Vertigo for 3 weeks and counting after fainting from panic attack

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Hi

Hopefully some of you might be able to help shed some light on what is happening.

Just over 2 weeks ago i had a panic attack in bed and was hyperventilating.. i never had a panic attack before even though i have suffered from anxiety most of my life. Im 35 male and generally in relatively good health. After the hyperventilating i got out of bed to go to the bathroom and i collapsed and fainted. I suddenly woke up in a daze on the floor and stumbled to the bathroom then fainted again. I don't know how long i was out for as i did not look at the time or how long i blacked out for. I stumbled back to bed and tried to sleep it off. I was feeling dazed and confused as i have never collapsed before.

2 years ago i was diagnosed with postural hypotension as usually if i get out of bed from a lying position to standing suddenly i would get a rush to my head of dizziness but wouldn't fall over as the blood would get to my head in time. I really should have noticed that after my panic attack this time the dizziness upon standing suddenly should have been avoided and i should have sat and waited for the blood to get to my head in time.

The problem is since the collapse i have been suffering from vertigo where it feels the room is spinning and dizziness. No nausea. I have had vertigo before 2 years ago which i treated with betahistine which i use occasionly whenever i had vertigo flare ups but this time round the betahistine did not work. I noticed the vertigo symptoms would flare up mildly initially and go away after a few secs whenever i got anxious. But after 2 days i would get dizzy spinning sensations lying down on my side or my back before bed. It would take an hour for the spinning to stop but whenever i switched from my back to side or vice versa the vertigo symptoms would become more pronounced.

A few days later after taking a nap i noticed my hands and arms had pins and needles as i was sleeping on my side and squashing my arms, the vertigo after that was exceptionally bad i couldn't even relax and watch tv as i would get more dizzy. i saw a gp at my doctors surgery and explained what happened and she checked my ear and my pulse for blood pressure.. weirdly my blood pressure came out normal i.e. no incident of postural hypotension. I was sent for an ECG as my heart rate was fast but i explained i suffer from anxiety. The gp said he thought i had minor BPPV and put me on prochlorezine for a few days, it didn't help either.

That same week i went back to doctors surgery and showed my ECG came back normal and asked about this BPPV and was told it can take weeks to calm down and i have to just wait it out. I was put on promethazine next which helped a little bit but did not stop the vertigo swaying sensation. I noticed that the vertigo would be better in higher oxygen environments i.e. outside and worse in low oxygen environments i.e. indoors or if i have anxiety and not breathing slowly.

A week went by and still no improvement and i went to the gym and when i attempted to do 20 reps of a very light weight i normally do with no issue i noticed my dizziness was getting really bad again to the point i felt i might collapse if i don't stop. I wasn't even exerting myself at all. The vertigo lasted for hours after and wouldn't calm down till 3 hours later and since then still isn't better than it was prior to gym yesterday. Right now writing this i feel things are swaying. I tried cinnarizine next which didn't seem to help either.

I concluded that what i have may not be BPPV as it seems to be brought on by not enough oxygen getting into my brain if that makes sense and explains why the medication does not work. I went back to gp today saw a different doc again and explained to him everything, he checked my ear and said i have fluid build up behind my ear drum. I tried to explain to him i get this every year and it's not related to my vertigo and that the other gp i saw last week checked my ears and everything was ok so it is not related to my ears even though i know vertigo can be a cause from inner ear issues. He wouldn't listen so i got frustrated asking what happens if you faint and get vertigo after this that doesn't go away and gets worse in low oxygen environments.

I see my regular gp next week finally but has anyone got an idea what is the problem?

I am sure it is related to me collapsing and fainting twice in same episode because that is when the vertigo started.

It feels like not enough oxygen is getting into my head/brain and it is making my coordination and balance is off i.e. i stumble and drop things a lot.

Does anyone can take a guess what i have or the cause?

I should mention if the vertigo gets worse like it did yesterday after working out or normally i get headaches at back of my head they subside as the vertigo calms down a bit but i am finding it dehabilitating.

Could it be something serious ie a blockage that's stopping enough oxygen getting to my brain?

