How do you know when there is something else going on?

they sound just like MAV + anxiety about MAV to me.
see your neuro-otologist about the MAV and ask about the anxiety too - some of the meds help with both.

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I get surges of dizziness like you describe, followed by a rush of anxiety and flushing hot along with head pressure and sometimes palpitations. Yep, all part of MAV.