Dr. Hitesh Kumar
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,
I was admitted to intensive care unit (ICU) in a hospital with below conditions at night 4 AM. Blood pressure (BP) 90/60 mmHg, temperature afebrile, pulse rate (PR) 80/min, cardiovascular system (CVS), R and PA NAD, giddiness, started generalized itching and nausea. There is no history of headache, visual disturbance, weakness of limbs and bowel and bladder disturbances. There is no history of diabetes mellitus (DM), hypertension (HTN), epilepsy, drug allergy and thyroid illness. There was blood and urine analysis, brain computed tomography (CT) and abdominal ultrasound done. There is no problem found. The diagnoses were vertebrobasilar insufficiency (VBI) and benign paroxysmal positional vertigo (BBPV). Please let me know if I was diagnosed right.
Hello,
Welcome to icliniq.com. I would like to know a few more details. What did you feel in giddiness exactly? Was it feeling of everything rotating around you or feeling of head rotating or feeling of darkness in the front of the eyes or increased heartbeat? For how long these problems lasted? Was it occurring episodically or persistent? Your discharge summary was mentioning vertiginous symptoms (attachment removed to protect patient identity). If computed tomography (CT) head was normal, I suggest you undergo Magnetic resonance imaging (MRI) brain as computed tomography (CT) head can miss out a few things in posterior part of the brain. Investigations to be done Magnetic resonance imaging (MRI) brain with MR angiogram intracranial vessels. The differential diagnosis is vertigo.
Patient's Query
Hi doctor,
Yes, I was feeling giddy and almost fell five to six times. There was darkness in the front of my eyes. It lasted for around 4 hours. I felt everything rotating around me. It was the first time and did not again occur. I had lots of itching and my fingers swollen. I have no history of allergy for anything. But when consulted to the doctor, my blood pressure (BP) was low and pulse rate (PR) 80/min. My question is, can vertebrobasilar insufficiency (VBI) or benign paroxysmal positional vertigo (BPPV) cause itching?
Hello,
Welcome back to icliniq.com. You have mentioned that everything is rotating around you and darkness in front of eyes. Everything rotating in front of eyes suggests vertigo and darkness in front of eyes suggest syncope, which is supported by low blood pressure. By your description possibly syncope and vertebrobasilar insufficiency (VBI) may be more likely. Itching is neither a feature of BPPV (benign paroxysmal positional vertigo) nor VBI.
Patient's Query
Hi doctor,
Thanks for confirming that benign paroxysmal positional vertigo (BPPV) nor vertebrobasilar insufficiency (VBI) causes itching. This incident has happened some time back. I suspect it was due to food poisoning. Is there any way to get the cause now by some tests?
Hi,
Welcome back to icliniq.com. By further investigations, maybe can find some cause and may be not find anything. If not find anything in tests, at least your anxiety will be reduced. You can get the following tests done for search the causes. magnetic resonance imaging (MRI) brain with magnetic resonance (MR) angiogram intracranial and neck vessels with contrast, 2D (two dimensional) echocardiography and 24-hour Holter monitoring.
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Neurology
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