Dear Doctor,

I have constant headaches. I have been through everything, from CT scans to eye check-ups, but they show that nothing is wrong. Yet I still walk around feeling dizzy all the time. What could be the problem?

Dennis

Dear Dennis,

You have not mentioned how long you have been having headaches; what is your age? Where is the pain located; is it periodic or regular, is it aggravated by certain foods, downward gaze or working on computers? Is it throbbing or pressure like? When you feel dizzy, is it a sense of rotation(vertigo) or sensation of falling down(syncope)?

Headache can be due to a wide variety of reasons. Among medical conditions, high blood pressure, chronic sinusitis, allergic rhinitis, visual defects, are some of the common problems causing chronic headache. Dental problems, ear problems can also cause headache, due to pain being referred to the head. Grave conditions like infections of the brain or its coverings, brain tumors can also cause headache, as one of the manifestations.

Imaging techniques like C.T. (computericed tomography) scans, MRI(magnetic resonance imaging), can identify an organic cause easily. So if that is normal, an organic condition is unlikely to be responsible for the headache.

Mental stress and anxiety can also cause headache, which may be one sided as in migraine or more diffuse as with tension headache. Cluster headache occurs commonly in young men, periodically after midnight and is associated with stuffed nose and or flu like symptoms. Anxiolytic and antidepressant drugs are used to treat these type of headaches. Mental relaxation by yoga or meditation techniques is also very useful in avoiding or minimising these types of headaches.

Dizziness while walking can be due to low blood pressure, chronic anemia, low blood glucose levels or varicose veins. These conditions are easily diagnosed and treatable. Infection and other disease conditions inside the ear cause sense of rotation as one of the manifestations, along with headache. These are also easily diagnosed by relevant tests and are curable.

In an elderly person, headache and dizziness can be due to degeneration of the cervical spine or ossicles inside internal ear which maintain equilibrium of the body.

Both headache and dizziness can be due to mental stress. One can benefit much by mental relaxation.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital