Disease and Condition

Dizziness
Also known as: Vertigo
What is it?
Dizziness is the false sensation of movement or spinning. Dizziness is often accompanied by a loss of balance or nauseated feeling.

Who gets it?
Most people feel dizzy at some point in their lives. Dizziness can occur in children and adults, but is more common in children during adolescence.

What causes it?
There are mechanisms in the inner ear that help the body sense position and control balance. This state of balance is called equilibrium. Dizziness occurs when the body’s equilibrium is upset. Most often, dizziness passes quickly and the cause is unknown. However, dizziness can also be a symptom of a disorder, infection, or underlying disease. These can include viral infections in the inner ear; benign positional vertigo, caused by a change in head position; Meniere's disease, which affects the volume of fluid in the inner ear; fever; low blood sugar; or neurologic brain disorders, such as tumors, infections, or brain injury. Dizziness can also be caused by disorders of the central nervous system, such as multiple sclerosis; circulatory system diseases such as hardening of the arteries (arteriosclerosis); motion sickness; insufficient blood supply to the brain, as occurs with transient ischemic attack (TIA) or stroke; exposure to toxic substances; diet; and food allergies.

What are the symptoms?
People who are dizzy feel as though they are spinning, or objects around them are moving or spinning. They may feel as though they are losing their balance and about to fall. If blood pressure has dropped too low, the person may faint, a temporary loss of consciousness called syncope. People with positional vertigo may experience mild, passing feelings of dizziness just by changing the position of their heads too quickly. Sometimes, however, vertigo may be more severe and last anywhere from hours to days. In these cases, the patient may also experience a loss of hearing, vision problems, nausea and vomiting, and ringing in the ears. People who commonly experience motion sickness will feel dizzy when riding in a vehicle, aircraft, or watercraft.

How is it diagnosed?
To diagnose true dizziness, your doctor will need to take a complete medical history and have a thorough understanding of your symptoms, when they occur, and how long they last. Then, he or she will perform a physical exam and some diagnostic tests to determine the cause of your dizziness. Your doctor will examine your eyes, checking for abnormal movements that could be a sign of problems with the inner ear or the nerve connections to the brain. You may be asked to recreate the types of activities that result in dizziness. Your doctor may order a tilt table test to determine what is causing the temporary decrease in blood flow to the brain. Other diagnostic tests include an electronystagmogram (ENG), which is a test of the balance mechanism of the inner ear; computed tomography (CT) or magnetic resonance imaging (MRI) scans of the brain, which can reveal tumor or signs of stroke; hearing and blood tests; and an angiogram, which reveals any blockages in the blood vessels. If infection is suspected, your doctor will take a sample of fluid from the ear or sinuses for further study.

What is the treatment?
If there is an underlying cause, such as brain tumor, TIA or stroke, disease, or infection, your doctor will provide treatment accordingly. For example, infection is treated with bed rest and antibiotics. However, if no cause is found for your dizziness, but it continues, your doctor may prescribe medication that affects the balance mechanism in your inner ear. These drugs can cause drowsiness in some people. Your doctor may simply recommend that you lie down for a few minutes until the dizziness passes. People who are prone to dizziness because they take medications for heart conditions or high blood pressure should avoid sudden changes of position. Sometimes surgery is recommended to relieve pressure in the inner ear.

Self-care tips
In most cases, occasional feelings of mild dizziness are no cause for alarm, but are related to a sudden change in position. However, if you feel dizzy frequently, the dizziness lasts for a long period of time, or you have dizziness with other symptoms such as headache, visual disturbances, or numbness on one side of the body, see your doctor immediately.
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