Dizziness

WHAT IS IT?
The term dizziness is used to describe everything from feeling faint or lightheaded to feeling weak or unsteady. Although an occasional dizzy spell or constant dizziness can be annoying and interrupt daily activities, dizziness rarely signals a serious, life-threatening condition.

Dizziness may be described as one of the following sensations:

• The false sense of motion or spinning (vertigo)
• Lightheadedness or the feeling of near fainting
• Loss of balance or unsteadiness (disequilibrium)
• Other sensations such as floating, swimming or heavy-headedness

A number of underlying health conditions can cause these problems. Often, dizziness stems from disruption or confusion in the signals your brain receives from your eyes, inner ear, or sensory nerves.

WHAT’S THE CAUSE?

• Vertigo

Vertigo usually results from a sudden or temporary change in the activity of the balance structures in your inner ear or in their connections into the brain. These connections sense movement and changes in your head position. Sometimes vertigo is severe enough to cause nausea, vomiting, and balance problems. The good news is, it generally doesn’t last long. Within a couple of weeks, the body usually adapts to whatever is causing the dizziness.

• Feeling faint
  

Sometimes nausea, pale skin, and clamminess accompany a feeling of faintness. Causes of this type of dizziness include:

1. Drop-in blood pressure (orthostatic hypotension). A dramatic drop in your systolic blood pressure — the higher number in your blood pressure reading — may cause lightheadedness or a feeling of faintness. This can occur after sitting up or standing too quickly.
2. Inadequate blood flow from the heart. Certain conditions such as diseases of the heart muscle (cardiomyopathy), an abnormal heart rhythm (arrhythmia) or a decrease in blood volume may cause inadequate blood output from the heart.

• Loss of balance (disequilibrium)

Disequilibrium is the loss of balance or the feeling of unsteadiness when you walk. Causes may include:

1. Inner ear problems. Abnormalities with your inner ear can cause you to feel like you’re unsteady while walking.
2. Medications. Loss of balance can be a side effect of certain medications, such as anti-seizure drugs, sedatives, and tranquilizers.
3. Nerve disorders. Nerve damage in your legs (peripheral neuropathy) may make it difficult to maintain balance.
4. Joint and muscle problems. Muscle weakness and osteoarthritis involving your weight-bearing joints can contribute to loss of balance.
5. Neurological conditions. Various neurological disorders can lead to progressive loss of balance, such as Parkinson’s disease and cerebellar ataxia.

• Other sensations

Sensations that are more difficult to describe, such as floating, swimming or heavy-headedness, are often referred to as nonspecific dizziness. Some causes include:

• Medications. Blood pressure-lowering medications may cause unspecific dizziness if they lower your blood pressure too much. Many other medications can cause feelings of dizziness that resolve when you stop the medication.
• Inner ear disorders. Some inner ear abnormalities can cause persistent, non-vertigo-type dizziness.
• Anxiety disorders. Certain anxiety disorders, such as panic attacks, may cause dizziness that’s associated with hyperventilation.
• Low iron levels (anemia). Other signs and symptoms that may occur along with dizziness include fatigue, weakness, and pale skin.
• Low blood sugar (hypoglycemia). This condition generally occurs in people with diabetes who use insulin. The dizziness may be accompanied by sweating and confusion.
• Ear infections. Sometimes, ear infections can lead to dizziness. This type of dizziness will go away when the infection clears up.

WHAT TESTS TO EXPECT

The types of tests you receive will depend on what your doctor thinks may be the cause. Possible tests include:

• Eye movement testing. Your doctor watches the path of your eyes when you track a moving object. You may also be given what’s called a caloric test, in which the movement of your eyes is observed when cold and warm water is placed in your ear canal at different times.
• Posturography testing. This test tells your doctor which parts of the balance system you rely on the most and which parts may be giving you problems. You stand in your bare feet on a platform and try to keep your balance under various conditions.
• Rotary-chair testing. During this test, you sit in a computer-controlled chair that moves very slowly in a full circle. At faster speeds, it moves back and forth in a very small arc.
• Magnetic resonance imaging (MRI). An MRI may be performed to rule out an acoustic neuroma or other brain abnormalities that may cause vertigo.

The treatment of dizziness is dependent on the cause of the condition. The best way to treat dizziness is to find out what’s causing it and eliminate or control the cause.

          Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.