Health Advise

Dr. Bo Milicevic, M.D.

What You Need To Know About Dizziness

As a child, spinning until you were dizzy was great fun. But otherwise, finding the room spinning when you get out of bed isn’t pleasant at all. The word “dizzy” is used to describe everything from feeling faint or lightheaded to feeling weak or unsteady. Dizziness that creates the sense that you or your surroundings are spinning or moving is called vertigo.                                

 

Dizziness is one of the most common reasons older adults visit their doctors.

  Signs and symptoms
Characteristics of dizziness may include
• A sense that you or your surroundings are spinning or moving (vertigo)
• A loss of balance
• Nausea
• Unsteadiness
• Wooziness
• Lightheadedness
• Faintness
• Weakness
• Fatigue
• Difficulty concentrating
• Blurred vision after quick head movements

Causes

Under normal circumstances, your sense of balance is controlled by a number of signals that your brain receives from several locations:
Eyes. No matter what your position, visual signals help you determine where your body is in space and how it’s moving.
Sensory nerves in your skin, muscles and joints send messages to your brain about body movements and positions.
Inner ear. The organ of balance in your inner ear is the vestibular labyrinth. It includes loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head.
Dizziness may have a number of potential causes. These may include:
Vertigo
Vertigo Å the false sense of motion or spinning Å is the most common symptom of dizziness. Sitting up or moving around may make it worse. Sometimes vertigo is severe enough to cause nausea and vomiting.

Causes of vertigo may include:

• Benign paroxysmal positional vertigo (BPPV) that involves intense, brief episodes of vertigo associated with a change in the position of your head, often when you turn over in bed or sit up in the morning.                                                 
• Inflammation in the inner ear that may cause sudden, intense vertigo which may persist for several days, with nausea and vomiting. Although the cause of this condition is unknown, it may be a viral infection.
• Meniere’s disease that involves the excessive buildup of fluid in your inner ear.
• Vestibular migraine that affects people who are very sensitive to motion.
• Acoustic neuroma, a noncancerous (benign) growth on the acoustic nerve, which connects the inner ear to your brain.                                                             
• Rapid changes in motion. Riding on roller coasters or in boats, cars or even airplanes may on occasion make you dizzy.
• Other causes. Vertigo can be a symptom of a more serious neurological problem such as a stroke, brain hemorrhage or multiple sclerosis.
Feeling of faintness (presyncope)
“Presyncope” is the medical term for feeling faint and lightheaded without losing consciousness. Sometimes nausea, pale skin and a sense of dizziness accompany a feeling of faintness.

Causes of presyncope include:

 • Drop in blood pressure after changing a body position (orthostatic hypotension)
• Inadequate output of blood from the heart due to blocked arteries (atherosclerosis), disease of the heart muscle (cardiomyopathy), abnormal heart rhythm (arrhythmia) or a decrease in blood volume.
Loss of balance (disequilibrium)
Disequilibrium is the loss of balance or the feeling of unsteadiness when you walk.

Causes may include:

• Inner ear (vestibular) problems.
• Joint and muscle problems. Muscle weakness and osteoarthritis Å the type of arthritis that involves wear and tear of your joints Å can contribute to loss of balance when it involves your weight-bearing joints.
 • Medications. Loss of balance can be a side effect of certain medications, such as anti-seizure drugs, sedatives and tranquilizers.
When to seek medical advice
See your doctor if you experience any unexplained, recurrent or severe dizziness. See your doctor immediately if you experience dizziness or vertigo along with any of the following:
• A new, different or severe headache
• Blurred vision
• Hearing loss
• Speech impairment
• Leg or arm weakness
• Loss of consciousness
• Falling or difficulty walking                                                                                      
• Numbness or tingling
• Chest pain or rapid or slow heart rate
Complications
Dizziness can increase your risk of falling and injuring yourself. Experiencing dizziness while driving a car or operating heavy machinery can increase the likelihood of an accident.
ou may also experience long-term consequences if an existing health condition that may be causing your dizziness goes untreated.

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