Question
Hello Dr Steve Ornstein,

I am writing to you as I am very concerned regarding my problem which is worrying me terribly.  When I bend forward it seems like I have a problem whereas I tend to get very dizzy, I already have balance problems and besides being dizzy I get the feeling like I'm going to pass out, like my brain is blanking out and at times I feel very nauseous when I press in the front of my neck where I feel some pain, like I will vomit.  What would be causing this problem ?  Why do I feel like I will black out?   Why the nausea?  What is happening to me Doctor I am so worried.  My local doctor has been unable to give me an explanation as to what may be happening.
Please help and give me some - any suggestions and advice to make this problem which is affecting my life and giving me much anxiety.  I appreciate any and all assistance you can offer me.

Many thanks

Karen

Answer
Hi Karen,

Try to take it easy, worrying is not going to make things better.

It may be related to the neck, however, more frequently it is a condition called benign paroxysmal positional vertigo (BPPV) and this can be related to the inner ear and can be associated with headaches.

The inner ear has otolith organs which contain crystals that can become dislodged. When they become dislodged, they can move into one of the canals causing these types of symptoms. Canalith repositioning is usually done by a physical therapist or doctor that may help. So, see if your doctor will refer you to an ear, nose and throat (ENT) specialist.

If this diagnosis is ruled out, see if your doctor will refer you to a neurologist. It is less common to be caused by the neck and it is usually on turning the head, but degeneration - osteophytes may affect structures, either nerve or vascular, that may be suggested from mri or vascular testing.

In the meantime, be aware of the possibility of losing your balance, which can lead to falling and injury. Sit down immediately when you feel dizzy. Use good lighting if you get up at night. Walk with a cane for stability if you're at risk of falling. If you can, have someone go with you when you go out.

I hope this helps.

Kind Regards,

Dr. Steve