While getting up from sleep in the morning vertigo, and fatigue occurs. After my first bowel movement I pass gas and feels the urge for second bowel movement again. While passing of gas, sometimes I get palpitations, pins and needles over belly area, flickering on buttocks occurs. Vertigo and fatigue goes away at the end of a day. Spinning in head and blackout eyes occurs after standing and lasts for few seconds.Occasionally, shaking occurs in neck region behind the head and thighs. Spicy feeling comes and goes in the nostrils. No fever, cough, or loss of smell.
I consulted a gastroenterologist and taking Iboverin and Checkcid. Many years back, palpitations used to occur, when I used to get up from the sleeep due to sudden big noise and from recent years, littlebit vertigo used to occur during urination and passing stool.
I had performed USG, thyroid profile, lipid profile, ECG, CBC, urine test, LFT, chest x-ray, abdominal x-ray. The results show TSH 6.11. Serurm bilirubin 1.1, SGOT 42, SGPT 56, triglyceride 193, VLDL 38, Abdomen pelvis report is fatty liver grade-I. Haematology report depicts WBC 8,300. Other remaining values are within range.
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I would like to know some details about your symptoms. Since when you started to have symptoms? What exactly you feel in vertigo, visualizing spinning of surroundings object around you, or feels spinning of your head inside, blurred vision, blackening in front of eyes, feeling of imbalance while walking, or something else? How is the consistency of your stool (solid/ semisolid/ liquid)? Do you have any bleeding in stool? One episode of palpitation lasts for how long time? And how frequent are episodes of palpitations (how many times in a week)? Are shaking in neck and thighs visible? Or is it only felt inside? Is there any shaking of hands also? Do you consume alcohol or other addictive items? If yes, please tell me how much and how frequently?
How is your sleep in a routine? Do you get sleepy soon after lying in bed? Or it takes a long time? Once got sleepy, do you have frequent awakenings during sleep? Do you feel fresh on awakening from rest in the morning? How is your usual mood in day-to-day activities? How is your appetite?
Please click a picture of your ECG (electrocardiography) and send it as an attachment.
MRI (magnetic resonance imaging) brain. 24-hour Holter monitoring. 2D echocardiography. Stool examination for ova and cyst. Serum vitamin B12. Get multiple BP measurements at lying position, standing position 1 minute after standing up, and 3 minutes after standing up. Make a chart of such BP measurements and send as attachment.Differential diagnosis:
? Presyncope. ? Anxiety disorder with panic attacks. ? Irritable bowel syndrome. ? Cardiac arrhythmias.Regarding follow up:
Revert with the above-mentioned information for better understanding and further judgment.
Thank you doctor,
Since 2018, I started to have symptoms. I feel blackening in front of eyes during standing up and occasionally imbalance during walking. My stool is semisolid and no bleeding in the stool. One episode of palpitations lasts for one minute and there are 4-5 episodes in a week. Shaking in thighs is visible like vibrations of muscles. There is mild shaking of hands also that is felt but not visible. I do not consume alcohol.
I get sleepy after going to bed. During sleep, frequent awakenings occurs once or twice. I feel lethargic after awakening from sleep in the morning. My mood is happy and I feel no symptoms and I worry about my parents and brother sometimes. Their ill health and debts makes me feel irritating. My hunger for food results in intake of morsels speedily during eating.
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As per your description, possibility of anxiety disorder and presyncope seem more likely. But we need to rule out few causes or other things related with such symptoms.
MRI brain. 24-hour Holter monitoring. 2D Echocardiography. Stool examination for ova and cyst. Serum Vitamin B12. Free T3, Free T4. NCV all four limbs. Make BP measurements chart as mentioned above.Differential diagnosis:
? Anxiety disorder with panic attacks. ? Irritable bowel syndrome.Treatment plan:
I suggest you get these investigations to rule out secondary possibilities for your symptoms. If we find something significant, we will think accordingly. And if we do not find anything particular, you should consult a psychiatrist.
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