I don't think it's a glucose issue i had blood test for diabetes last year and other blood tests i.e. anemia etc

I dont know if i hit my head upon falling and blacking out but i dont remember having any bumps or pain after blacking out when it happened.

What could this possibly be? Is there such thing as a blockage to the brain of oxygen or small.partial blockage. It cant be plaque i am taking statins for nearly a year and also 75mg of daily aspirin so i dont think a small blood clot would occur that's causing it.

I honestly dont know what is causijg this but i dont think it is BPPV unless it is BPPV with something else undiagnosed.

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17 Replies

  • Posted

    I don't know if this will help, as I am still suffering myself, but try asking your doctor to look for semicircular canal dehescience. It is basically a broken or damaged bone near the inner ear that lets tiny amounts of fluid into canals that it shouldn't. This causes dizziness like you describe. It could have been caused if you bumped your head when you fainted or it might just be a birth defect, like they thought might be my problem. A diagnoses isn't always found because sometimes the damage is too small to detect with the scans, but it's worth a try. I hope you feel better soon, I understand your frustration.

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    • Posted

      When the doc saw me yesterday he said there was fluid either side of my ear drum on the right but i get this every year in eustastian tube.

      How can my gp see if it is semi circular canal dehescience do i need to see a specialist ear doc?

      You mentioned it is so small it doesnt show up on scans so how can they tell if it is that?

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  • Posted

    Pete, are you quite sure it's not just due to extreme hyperventilation? I'm asking this because you said at the start of your post that you knew you'd been hyperventilating, so you clearly know the symptoms.

    I've suffered two severe episodes of BPPV in my life (still in the middle of the second one now!) and also hyperventilated a lot if I got anxious when I was young. I can confirm that there is a degree of overlap between the symptoms of the two conditions. Prolonged hyperventilation produces exactly the same dizziness and nausea as vertigo but without the real sensation of spinning - well, in my case anyway. It also causes sensations of numbness or pins-and-needles in your fingers and face and, in extreme cases, can even cause your fingers to become stiff for a while.

    When I was very young I also suffered from the postural hypotension thing you describe. I don't think I ever passed out when getting out of bed but I know I had a few near misses - nausea, sweating, tunnel vision etc.

    I can connect with that sensation of not getting enough oxygen. That goes hand-in-hand with hyperventilation. As I'm sure you know, the real problem during episodes of hyperventilation is insufficient carbon dioxide, not oxygen. (I'm a former nurse btw.) When we hyperventilate, we "rinse out" too much carbon dioxide from our lungs. I know CO2 is normally thought of as a waste product of respiration - which it is, of course - but it also has a role in keeping the body's electrolyte balance in order. When we eliminate too much of it, the body's chemistry temporarily goes haywire, causing all sorts of unpleasant symptoms.

    Paradoxically, one of these symptoms is the feeling that we're not breathing enough. In the old days doctors used to suggest breathing in and out of a paper bag. I got told to do that as a young girl. The science is actually sound, as this would cause re-breathing of some of the excessive CO2 that had been exhaled, thus correcting the electrolyte imbalance. In reality it's a complete non-starter. Trying to get someone who already feels they're not getting enough oxygen to breathe from a paper bag is obviously going to cause more distress.

    No one ever explained any of this to me when I was young, but once I started training as a nurse I began to understand what was going on during these hyperventilation episodes, which can still occur now in old age, but only very rarely. I used to get myself out of them by deliberately breathing not quite as deeply or rapidly as I felt I needed to, for as long as I possibly could - which will be maximum one minute at the start of an attack. Then I'd let myself take just two or three deep breaths to "catch up" before deliberately depressing my breathing again. As my CO2 levels gradually built up, I'd find I could go longer without taking a deep breath in each cycle, till the attack subsided. I can really recommend this method, from personal experience. Some therapists recommend breathing to a count - holding your breath for a fixed number of seconds before breathing out etc. - but I've always found this counterproductive.

    As another poster has suggested, it might be a good idea to get a more thorough check of your ears, since the actual spinning sensation seems to have started immediately after your fainting attack, with a possible head injury.

