Understanding Dizziness: Symptoms, Causes, Diagnosis, Treatments

Understanding Dizziness and Vertigo

Feeling dizzy or vertiginous can be unpleasant and disruptive. Dizziness refers to a sense of imbalance, wavering, or lack of steadiness, while vertigo is a subtype of dizziness creating the illusion of movement. Dizziness affects around 20-30% of people at some point in their lives.

Vertigo, a spinning sensation, results from problems in the inner ear, brain, or sensory nerve pathways. Understanding the causes and treatments for dizziness and vertigo can help you find relief.

Causes of Dizziness and Vertigo

There are various potential causes of dizziness and vertigo:

• BPPV - Benign paroxysmal positional vertigo, or BPPV, is the most common cause of vertigo. It results from calcium carbonate crystals becoming dislodged in the inner ear. Moving the head in certain ways triggers brief vertigo spells.
• Vestibular neuritis - This inner ear infection inflames the vestibular nerve leading to vertigo.
• Meniere's disease - Fluid buildup in the inner ear causes pressure and vertigo attacks.
• Vertigo - Problems with the brain or brainstem can lead to vertigo and imbalance.
• Medications - Some medications like antidepressants, anticonvulsants, and sedatives can cause dizziness.
• Low blood pressure - A sudden drop in blood pressure on standing leads to dizziness.
• Anxiety disorders - Hyperventilation from anxiety can cause dizziness.
• Stroke - Post-stroke dizziness is common, resulting from damage to the brainstem or cerebellum.

Symptoms of Dizziness and Vertigo

Dizziness and vertigo have some overlapping symptoms but also differ in some ways:

• Spinning sensation - Feeling like you or your surroundings are spinning is a hallmark of vertigo.
• Unsteadiness - Dizziness creates a sense of being off-balance, wobbly, swaying, or floating.
• Nausea and vomiting - The spinning vertigo sensation often leads to nausea and vomiting.
• Vision changes - Objects can appear blurry or move back and forth with vertigo.
• Hearing changes - Vertigo may cause ringing, roaring, or muffled hearing.
• Lightheadedness - Some types of dizziness cause faintness and near-fainting.
• Headache - Both vertigo and dizziness can trigger headaches.
• Disorientation - Loss of spatial awareness may occur, along with confusion.

Diagnosing the Cause of Dizziness and Vertigo

Since many conditions can cause dizziness and vertigo, doctors must perform a thorough evaluation to pinpoint the underlying problem. Diagnostic tests may include:

Medical History

Your doctor will ask about your symptoms, including:

• Type of dizziness - spinning, floating, swaying
• Triggers - head position changes, standing up
• Duration - seconds, minutes, hours
• Associated symptoms - hearing changes, nausea, headache
• Frequency of episodes
• Medications, previous illnesses, injuries

Physical Exam

An exam assessing your:

• Blood pressure - low BP can cause dizziness
• Head and neck - for signs of injury or infection
• Heart rate and rhythm
• Ear canals and eardrums - for infection
• Eye movements - for signs of neurological problems
• Coordination and balance

Hearing and Balance Tests

Tests like electronystagmography (ENG) measure eye movements in response to hot and cold water in the ears to assess inner ear function.

Imaging Tests

CT or MRI scans help identify strokes, tumors, or other neurological causes.

Blood Tests

Blood work helps diagnose issues like anemia, hypothyroidism, or autoimmune disorders associated with dizziness.

Treatments for Dizziness and Vertigo

Treatment depends on the underlying cause but may include:

Medications

• Antihistamines like meclizine help reduce inner ear symptoms.
• Anticholinergics like scopolamine patch for ongoing vertigo relief.
• Steroids like prednisone to decrease inner ear inflammation.
• Antibiotics for infections causing vestibular neuritis.
• Adjusting dosage of medications causing dizziness as a side effect.

Vestibular Therapy

Exercises that promote central nervous system compensation for inner ear deficits.

Canalith Repositioning

Gentle head and body movements to reposition inner ear calcium crystals in BPPV.

Surgery

Surgeries like vestibular neurectomy for intractable Meniere’s disease.

Preventing Episodes of Dizziness and Vertigo

You can reduce episodes of dizziness/vertigo through:

• Avoiding positions that trigger vertigo like extending the neck back.
• Using caution when turning the head.
• Rising slowly from sitting or lying down.
• Using a walking aid for stability if needed.
• Increasing fluid and salt intake to avoid dehydration.
• Wearing flat, supportive, non-slip shoes.
• Improving lighting in rooms to avoid tripping.
• Performing gentle balance exercises daily.
• Practicing stress management and relaxation techniques.
• Considering alternative medications if dizziness is a side effect.

When to See a Doctor

Consult your doctor promptly if you experience:

• Severe vertigo with nausea/vomiting
• Dizziness/vertigo with slurred speech, visual changes, weakness, loss of coordination, or mental confusion
• Head injury preceding vertigo symptoms
• Hearing loss or ear fullness/pressure with vertigo
• Dizziness causing falls or injury
• New onset of vertigo in older adults

Seek emergency care for vertigo with severe headaches, chest pain, shortness of breath, or following seizures/loss of consciousness.

Coping with Recurrent Dizziness and Vertigo

Repeated bouts of dizziness or vertigo can be demoralizing. Strategies for coping include:

• Learning triggers and early warning signs
• Carrying motion sickness medication
• Having a support person accompany you at dizzying events
• Using grounding techniques during episodes like staring at a fixed spot
• Practicing stress management and self-care
• Joining support groups to share experiences
• Being patient - symptoms often improve over time

The Outlook for Dizziness and Vertigo

With prompt treatment of underlying causes, most people find significant relief from dizziness and

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.