while ago as I was just very sick (fever - thats when it started), now it is much better I would say. Anxiety and stress I would say is through the roof, haven't felt this unhappy before.
Thank you for your time.
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and being a neurologist I will try to address your concern.
I would like to thank you for that detailed description. Reading through it though I must say I agree with your doctor that there is not any indication of a brain lesion (fortunately). There is no motor, sensitive, coordination or balance deficit which would make a brain MRI necessary. Also the fact that the symptoms disappear when you're occupied with other activities goes against that as neurological deficits would be steadily present or even more pronounced when challenged with other activities.
BPPV (Benign paroxysmal positional vertigo) is a good suggestion but again the fact they appear at rest goes against it. That is because this type of vertigo is triggered or exacerbated by head movements, so rest would make it better and movement exacerbate it.
Given the fact blood work has come up fine which excludes metabolic or hormonal issues I would say that the most likely cause for your symptoms is anxiety. Anxiety can produce many different symptoms, mimicking many different conditions. Given the level of stress you describe as well as the type of symptoms and their appearance only at rest I believe anxiety to be the cause.
Regarding how to manage it depends on how much it affects you. In a young individual such as yourself I would try to avoid or postpone medication use. Would try regular physical activity and activities like yoga which help a lot. Also avoid stimulants like caffeine, energy drinks, alcohol etc. Psychotherapy can also help in learning relaxation techniques.
If such measures do not work then medication may be used, generally SSRI antidepressants are used which are among the most used medications for anxiety.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and being a neurologist I will try to address your concern.
I would like to thank you for that detailed description. Reading through it though I must say I agree with your doctor that there is not any indication of a brain lesion (fortunately). There is no motor, sensitive, coordination or balance deficit which would make a brain MRI necessary. Also the fact that the symptoms disappear when you're occupied with other activities goes against that as neurological deficits would be steadily present or even more pronounced when challenged with other activities.
BPPV (Benign paroxysmal positional vertigo) is a good suggestion but again the fact they appear at rest goes against it. That is because this type of vertigo is triggered or exacerbated by head movements, so rest would make it better and movement exacerbate it.
Given the fact blood work has come up fine which excludes metabolic or hormonal issues I would say that the most likely cause for your symptoms is anxiety. Anxiety can produce many different symptoms, mimicking many different conditions. Given the level of stress you describe as well as the type of symptoms and their appearance only at rest I believe anxiety to be the cause.
Regarding how to manage it depends on how much it affects you. In a young individual such as yourself I would try to avoid or postpone medication use. Would try regular physical activity and activities like yoga which help a lot. Also avoid stimulants like caffeine, energy drinks, alcohol etc. Psychotherapy can also help in learning relaxation techniques.
If such measures do not work then medication may be used, generally SSRI antidepressants are used which are among the most used medications for anxiety.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response. I would like to add that this feeling is noticeable almost only indoors. When I am outside, I don't notice it. For instance, sometimes (for 1 or 2 steps only) the ground feels "uneven", indoors. Again, this doesn't cause any balance problems but just feels strange.
Lastly, for anxiety and stress, is talking to a friend or family member recommended or would it be better to seek the services of a professional in the field?
Lastly, for anxiety and stress, is talking to a friend or family member recommended or would it be better to seek the services of a professional in the field?
Brief Answer:
Read below.
Detailed Answer:
Thank you for the feedback.
I think the fact it shows only in certain moments goes to back the anxiety hypothesis. Any lesion of the nervous system as I said would cause a constant deficit, not only indoors. There is the exception of epileptic seizures which can be episodic, but really the description doesn't seem to fit with a seizure and there is no reason why exclusively indoors or at rest.
As for talking to a friend or family member, there is nothing wrong in speaking with someone close to you which you trust, but if possible to get professional help might be even better as are more qualified and can teach relaxation techniques as well as discuss about possible causes and ways of thinking at the root of the issue.
Read below.
Detailed Answer:
Thank you for the feedback.
I think the fact it shows only in certain moments goes to back the anxiety hypothesis. Any lesion of the nervous system as I said would cause a constant deficit, not only indoors. There is the exception of epileptic seizures which can be episodic, but really the description doesn't seem to fit with a seizure and there is no reason why exclusively indoors or at rest.
As for talking to a friend or family member, there is nothing wrong in speaking with someone close to you which you trust, but if possible to get professional help might be even better as are more qualified and can teach relaxation techniques as well as discuss about possible causes and ways of thinking at the root of the issue.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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