    From your post it sounds as if you're taking care of your general health, with regular blood tests etc., which is also important.

    But you do mention that you are prone to panic attacks, which can bring on all kinds of physical signs and symptoms, some due to hyperventilation and some to other causes. I hope you're getting the help you need to address this problem too.

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    • Posted

      Hi thanks for your reply

      I should have been clearer i only ever had one panic attack with hyperventilation i never had panic attack before this even though i suffer from anxiety. The hyperventilating was very pronounced as i was breathing in and out heavily.

      Even when im just sitting and relaxing im getting this vertigo. Since i went to the gym 2 days ago lifting those light weights 20 reps my vertigo is there nearly all the time now as im writing this. I started to get really dizzy as mentioned and felt like i may pass out if i didnt stop. The vertigo lasted for a few hours before calming down but overall it's there all the time.

      What could be causing this?

      It cant be hyperventilating i try breathing more slowly now yet it still is there. Trying to focus on something makes me dizzy.

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    • Posted

      Pete, as your doctor says, you might be suffering from BPPV as well. Nothing is impossible. If this is the case, a specialist physiotherapist or an ENT doctor should be able to fix it, though it will eventually clear up of its own accord anyway.

      It's probably not a good idea to over-exert yourself in the gym - even with light weights - at a time when you're clearly not feeling too good.

      If you have been hyperventilating without realising it (and most people are totally unaware of it when it's happening) it will take more than one session of conscious breathing to reduce the symptoms. 

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    • Posted

      But i have never hyperventilated prior to that incident 2 weeks ago never had a panic attack either. I knew it was a panic attack because i never had something like that.

      To me it seems related to me blacking out and falling over twice in same epsiode. I cant seem to figure out what has happened that's causing this vertigo symptoms to come and go.

      Is it possible it is BPPV? Prior to the gym on thursday i would always get it lying down either on my back or side which ia indicator of BPPV but i feel like i may have done some damage that's blocking blood flow or oxygen to my brain etc.

      What do you think it could be? How long does BPPV last or start to get better?

      I was the one who said to the doc it's possible i have BPPV and something else.

      It is affecting my coordination as i am dropping things and bumping into things.

      What would cause the vertigo to be better or non existent in high oxygen environments ie outside and worse indoors?

      Like i said up till Thursday before i went gym i was on assumption it was BPPV and would clear on its own eventually but seeing as i went gym lifted light weights and did not breathe properly (i always do this in past never had an issue) it sudden brought out the same symptoms prior to collapsing 2 weeks ago.

      How do i breathe properly to eliminate these symptons cos i cant be hyperventilating 24 hours a day can i?

      Thank you for your help i appreciate it

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    • Posted

      P.s. lily it seems from my initial post that you seem to think i have had panic attacks all my life i have anxiety but never had a full blown panic attack except 2 weeks ago.

      I can't be hyperventilating all the time surely.

      To me it seems like it has to be related to me blacking out and maybe damaging something in my head. I get headaches if the vertigo gets worse at back of my head it feels like oxygen or something isn't getting to my head or is obstructed somehow what could that be?

      It seems strange how higher oxygen environments prior to thursday would help remove all the vertigo but since then and the gym thing i have vertigo all the time either mildly or full blown as i am experiencing now.

      The doc who saw me last week checked my ears it came back clear only yesterday the doc saw fluid but i already have been experiencing vertigo since then so it cant be related to the fluid i assume.

      Is it possible a small blood clot or something else is obstructing the blood flow/oxygen to my brain?

      To me because it was better in higher oxygen environments something is causing an obstruction.

      If it is hyperventilating how do i change my breathing to correct it? It doesn't feel like it could be that. Writing this on my phone focusing on something is making my vertigo worse and making me feel more uncoordinated.

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    • Posted

      Pete, you really need to get back to your doctor if you're so concerned. Forums like this one are a useful way for people to make suggestions based on their own experience, but aren't a substitute for medical diagnosis.

      I hope you can find the help you need.

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    • Posted

      It's more potential other causes because there are so many. What would you say this whole not getting enough oxygen to the brain vertigo feeling is if you were to guess?

