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What Causes Episodes Of Passing Out And Ringing In Ears During Menopause?
Question: My fiancée is 53, beginning menopause. Recently she has had episodes of severe positional syncope, most severe when leaning her head back, or lying down by laying back. Not as severe if she lays down by first getting on hands and knees, then lowering herself. She feels some sort of pressure at the base of her skull when the episodes occur. Seems like she has lesser episodes when getting up from supine position, instead of when laying down. She also has been awakened suddenly, with the same sort of "about to pass out" feeling, even though she was sound asleep when it happened. She just told me she also has some ringing in her ears. We believe her BP is normal. She takes Simistatin (sp?) for cholesterol, but we believe that is normal. she just had a physical a couple of months ago, and labs/EKG all normal. Does this sound life threatening? What could the possible causes be for those symptoms? I know of no visual changes or other symptoms.
Brief Answer:
She has an ENT problem, in all probability.
Detailed Answer:
Dear XXXXX,
I certainly feel that the positional syncope that you mention is paradoxically not true syncope as you mention incidents wherein she reports the "about to pass out sensation" - which you identify as syncope. True syncope does not come calling with such elegant warnings. The parrallel fact that she indeed has a "ringing" in her ears points towards a diagnosis of problems of the auditory canal. This is vertigo. Given an ear pathology we can also have syncope occurring. The other causes of syncope are ruled out as you mention normal readings of her BP, EKG and Labs. So, I would ask you to visit an ENT doctor and get an otoscopic test done. There is apparently now, no other way to exactly say, which part of the ear is affected, and thus which medication to prescribe her, to obtain relief. This is not a life threatening condition, though it is very annoying and frightening. There is a rare chance of a lesion in the brain, and this very rare possibility can be ruled out, again with the various examinations an ENT doctor quickly performs. Kindly get an Otoscopy done as soon as possible.
Regards,
Dr. Neel Kudchadkar
She has an ENT problem, in all probability.
Detailed Answer:
Dear XXXXX,
I certainly feel that the positional syncope that you mention is paradoxically not true syncope as you mention incidents wherein she reports the "about to pass out sensation" - which you identify as syncope. True syncope does not come calling with such elegant warnings. The parrallel fact that she indeed has a "ringing" in her ears points towards a diagnosis of problems of the auditory canal. This is vertigo. Given an ear pathology we can also have syncope occurring. The other causes of syncope are ruled out as you mention normal readings of her BP, EKG and Labs. So, I would ask you to visit an ENT doctor and get an otoscopic test done. There is apparently now, no other way to exactly say, which part of the ear is affected, and thus which medication to prescribe her, to obtain relief. This is not a life threatening condition, though it is very annoying and frightening. There is a rare chance of a lesion in the brain, and this very rare possibility can be ruled out, again with the various examinations an ENT doctor quickly performs. Kindly get an Otoscopy done as soon as possible.
Regards,
Dr. Neel Kudchadkar
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Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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