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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10341
Experience:  14 years experience in the field of Family Practice
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I am here on behalf of my wife 31YOF. She has been

Customer Question

Hi I am here on behalf of my wife 31YOF. She has been experiencing dizzy spells as of the past 3 weeks or so. She has been to the ED twice in the last week for these dizzy spells. She gets dizzy and or light headed very weak and a out of body experience. Once she stabilizes she gets a bad headache and pretty much knocks her out for a couple of hours. Also for the past I would say couple of years has had a on and off pain in the rt eye and orbital area. She has been to eye doctors and they say she checks out OK, just like the DR.'s at the ED possibly vertigo. Her latest dizzy spell was this morning, you can tell she doesn't feel right, gets pale, clammy skin. I tried getting a radial pulse but had to go to carotid to get a palpable pulse. This tells me her BP possibly took a dive for some reason. She is on medication for anxiety, she seems to get these spells in crowded areas as if it were a anxiety attack, but this morning we were home no crowds. Any advice?
Submitted: 1 year ago.
Category: Medical
Expert:  Anthony Bray, MD replied 1 year ago.


I agree that low blood pressure might be cause of her dizzy spells. That is certainly one possibility . Get blood pressure cuff at pharmacy ( recommend one for wrist ) have her monitor pulse and blood pressure for several seated resting measures and thus get a baseline .

Of she gets dizzy and especially light headed sensation then it could relate to drop in blood pressure ....This could be vasovagal ( that may be triggered by nausea or anxiety)

Make sure too she is not pregnant ! Fainting or dizzy spells is common presentation of pregnancy !

If she has sense of vertigo or room spinning then that type symptom would more suggest an inner ear problem as cause ...common if comes and goes to be BPV( benign positional vertigo ) labyrinthitis is caused by inflammation of inner ear and may be caused by virus ( this usually may be severe and cause nausea for a week or so then resolve) other causes are possible too...

I hope that this information is helpful Let me know if you have further questions or discussion.I will be happy to get back with you.If my answers have been helpful and to your satisfaction then please remember to leave positive feedback Thank you and Best Regards,

Anthony Bray MD

Customer: replied 1 year ago.
Thanks for the reply Doc. I have taken her BP on the tail end of one of the spells 110/70 ish. Pregnancy is pretty much ruled out, her tubes were tied almost three years ago, but still a slight possibility. She has been complaining of a head ache today and when I asked her what kind of head ache/type/feels like/1-10 rating she said it's like a headache but it's more of a feeling of pressure, dull type of pain around the rt orbital area and rates it as a 2/10. Neausea coming and going through out the day along with times of feeling light headed.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

With her headaches and pressure sensation it may be worth her being checked more closely to rule out a sinus infection...

Nausea makes sense as this would cause a vagal response which would transiently lower both pulse rate and blood presure and could well make her feel light headed...

The 110/70 is normal but as she does not have a high baseline then she may more easily fall to a low pressure such as 85/50 which could make her feel light headed or feel faint...

Dull pressure right eye area could be associated with right frontal sinus infection or right ethmoid sinus infection as possible culprits to consider..

I hope that this is helpful for you. I hope that she feels better soon. If she feels light headed again then have her lie down I would advise as first step..

Let me know if I may be of further help. Best Regards!

Anthony Bray MD

Customer: replied 1 year ago.
I would agree with the sinus' except the last time she had these episodes she had a full cat scan and sinus mri and everything checked out ok, the whole time during the scans still suffering from the pressure around the eye. She's had her whole head scanned a few different times with the same result everything is fine. This maybe different this time and may be sinus issue.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again!

Well her doctor may do first more of clinical exam such as percussiing over sinuses and exam up nostrils and back of throat ...these would be first steps and may clarify the picture. I would not rush to sinus CT to easily ...I agree with you there...I would want to avoid over testing too...

It sounds that headache pattern may be of recurrent nature to this same area ?? If throbbing quality of headache then migraine type may be cause ...nausea would fit potentially with migraine

On the other hand the description of sense of PRESSURE around the right eye does SOUND more of a sinus type problem....

I would wonder if a decongestant might lead to any sense of improvement for her ...Sudafed ( behind the counter at pharmacy for example )

I hope that this is helpful.Let me know if you have further questions or discussion.Take Care!

Anthony Bray MD

Customer: replied 1 year ago.
She tried just a general ibuprofen today with little to no relief I will have her try something like a decongestant and see if that helps, again in the past it hasn't but we will give it a try.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again-

Ok I hope that she feels better. If frequent eye pain not explained have her checked by opthalmologist .( checking on eye pressure ) Different explanations are possible for headaches and eye pain....

Customer: replied 1 year ago.
I'll have to have her go back to the eye Doc again. She went and had a full exam with the eye Doc the last time this was a issue. Do you think that it could at all be possible that it's stress related? I wouldn't think stress would have these type of symptoms, but I could be wrong.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

Well stress may aggravate many things. It does not sound like the most typical tension type headache which is common with stress ( pressure sensation could fit but localized around right eye would not )

The nausea and one sided headache could fit migraine type but you have not related that she has any throbbing quality to this but more a pressure type quality ...

So it strikes me more as a sinus type headache in its characteristics . .

If bright light makes headache worse then that would fit more of migraine type ...

I agree that stress would not seem likely to be as likely a cause with right periorbital headaches ....

Let me know if you have anything further ..

Best Regards,

Anthony Bray MD