Dr. Abhaya Kant Tewari
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.
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Patient's Query
Hi doctor,
It started with dizziness over two weeks ago. Doctors thought that it is labyrinthitis but now I am getting inward head and body tremors that make me feel like a nervous wreck. I was prescribed the tablet Betahistine hydrochloride 16 mg for the Labrynthitis and I am wondering if these tremors could be a reaction to the medication or could something be connecting it all? It all seems to start in the head then it is like it is taking over my body. I am experiencing multiple episodes a day now. I am also taking the capsule Ramipril 10 mg and the tablet Amlodipine 10 mg.
Hi,
Welcome to icliniq.com.
1. What I gather is that you had an onset of symptoms two weeks ago with dizziness. Now dizziness actually encompasses a multitude of symptoms and is not a very specific symptom. If it has an associated illusion of spinning/rotating with sound and fullness in the ear, the cause is likely to be labyrinthitis and the tablet Betahistine is commonly prescribed for this. A more detailed onset and progression of symptoms will clarify the situation better.
2. However, as the symptoms have progressed to include tremors, restlessness, and something starting in the head and involving the whole body is not likely to be labyrinthitis. The tablet Betahistine may not be able to help you, though the symptoms you have mentioned are not associated with it if it is not helping, there is no point in continuing it. As you are already on medication for hypertension, the tablet Betahistine may be further dropping the blood pressure, causing your symptoms.
3. A more detailed history of any factors causing anxiety and restlessness should also be looked into, maybe anxiolytic drugs will help.
Regarding follow up
Patient's Query
Hi doctor,
I do have some ringing in the ears. I have had some anxiety issues previously and I have definitely felt super anxious and stressed this past fortnight due to feeling all these things. I went to the doctor after the fifth day of the dizziness and slight tightness in the chest. They took blood to check for heart attack and did ECG, they were happy with both. During the night I started getting this really shaky feeling inside the upper body. I was wakening up with it which started affecting my sleep pattern. On day 13th, my neck went stiff and was accompanied by a terrible headache. I went to the doctor again, and they performed another ECG and made me do some walking, eyesight, and reflex tests. They were satisfied there was nothing sinister and sent me back home. My doctor has requested a CT scan. I had a much better sleep last night but I did have upper body pain/spasm and then when I woke up I could feel my head shaking at the back/center of my head which then seems to start a whole body inward shake and nervousness. I have not had many headaches since the one on day 13th. No history of tumors in the family. Mother had a heart attack two years ago (possibly due to Covid) and she has type 2 diabetes. I guess I am just worried that things have progressed from the original dizziness to this. Dizziness is not as extreme as these other symptoms.
Hi,
Welcome back to icliniq.com.
1. The detailed history has been helpful to me in approaching your problem.
2. The onset was most likely an inner ear problem (can be caused by many different varied causes from the common cold, dehydration, post-viral infection, etc.). The tablet Betahistine was correctly prescribed and has improved your symptoms.
3. The future course of illness is either a mild undesired side effect of the tablet Betahistine or rather more likely due to anxiety. In view of the previous history, it fits in with the problem. Mild anxiolytics may help. The CT (computed tomography) will help but is unlikely to have any abnormality, so do not worry about it. The best course will be mild anxiolytic drugs, mild physical exercise, and stress management.
Your problem will go away.
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Neurology
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