Q. I get dizziness when I look up or get up. What is causing this?

Answered by
Dr. Aida Abaz Quka
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 06, 2018 and last reviewed on: Oct 27, 2022

Hello doctor,

I have been getting bouts of confusion, dizziness (when looking up and sometimes when getting up), headaches, pulses, and pressure in my head and what I can only explain as brain fog (during these episodes, I find that my problem solving and my cognitive function is diminished). The episodes have been happening on and off for the last year, in which I have had three MRIs, a full cognitive function test, a full set of blood tests, a count, liver, kidney, cardiac panel, arthritis, and sleep apnea test. I have also had a cardiac stress test, 24-hour Holter monitor, 5-day event monitor, and echocardiogram, and these were all negative (no abnormalities were picked up). However, of late, I have found that these episodes have been getting more frequent. Could you advise if this could be intracranial pressure, a tumor, seizures, epilepsy, or some neurodegenerative disease?



Welcome to

I carefully read your question and explained that your symptoms do not seem to be related to intracranial hypertension or any other disorders.

An inner ear disorder, vertigo, or epilepsy may lead to such a clinical situation. For this reason, I recommend consulting with an ENT specialist and performing labyrinthine tests to exclude an inner ear disorder.

If this test result is normal, I would recommend performing an EEG.

It is necessary to check also thyroid hormone levels for possible thyroid gland dysfunction. Hope you will find this answer helpful.

Thank you, doctor,

Please be advised that I already have an exercise stress test, echocardiogram, ECG, 24 Holter monitor, and 5-day event monitor, which were negative. Could these episodes be epilepsy, and if so, would an EEG be the best next step? If not, what diagnostic tests do you advise going for? In your professional opinion, what do you think these symptoms could be related to?



Welcome back to

It is not typical for epilepsy seizures to be triggered by looking up or standing up position. Anyway, an EEG would help exclude this possibility.

Cervical spine chronic degeneration can trigger all these clinical scenarios too. For this reason, it is important performing a cervical column X-ray study.

I recommend consulting with an ENT specialist and performing labyrinthine tests, as inner ear dizziness is usually triggered by head movements (like in your case).

Another possibility to consider is orthostatic hypotension, a disorder characterized by decreased blood pressure values when standing up or sitting from a lying position. Again, head Up Tilt test would help investigate this disorder.

Regarding intracranial hypotension, we can exclude this possibility as repeated brain MRI studies have resulted in normal.

It would help if you discussed the matter with your doctor on the above tests. Hope you will find this answer helpful.

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