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

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

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, full set of blood tests, 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, echocardiogram and these were all negative (no abnormalities were picked up). 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 sort of neurodegenerative disease?



Welcome to icliniq.com.

I passed carefully through your question and would explain that your symptoms do not seem to be related to intracranial hypertension or any of the other disorders.

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

If these tests result 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.

For more informationconsult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Thank you doctor,

Please be advised that I have already 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 icliniq.com.

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

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

I would also 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, which is a disorder characterized by a decrease in blood pressure values when standing up or sitting from lying position. Head Up Tilt test would help investigate this disorder.

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

You should discuss with your doctor on the above tests. Hope you will find this answer helpful.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

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