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Dr. Arun Phophalia
Dr. Arun Phophalia , Doctor (MD)
Category: Health
Satisfied Customers: 31182
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Hi Im 41 years old and occasionally i get these spells, first

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Hi I'm 41 years old and occasionally i get these spells, first i feel pressure in my head and either see black with stars or cannot hear, i get verry hot with a sweat, feel nauseous, breath very fast, there is no pain though, while this is happening i'm aware of everything but can't do much, it usually only lasts for 5 min or so, after the sweat passes i get my vision or hearing back and get very cold, i'm not on any medication of any kind , can anyone give a suggestion as to why this is happening? I looked into the low and high blood pressure symptoms, but it says nothing about the sudden high rise in body temp. ty

Greetings Michelle.

Since when are these symptoms / episodes?
Were any investigations done?
Any significant past medical history or surgery?

Are your periods normal?
Any family history?
Do you smoke?

Dr. Arun

Customer: replied 3 years ago.

it happened a few time in my 3 pregnancies when i was in my 20's but my doctor said it was nothing to worry about , it stopped for awhile but now it's happening again so... i had a hysterectomy at the age of 38, no family history as far as i know and i do smoke about a half a pack a day

Hello Michelle,

Following would be the diagnostic considerations;

1) Transient neurological attacks (TNAs). TNAs are defined as episodes of sudden onset of neurological symptoms that completely resolve. These are classified as focal and non focal. A nonfocal TNA is a temporary event of diffuse, non localizing, cerebral symptoms that set in suddenly and resolve quickly. Symptoms of nonfocal TNAs may be altered consciousness, dizziness, visual abnormality, abnormal sensation, weakness, or generalized feelings of unwell with a clinical suspicion for neurological disease. TNAs are considered to be benign.

2) Syncope

3) Migraine or migraine variants

Following are the investigations for ascertaining the cause of your episodes;

1) MRI with gadolinium contrast

2) Magnetic resonance angiography (MRA)

3) Tilt table test

4) Carotid sinus massage

5) Electroencephalography (EEG)

6) Stress cardiac test

7) Total creatine kinase (CK) and heart enzymes; done immediately after the episode and would tell about the abnormal brain or heart activity which caused the event.

8) Following also may be done after the episode; blood electrolytes and blood glucose.


Following are the causes which too may be responsible and can be ascertained by the above investigations;

1) bradyarrhythmias; this is sudden slowing of the heart. it is mainly due to sinus and atrial node dysfunctions. Sick sinus syndrome is a prototype of these arrhythmias. 24 hour Holter monitoring, echocardiography etc are the investigations done for it.


2) neurocardiogenic mechanisms; this is fall of the blood pressure suddenly due to a sudden sympathetic failure (failure of the autonomic nervous system). It can be accompanied by flushing, nausea, and sweating.


3) carotid hypersensitivity syndrome is an exaggerated response to carotid sinus stimulation.


4) orthostatic hypotension is due to failure of autonomic nervous system and related heart regulatory mechanisms.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.


We have recently implemented a new rating and feedback system. Please be aware that you are rating my courtesy and service as a professional. If you have any questions whatsoever, or there is anything I can clarify for you, please temporarily bypass the rating system by clicking “Continue the Conversation” or "Reply."

Clicking either of the lowest two options reflects poorly on me so please reply to me if there is anything else I can do to help before choosing those options. I appreciate your patience while we work out the kinks. It's important to me that you are 100% satisfied with the service I have provided you. Thank you.

Customer: replied 3 years ago.

ty for your time, i suppose i should go get some tests done lol i scared my friend who was with me when it last happened, he said i turned green and my eyes dialated, ty again for your suggestions. Michelle

You are very welcome, Michelle.

I can understand these episodes can be scary for someone watching. This need ascertainment of the cause.

It is privilege assisting you.

Please rate the answer Excellent / Good, if the interaction has been satisfactory. Only a positive rating gives us credit for time and expertize.
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31182
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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