      Im not hyperventilating now yet everything is shaking and unstable it feels.

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    • Posted

      Would an issue with not enough oxygen getting to the brain be a neurologist thing?

      What i don't understand is why has it gotten worse since thursday? I'm lying in bed and the room feels like it's spinning.

      I can't figure out why what i did in the gym has increased the symptoms sad more specifically why it is happening. Surely this cannot be BPPV?

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  • Posted

    From your description, you have not been examined fully yet by a physician with emphasis on balance. Although they mentioned the possibility of BPPV, they did not prove it. You need to see ENT with a special intetest in neurotology, or a neurotologst.

    Eleftherios S. Papathanasiou, PhD, FEAN

    Clinical Neurophysiologist,

    Fellow of the European Academy of Neurology

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    • Posted

      Thankyou for your reply.

      But how is this linked to me having a panic attack and hyperventilating then passing out?

      It seems the vertigo is related to that incident i don't see how my ears could be involved given how it started.

      Is it possible i hit my head and that's disrupted something in my ear?

      It's affecting my coordination and feels like not enough oxygen is getting to my brain.

      I notice it's worse when im anxious and better when calmer. It seems like if i stay still it adjusts itself after a while.

      But i always get it upon lying down in bed feels like everything is swaying.

      If it is related to the ear why is it when i went to the gym and did 20 reps of a very light weight the dizziness and almost passing out came back with a vengeance? I'm not sure how the ear would be affecting the oxygen getting to my brain.

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  • Posted

    I've had vestibular disorders for half my life and one of the hardest things for me is exercising. When I exercise, it makes me very dizzy. A lot of people on this site can attest to having the same happen to them. This is why daily tasks are so hard for people with vestibular disorders as a lot of moving around makes it hard.

    You say lack of oxygen to your brain but why do you think it would be: is your breathing wrong? Is there immense pressure in your head? Have you had CT/MRIs of brain? Was your pulse oxygen checked? Was your CO2 in your blood checked?

    Did the panic attack cause hyperventilating or did the hyperventilating cause a panic attack?

    Most of us here have had CT and/or MRI of brain. That will help ease your fears, I'm sure.

    I am not a doctor at all but I know what it's like to be scared over this and the truth is until you're thoroughly checked out, you're going to wonder what's going on. Anxiety/panic can cause all the time dizziness. Why? No clue. The body is weird. I never had panic attacks before I had a vestibular disorder so I also know what it's like for it to all be new.

    Hang in there. Ask for tests from your doctor and ask to see an ENT or neurotologist, as suggested.

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    • Posted

      Thanks for your reply.

      My doc hasnt sent me for all those teats yet as i have to wait to see if it is indeed bppv.

      It feels like there is not enough oxygen getting to my brain as in that's what it teels like.

      Im startting to think it must be something to do with vestibular issue.

      The panic attack caused the hyperventilating which then made me collapsed. I should have stayed in bed till my breathing was sorted before getting up.

      Maybe i fell and hit my head upon fainting which has caused some sort of vestibular disorder?

      I just don't see why me fainting twice in same episode after a panic attack and fainting would cause this vertigo which won't go away for 3 weeks now.

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    • Posted

      Yeah I get what you're saying.

      Vestibular disorders are weird. Some people wake up one day and get them. Some happen, like mine, from outside factors (energy drinks). Some from traveling (long car rides, boats, planes). And some people get them from brain trauma.

      I'm not sure but I feel like if you would've hit your head your doc may have been able to tell if it was a concussion or something of the like. I could be wrong tho. Also, stress can make vertigo/dizziness worse so maybe you had an underlying issue that the panic attack brought forth. Maybe it was a matter of time and the attack sent your body into a whirlwind.

      Someone actually just posted in one of my threads an article about a woman who saw a balance doctor and he explained that your balance messes with your fight or flight response so when you get dizzy/vertigo, your body panics. Maybe you were having a vertigo attack and your body panicked.

      A lot of possibilities but it doesn't sound as if it's anything sinister. So just hang in there and let us know what your tests say!

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