Dizziness

Overview  

Healthcare providers define dizziness as a state of impaired or disrupted spatial orientation. Individuals may describe dizziness as a sensation of feeling woozy or light–headed. When dizziness induces a false perception of oneself or the surroundings spinning or moving, it is known as vertigo. 

Dizziness is a common reason for adults to seek medical attention. Frequent episodes of dizziness or persistent dizziness can significantly impact one’s daily life. However, it is important to note that dizziness rarely indicates a life–threatening condition. 

People experience dizziness in various ways, which may include: 

• Feeling like they might faint. 
• Experiencing nausea. 
• Sensation of being unsteady on their feet, akin to losing their sense of balance. 
• Feeling disoriented or confused. 

The treatment for dizziness depends on its underlying cause and the specific symptoms a person is experiencing. Treatment is typically effective, but it’s important to be aware that the issue may recur. 

Symptoms   

Dizziness can feel different for different people, including: 

• Spinning Sensation (Vertigo): It may seem like you or your surroundings are moving when they’re not. 
• Lightheadedness: You might feel like you’re about to faint or pass out. 
• Unsteadiness: You may struggle to maintain your balance and feel wobbly. 
• Floating Sensation: Some people describe feeling like they’re floating or having a heavy head. 

These sensations can be triggered or worsened by activities like walking, standing up, or moving your head. Dizziness may also come with nausea and can be sudden or last for days, sometimes returning. 

Recurrent, severe, or unexplained dizziness: If you have dizziness that keeps coming back, is severe, or doesn’t have an obvious cause, it’s a good idea to see a doctor. 

Emergency care needed if you have new, severe dizziness along with: 

• Sudden, severe headache 
• Chest pain 
• Difficulty breathing 
• Numbness or weakness in arms or legs 
• Fainting 
• Double vision 
• Fast or irregular heartbeat 
• Confusion or slurred speech 
• Trouble walking or stumbling. 
• Continual vomiting 
• Seizures 
• Sudden hearing change 
• Facial numbness 

Causes  

Dizziness occurs when there’s a disturbance in your balance system, which relies on consistent input from your ears, eyes, tissues, and central nervous system. This information is vital for your central nervous system to maintain your balance. Any disruption in this information flow can result in feelings of unsteadiness and dizziness. Various factors, like inner ear problems, neurological issues, medications, or even stress, can contribute to this sensation. The way you experience dizziness and what triggers it can provide clues to potential causes. Additionally, the duration of your dizziness and any accompanying symptoms are essential for pinpointing the underlying issue. 

Inner ear disorder 

The sense of balance relies on various parts of the sensory system, including: 

• Eyes: These assist in determining the body’s position in space and its movements. 
• Sensory nerves: They transmit messages to the brain regarding body movements and positions. 
• Inner ear: This contains sensors responsible for detecting gravity and back–and–forth motion. 

Vertigo is the unsettling perception that your environment is in motion or spinning around you. This sensation arises when there is a discrepancy between the signals received by your brain from the inner ear and what your eyes and sensory nerves are reporting. The brain’s attempt to reconcile this disparity results in the experience of vertigo. 

Common Causes of Vertigo: 

• Benign Paroxysmal Positional Vertigo (BPPV): 
  • Description: BPPV is the most prevalent cause of vertigo, characterized by intense and brief episodes of false spinning or movement sensations. 
  • Triggers: Rapid changes in head position, such as turning over in bed, sitting up quickly, or sustaining a head injury. 
• Infection–Related Vertigo: 
  • Vestibular Neuritis: A viral infection affecting the vestibular nerve can lead to persistent and severe vertigo. 
  • Indicators: Vestibular neuritis may be accompanied by sudden hearing loss, potentially indicating labyrinthitis. 
• Meniere’s Disease: 
  • Symptoms: This condition is marked by the abnormal accumulation of fluid in the inner ear, resulting in sudden bouts of vertigo lasting several hours. 
  • Additional Signs: Patients with Meniere’s disease may also experience fluctuating hearing loss, ear ringing, and a sensation of ear blockage. 
• Migraine–Associated Vertigo: 
  • Migraine Connection: Individuals who suffer from migraines may encounter episodes of vertigo or other forms of dizziness, even when not experiencing a severe headache. 
  • Duration: These vertigo episodes can persist for minutes to hours and may be accompanied by headache, light sensitivity, and noise sensitivity. 

Dizziness caused by circulatory issues: 

• Low blood pressure: A sudden decrease in systolic blood pressure, which is the higher of the two blood pressure numbers, can result in transient lightheadedness or a brief sensation of fainting. This phenomenon is often experienced when transitioning from a seated or lying position to standing up rapidly, and it is commonly referred to as orthostatic hypotension. 
• Poor blood circulation: Conditions like cardiomyopathy, heart attacks, heart arrhythmias, or transient ischemic attacks can give rise to dizziness. This dizziness can be attributed to a reduction in blood volume, leading to insufficient blood circulation to both the brain and the inner ear. 

Additional causes of dizziness can include various factors: 

• Neurological disorders: Some neurological conditions, such as migraines, multiple sclerosis, and Parkinson’s disease, can disrupt your sense of balance and lead to dizziness. 
• Concussion: Head injuries like concussions can damage the brain, resulting in dizziness among other symptoms. 
• Medications: Certain medications, including anti–seizure drugs, antidepressants, sedatives, and tranquilizers, may have dizziness as a potential side effect. Blood pressure–lowering medications, if they excessively reduce blood pressure, can also cause faintness. 
• Anxiety disorders: Specific anxiety disorders, like panic attacks and agoraphobia (fear of open spaces), can trigger lightheadedness or a sensation often described as dizziness. 
• Low iron levels (anemia): Anemia, characterized by low iron levels, can manifest with dizziness alongside other symptoms like fatigue, weakness, and pale skin. 
• Low blood sugar (hypoglycemia): Hypoglycemia, which typically affects individuals with diabetes who use insulin, may lead to dizziness, accompanied by symptoms like sweating and anxiety. 
• Carbon monoxide poisoning: Symptoms of carbon monoxide poisoning are flu–like and encompass headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion. 
• Overheating and dehydration: Overheating (hyperthermia) or dehydration, particularly in hot weather or if you’re not consuming enough fluids, can induce dizziness. This risk may be heightened if you are taking specific heart medications. 
• Acoustic neuroma: Noncancerous tumors in the inner ear can disrupt balance and cause feelings of dizziness. 

Risk factors  

The following factors may make people more susceptible to experiencing dizziness:  

• Age: Older adults are at a greater risk of developing medical conditions that can lead to dizziness, particularly a feeling of unsteadiness. They are also more prone to taking medications that have dizziness as a side effect.
• Prior dizziness episode: If you have previously encountered episodes of dizziness, it increases the probability of experiencing dizziness again in the future.