Audiology

Dizziness


Definition

Dizziness is a term used to describe a range of sensations, such as feeling faint, woozy, weak or unsteady. Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo.

Dizziness is one of the more common reasons adults visit their doctors. Frequent dizzy spells or constant dizziness can significantly affect your life. But dizziness rarely signals a life-threatening condition.

Treatment of dizziness depends on the cause and your symptoms. It's usually effective, but the problem may recur.

Symptoms

People experiencing dizziness may describe it as any of a number of sensations, such as:

  • A false sense of motion, rocking, turning or spinning (vertigo)
  • Lightheaded, “head rush" or feeling faint
  • Unsteadiness or loss of balance
  • A feeling of floating, wooziness, fogginess

These feelings may be triggered or worsened by walking, standing up or moving your head. Your dizziness may be accompanied by nausea or be so sudden or severe that you need to sit or lie down. The episode may last seconds to days and may recur.

Causes

Dizziness has many possible causes, including inner ear disturbances, headache disorders, motion sickness, infection and medication effects. 

The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause.

Your sense of balance depends on the combined input from the various parts of your sensory system. These include your:

  • Eyes, which help you determine where your body is in space and how it's moving
  • Sensory nerves from your neck, spine and lower limbs, which send messages to your brain about body movements and positions
  • Inner ear, which houses sensors that help detect gravity, turning and back-and-forth motion

Inner ear problems that cause dizziness (vertigo)

Vertigo is the false sense that your surroundings are spinning or moving. With inner ear disorders, your brain receives signals from the inner ear that aren't consistent with what your eyes and sensory nerves are receiving. Vertigo is what results as your brain works to sort out the confusion.

  • Benign paroxysmal positional vertigo (BPPV). This condition causes an intense and brief but false sense that you're spinning or moving. These episodes are triggered by a rapid change in head movement, such as when you turn over in bed, sit up or experience a blow to the head. BPPV is the most common cause of vertigo.
  • Infection. A viral infection of the vestibular nerve, called vestibular neuritis, can cause intense, constant vertigo. If you also have sudden hearing loss, you may have labyrinthitis.
  • Meniere's disease. This disease involves the excessive buildup of fluid in your inner ear. It's characterized by sudden episodes of vertigo lasting as long as several hours. You may also experience fluctuating hearing loss, ringing in the ear and the feeling of a plugged ear.

Neurologic causes of vertigo

  • Migraine. People who experience migraines may have episodes of vertigo or other types of dizziness even when they're not having a severe headache. Such vertigo episodes can last minutes to hours and even days and do not need to be associated with headache
  • Other neurologic problems such as Parkinson’s disease and multiple sclerosis can lead to progressive loss of balance, but not vertigo.

Other causes of dizziness

  • Drop in blood pressure. A dramatic drop in your systolic blood pressure — the higher number in your blood pressure reading — may result in brief lightheadedness or a feeling of faintness. It can occur after sitting up or standing too quickly. This condition is also called orthostatic hypotension.
  • Poor blood circulation. Conditions such as cardiomyopathy, heart attack, heart arrhythmia and transient ischemic attack could cause dizziness. And a decrease in blood volume may cause inadequate blood flow to your brain or inner ear.
  • Medications. Dizziness can be a side effect of certain medications — such as anti-seizure drugs, antidepressants, sedatives and tranquilizers. In particular, blood pressure lowering medications may cause faintness if they lower your blood pressure too much.
  • Anxiety disorders. Certain anxiety disorders may cause lightheadedness or a woozy feeling often referred to as dizziness. These include panic attacks and a fear of leaving home or being in large, open spaces (agoraphobia).
  • Low iron levels (anemia). Other signs and symptoms that may occur along with dizziness if you have anemia include fatigue, weakness and pale skin.
  • Low blood sugar (hypoglycemia). This condition generally occurs in people with diabetes who use insulin. Dizziness (lightheadedness) may be accompanied by sweating and anxiety.
  • Overheating and dehydration. If you're active in hot weather, or if you don't drink enough fluids, you may feel dizzy from overheating (hyperthermia) or from dehydration. This is especially true if you take certain heart medications

When to seek medical attention?

Call 911 or go to an emergency room if you experience:

  • Dizziness after a head injury,
  • Fever over 101°F, headache, or very stiff neck,
  • Convulsions or ongoing vomiting,
  • Chest pain, heart palpitations, shortness of breath, weakness, a severe headache, inability to move an arm or leg, change in vision or speech, or
  • Fainting and/or loss of consciousness

Consult your doctor if you:

  • have never experienced dizziness before,
  • experience a difference in symptoms you have had in the past,
  • suspect that medication is causing your symptoms, or
  • experience hearing loss.

How will my dizziness be treated?

Your Comprehensive ENT physician will ask you to describe your dizziness and answer questions about your general health. Along with these questions, your doctor will examine your ears, nose, and throat. Some routine tests will be performed to check your blood pressure, nerve and balance function, and hearing. Possible additional tests may include a CT or MRI scan of your head, special tests of eye motion after warm or cold water or air is used to stimulate the inner ear (VNG: videonystagmography), and in some cases, blood tests, neurology evaluation or a cardiology (heart) evaluation. Together you and your doctor will determine the best treatment based on your symptoms and the cause of them. Treatments may include medications, surgery or balance exercises.

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