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Suggest Treatment For Dizziness And Imbalance
Question: For three weeks now, off and on when walking I feel off balance - almost like I'm being pulled to the right, but I walk straight. I've noticed it's worse in the supermarket or after I move my head around a lot - for instance the other day I was helping my son look for his shoes and I was moving my head around looking for them and when I stood up straight I felt a little off balance. I had an MRI of my brain six months ago but I'm afraid this is a brain tumor or cancer. I've seen my GP and at first she thought it might be a sinus infection so she gave me a sulfa drug. She also checked my ears with her instrument and said there's no infection. I went back after finishing the sulfa drug and she said she thinks it's anxiety, and started me on 10mg of Prozac. I've been on it for 6 days and I'm still dizzy - like I'm being pulled to the right when walking, randomly. Not all of the time. Sometimes when sitting I also feel it, but for the most part i'm fine when sitting, lying down, driving in the car, and it doesn't happen ALL the time when walking. It happens off and on. But I literally walk straight for the most part, it just feels like I'm being pulled. Is this a brain tumor/cancer? I also want to note that I do have a horrible post nasal drip that literally tastes like a sewer - I've had that for over a month now. And all of this "off balance" feeling started after a panic attack over three weeks ago. I went to the ER and they looked in my ears and said one was filled with fluid, but wasn't infected. I was also getting over a cold at that time, but that's been long gone. The off balance/feeling of being pulled to the right is still there. So scared this is brain cancer.
Brief Answer:
Brain tumor very unlikely.
Detailed Answer:
I read your query carefully and I understand your concern.
Regarding your fear about brain tumor I don't think you should fear that at all. Your symptoms are not suggestive about brain tumor and the MRI which you have had would certainly evidence it, rest assured about that.
If the symptoms look to be present when you change your position not being evident when supine (lying down) but manifesting when you move to a standing position then I would look first at the possibility of orthostatic hypotension. For that you should be evaluated by your doctor by looking for an excessive drop in blood pressure when moving from supine to standing.
Second possibility is paroxysmal vertigo related to the inner ear although it seems your ENT doctor excludes that.
Another possibility is stenosis (narrowing) of your cervical blood vessels. That might have been excluded with the MRI but I should see the report to see whether the MRI exam included the neck blood vessels. If it hasn't then an ultrasound of the vessels of the neck is indicated. (at your age not very likely though).
It could be also related to changes in your cervical spine although again unlikely at your age unless you have some reumatological condition or a past trauma.
If all those are excluded then I would consider the possibility of being related to anxiety as well, but that should be only after other options have been exhausted. It doesn't seem to be any brain life threatening condition though, so try not to panic.
I remain at your disposal for further questions.
Brain tumor very unlikely.
Detailed Answer:
I read your query carefully and I understand your concern.
Regarding your fear about brain tumor I don't think you should fear that at all. Your symptoms are not suggestive about brain tumor and the MRI which you have had would certainly evidence it, rest assured about that.
If the symptoms look to be present when you change your position not being evident when supine (lying down) but manifesting when you move to a standing position then I would look first at the possibility of orthostatic hypotension. For that you should be evaluated by your doctor by looking for an excessive drop in blood pressure when moving from supine to standing.
Second possibility is paroxysmal vertigo related to the inner ear although it seems your ENT doctor excludes that.
Another possibility is stenosis (narrowing) of your cervical blood vessels. That might have been excluded with the MRI but I should see the report to see whether the MRI exam included the neck blood vessels. If it hasn't then an ultrasound of the vessels of the neck is indicated. (at your age not very likely though).
It could be also related to changes in your cervical spine although again unlikely at your age unless you have some reumatological condition or a past trauma.
If all those are excluded then I would consider the possibility of being related to anxiety as well, but that should be only after other options have been exhausted. It doesn't seem to be any brain life threatening condition though, so try not to panic.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Ok. The past few days I've also been more forgetful. We have a lot going on in our lives right now - we just moved and we're all trying to get used to the house, plus the holidays, plus me stressing out that I have a brain tumor. But I've been forgetting things I normally wouldn't. I just started Prozac 7 days ago - could this be related? Still really scared of a brain tumor.
For instance, I forget sometimes where I put my can of soda, I forgot that my husband needs to cut my son's hair before I put him in the bath (after we discussed it a couple of hours before), I forgot that while we're out and about I need to drop something off to a friend. Could this be related to the Prozac I started 7 days ago? Or is it a sign I'm getting worse and my BT fears are valid? So scared.
For instance, I forget sometimes where I put my can of soda, I forgot that my husband needs to cut my son's hair before I put him in the bath (after we discussed it a couple of hours before), I forgot that while we're out and about I need to drop something off to a friend. Could this be related to the Prozac I started 7 days ago? Or is it a sign I'm getting worse and my BT fears are valid? So scared.
Brief Answer:
No brain tumor, Prozac has side effects.
Detailed Answer:
I can see that you are really worried about it, but again, you can be confident that with a normal MRI you don't have a brain tumor.
Prozac as most drugs has its share of possible side effects. Actually dizzyness is one of them, but since you've had it for longer than 7 days, Prozac isn't the cause.
On the other hand while it is used for anxiety, its anti-anxiety effect takes at least 2-3 weeks to come into effect, actually at the beginning of the therapy it is known to cause at times even more anxiety, a paradoxical effect I know, but well known. (Some doctors including me, accompany it with another antianxiety drug of the benzodiazepine class during the first few weeks of therapy).
So you might well understand that your anxiety level could well be higher, especially considering your life-changing stressful events of these days. That also could affect your concentration seeming like memory loss.
You can schedule a visit with a neurologist if you're really worried about your memory, there are appropriate tests to evaluate whether there is true memory impairment, but I suspect they'll come out fine considering your age and normal MRI.
Also I have been assuming that you are being followed for your thyroid function, because its abnormalities can affect both mood and memory and therapy modifications might be needed if that is the case.
I hope to have been of help. I'll be happy to answer any further questions you might have. (If on the other hand you have no further questions you can close the query and rate it as you see fit).
No brain tumor, Prozac has side effects.
Detailed Answer:
I can see that you are really worried about it, but again, you can be confident that with a normal MRI you don't have a brain tumor.
Prozac as most drugs has its share of possible side effects. Actually dizzyness is one of them, but since you've had it for longer than 7 days, Prozac isn't the cause.
On the other hand while it is used for anxiety, its anti-anxiety effect takes at least 2-3 weeks to come into effect, actually at the beginning of the therapy it is known to cause at times even more anxiety, a paradoxical effect I know, but well known. (Some doctors including me, accompany it with another antianxiety drug of the benzodiazepine class during the first few weeks of therapy).
So you might well understand that your anxiety level could well be higher, especially considering your life-changing stressful events of these days. That also could affect your concentration seeming like memory loss.
You can schedule a visit with a neurologist if you're really worried about your memory, there are appropriate tests to evaluate whether there is true memory impairment, but I suspect they'll come out fine considering your age and normal MRI.
Also I have been assuming that you are being followed for your thyroid function, because its abnormalities can affect both mood and memory and therapy modifications might be needed if that is the case.
I hope to have been of help. I'll be happy to answer any further questions you might have. (If on the other hand you have no further questions you can close the query and rate it as you see fit).
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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