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Why do I have a spinning sensation on waking up in the morning?

Answered by: Dr. Debashish Chowdhury
Associate Professor of Neurology
G.B.Pant Hospital
New Delhi

Q. Why do I have a spinning sensation on waking up in the morning? The spinning happens every time I get up too quickly in the morning and on lying down at night. I fainted about 4 weeks ago after getting out of bed and hit the back of my head on a pretty hard surface in the bathroom. I did go to the emergency room that day and they did the following blood work: EKG, CT scan and MRI. They also checked me for internal bleeding and everything came out fine. I was released that day and have had this spinning sensation every night and in the morning. Once I am up I have no issues unless I lean my head backwards and then I start to spin. It has been 4 weeks now and the symptoms I have are the same and have not gotten better. I haven't had any vision problem, chest pain or headache; just spinning. My doctor keeps telling me that it will just take time to recover but I am concerned that the symptoms are not getting better and is about the same as it was 3 weeks ago. Should I see a specialist and get checked for vertigo?

A.  Your problem clearly suggests that you have these spinning sensations while you change your position (from sitting/standing to lying down at night and from lying down to standing in the morning). You also have these sensations while you have a change in your position of head (leaning backwards). You don't have any other complaints. These symptoms suggest the possibility of a disorder called benign paroxysmal positional vertigo, which usually remits on its own within weeks (hence the term benign). Sometimes, however, it can be prolonged. As the name suggests, the vertigo is induced by change in position and usually occurs in paroxysms with intermittent remission. Since your imaging (CT/MRI) has been normal and ECG is normal too (suggesting that your heart is ok), your treating doctor has been reassured. However, if your problems continue, it is important to seek an opinion from an ENT specialist who can rule out some other causes mimicking benign paroxysmal positional vertigo.

A.  Your problem clearly suggests that you have these spinning sensations while you change your position (from sitting/standing to lying down at night and from lying down to standing in the morning). You also have these sensations while you have a change in your position of head (leaning backwards). You don't have any other complaints. These symptoms suggest the possibility of a disorder called benign paroxysmal positional vertigo, which usually remits on its own within weeks (hence the term benign). Sometimes, however, it can be prolonged. As the name suggests, the vertigo is induced by change in position and usually occurs in paroxysms with intermittent remission. Since your imaging (CT/MRI) has been normal and ECG is normal too (suggesting that your heart is ok), your treating doctor has been reassured. However, if your problems continue, it is important to seek an opinion from an ENT specialist who can rule out some other causes mimicking benign paroxysmal positional vertigo.

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