Dr. Shivam Om Mittal
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hello doctor,
I seem to be getting these dizzy rush sensations. They happen randomly throughout the day, but mostly when I am on the computer. It feels like an electrical pulse is surging up through the back of my head. I also feel dizzy turning side to side and when I get a headache, it feels like it is coming from deep within my left ear. It causes me to panic and get a lot of anxiety afterward. What could this electrical rush sensation be? Then, also, after I get it, I cannot look up too quickly because I feel very dizzy. It usually happens again, while typing on the computer or looking down at a smartphone.
Hello,
Welcome to icliniq.com. I will try my level best to help you out. Your symptoms are mostly dizziness, which worsens with sudden eye movements or body movements, and are sometimes associated with headaches. Based on the symptoms, the most common cause in your age group is a vestibular migraine or benign paroxysmal positional vertigo (BPPV). I assume you do not have any other risk factors such as diabetes, hypertension, previous stroke or diagnosis of epilepsy. A simple neurological examination using Dix Hallpike Maneuver can help differentiate between BPPV and vestibular migraine. Also, further questions on the quality of headache, location and associated symptoms such as light sensitivity, loud noise sensitivity and nausea are other important questions, that can happen with vestibular migraine. Treatment for BPPV is physiotherapy with some specific exercises and medicines such as Topiramate or Valproic acid for vestibular migraine. If there are any red flags on neurological exam, then an MRI (magnetic resonance imaging) of the brain would be needed.
Patient's Query
Thank you doctor,
I have had an magnetic resonance imaging (MRI) which was normal. I have had a full workup with the Frenzel goggles and no nystagmus or unusual eye movements were ever noted. I am also now negative on the Dix Hallpike test, although when this first happened, I did have benign paroxysmal positional vertigo (BPPV) because I did the Epley Maneuver on myself and had spun for five to 10 seconds on my right side. I have had full blood work and normal levels, including thyroid and iron. My left ear also feels full at times and I have tinnitus (faintly) - all hearing tests were normal. I have not done an electroencephalogram (EEG), but I do not have any seizure history although worry this can be a seizure. For example, I could just be typing on the computer with my head slightly tilted and I get a brain zap or electrical pulse sensation that feels like it is running up the back of my head. It only lasts two seconds. This all started after months of sitting with poor posture, using a laptop. I also have a history of generalized anxiety disorder. I was getting these symptoms before and I got the spinning when doing the Epley. But now, I am negative doing the Epley and am still getting these symptoms. What is the likelihood of focal seizures?
Hello,
Welcome back to icliniq.com. I am glad you had a brain magnetic resonance imaging (MRI) and it is normal. Also, I am glad that the benign paroxysmal positional vertigo (BPPV) symptoms improved after Epley's. The symptom you described in the last message is called Lhermitte's phenomenon/sign which is an electric shock-like sensation going down from the neck region down to the spine, precipitated by head flexion movements. I would recommend MRI cervical spine and serum vitamin B12 levels (if not done already). Focal seizures are less likely but seizures can present with some unusual stereotypical episodes. To complete the work up, sleep deprived electroencephalogram (EEG) can be done to record one of the spells of the dizzy sensation. But, I believe that seizure is less likely.
Patient's Query
Thank you doctor,
I have read that this can be a symptom of multiple sclerosis (MS), but that is not likely because my magnetic resonance imaging (MRI) was normal, same with Chiari malformation. One thing an X-ray noted, however, was my atlas joint being misaligned. Also, does this syndrome cause intense dizzy spells too?
Hello,
Welcome back to icliniq.com. So, the magnetic resonance imaging (MRI) cervical spine was normal with no evidence of Chiari malformation. That is reassuring. Multiple sclerosis (MS) is one of the cause, but there are other common causes such as vitamin B12 deficiency, radiculopathy (pinched nerve due to bulging disk), etc.Atlas misalignment, if truly present, can cause symptoms of neck pain and dizziness. I would recommend seeing a therapist for neck exercises for the neck pain.
Patient's Query
Thank you doctor,
I only had an magnetic resonance imaging (MRI) of the brain, not spine. Would multiple sclerosis (MS) lesions be in the brain, if MS? Also, this syndrome you describe, would it be present all the time when bending the neck? This happens very sporadically and almost always associated with computer use. Also, the sensation does not radiate down my spine into my legs. It feels like it rushes up the back of my head.
Hello,
Welcome to icliniq.com. Multiple sclerosis (MS) patients will typically have abnormal magnetic resonance imaging (MRI). MS is less likely in your case. But other common causes related to cervical spine or disc can cause the symptoms. Because the symptoms are position specific, that is, typing on a computer, it seems to be the neck region that could be a problem.
Patient's Query
Thank you doctor,
So, could it be possible that this is all originating in the neck, perhaps because of neck strain? Also, can neck compression cause benign paroxysmal positional vertigo (BPPV)?
Hello,
Welcome back to icliniq.com. We see upper cervical radiculopathy causing vertigo symptoms. So, this could be associated with some neck strain due to poor posture. Magnetic resonance imaging (MRI) cervical spine will be very helpful to elucidate that. BPPV (benign paroxysmal positional vertigo) is an inner ear problem and does not arise from the neck. But, as I mentioned, the neck symptoms can cause vertigo.
Patient's Query
Thank you doctor,
Yes, it does. Can you confirm based on symptoms that this is not Lhermitte's sign as it does not radiate down my spine into my limbs and is not there when I bend my head down? I just did the standing test and no electrical sensation felt. As mentioned, it happens at the occiput and radiates upwards.
Hello,
Welcome back to icliniq.com. Based on your symptom, this is different from your previous description of pain radiation. If it is going up to the occiput, then another differential is occipital neuralgia. Also, C1-C2 radiculopathy can have pain radiation upwards to the occiput.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
Neurology
Related Questions
Is my dizziness related to any heart problem?
I get dizziness when I look up or get up. What is causing this?
Do you see any abnormality in the attached EEG report?
I have spinning of my head with nausea and vomiting. What could this be?
I have problems falling and staying asleep. Please comment on my EEG reports.
My mom has been suffering from head spinning. Why?
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
