Dizziness is classified into three categories-verti-go, syncope, and nonsyncope nonvertigo. Each category
has a characteristic set of symptoms, all related to the sense of balance. In general, syncope is defined by a brief loss of consciousness (fainting) or by dimmed vision and feeling uncoordinated, confused, and lightheaded. Many people experience a sensation like syncope when they stand up too fast. Vertigo is the feeling that either the individual or the surroundings are spinning. This sensation is like being on a spinning amusement park ride. Individuals with nonsyncope nonvertigo dizziness feel as though they cannot keep their balance. This sensation may become worse with movement.
The brain coordinates information from the eyes, the inner ear, and the body’s senses to maintain balance. If any of these sources of information is disrupted, the brain may not be able to compensate. For example, people sometimes experience motion sickness because the information from their body tells the brain that they are sitting still, but information from the eyes indicates that they are moving. The messages don’t correspond and dizziness results.
Vision and the body’s senses are the most important systems for maintaining balance, but problems in the inner ear are the most frequent cause of dizziness. The inner ear, also called the vestibular system, contains fluid that helps to fine tune the information the brain receives from the eyes and the body. When fluid volume or pressure in the inner ear changes, information about balance is altered. The discrepancy gives conflicting messages to the brain about balance and induces dizziness.
Certain medical conditions can cause dizziness because they affect the systems that maintain balance. For example, the inner ear is very sensitive to changes in blood flow. Because such medical conditions as high blood pressure or low blood sugar can affect blood flow, these conditions are frequently accompanied by dizziness. Circulation disorders are the most common causes of dizziness. Other causes are head injuries, ear infections, allergies, and nervous system disorders.
Dizziness often disappears without treatment or with treatment of the underlying problem, but it can be long-term or chronic. According to the National Institutes of Health, 42% of Americans will seek medical help for dizziness at some point in their lives. The costs may exceed a billion dollars and account for five million visits to physicians annually. Episodes of dizziness increase with age. Among people aged 75 or older, dizziness is the most frequent reason for seeing a doctor.
Causes & symptoms:
Careful attention to symptoms can help determine the underlying cause of the dizziness. The underlying problems may be benign and easily treated, or they may be dangerous and require intensive therapy. Not all cases of dizziness can be linked to a specific cause. More than one type of dizziness can be experienced at the same time and symptoms may be mixed. Episodes of dizziness may last for a few seconds or for days. The length of an episode is related to the underlying cause.
The symptoms of syncope include dimmed vision, loss of coordination, confusion, lightheadedness, and sweating. These symptoms can lead to a brief loss of consciousness or fainting. They are related to a reduced flow of blood to the brain; they often occur when a person is standing up and can be relieved by sitting or lying down. Vertigo is characterized by a sensation of spinning or turning, accompanied by nausea, vomiting, ringing in the ears, headache, or fatigue. An individual may have trouble walking, remaining coordinated, or keeping balance. Nonsyncope nonvertigo dizziness is characterized by a feeling of being off balance that becomes worse if the individual tries moving or performing detail-intense tasks.
A person may experience dizziness for many reasons. Syncope is associated with low blood pressure, heart problems, and disorders in the autonomic nervous system, which controls such involuntary functions as breathing. Syncope may also arise from emotional distress, pain, and other reactions to outside stressors. Nonsyncope nonvertigo dizziness may be caused by rapid breathing, low blood sugar, or migraine headache, as well as by more serious medical conditions.
Vertigo is often associated with inner ear problems called vestibular disorders. A particularly intense vestibular disorder, Meniere’s disease, interferes with the volume of fluid in the inner ear. This disease, which affects approximately one in every 1,000 people, causes intermittent vertigo over the course of weeks, months, or years. Meniere’s disease is often accompanied by ringing or buzzing in the ear, hearing loss, and a feeling that the ear is blocked. Damage to the nerve that leads from the ear to the brain can also cause vertigo. Such damage can result from head injury or a tumor. An acoustic neuroma, for example, is a benign tumor that wraps around the nerve. Vertigo can also be caused by disorders of the central nervous system and the circulation, such as hardening of the arteries (arteriosclerosis), stroke, or multiple sclerosis.
Some medications cause changes in blood pressure or blood flow. These medications can cause dizziness in some people. Prescription medications carry warnings of such side effects, but common drugs such as caffeine or nicotine can also cause dizziness. Certain antibiotics can damage the inner ear and cause hearing loss and dizziness.
Diet may cause dizziness. The role of diet may be direct, as through alcohol intake. It may be also be indirect, as through arteriosclerosis caused by a high-fat diet. Some people experience a slight dip in blood sugar and mild dizziness if they miss a meal, but this condition is rarely dangerous unless the person is diabetic. Food sensitivities or allergies can also be a cause of dizziness. Such chronic conditions as heart disease and serious acute problems such as seizures and strokes can cause dizziness. These conditions, however, usually exhibit other characteristic symptoms.
During the initial medical examination, an individual with dizziness should provide a detailed description of the type of dizziness experienced, when it occurs, and how often each episode lasts. A diary of symptoms may help to track this information. The patient should report any symptoms that accompany the dizziness, such as ringing in the ear or nausea, any recent injury or infection, and any medication taken.
The examiner will check the patient’s blood pressure, pulse, respiration, and body temperature as well as the ear, nose, and throat. The sense of balance is assessed by moving the individual’s head to various positions or by tilt-table testing. In tilt-table testing, the person lies on a table that can be shifted into different positions and reports any dizziness that occurs.
Further tests may be indicated by the initial examination. Hearing tests help assess ear damage. X rays, computed tomography scan (CT scan), and magnetic resonance imaging (MRI) can pinpoint evidence of nerve damage, tumors, or other structural problems. If a vestibular disorder is suspected, a technique called electronystagmography (ENG) may be used. ENG measures the electrical impulses generated by eye movements. Blood tests can determine diabetes, high cholesterol, and other diseases. In some cases, a heart evaluation may be useful. Despite thorough testing, however, an underlying cause cannot always be determined.
Doctors caution that childhood syncope (fainting), although rarely serious, can indicate a serious cardiac. If the fainting is abrupt or happens with exertion, it may indicate a more serious problem.
Because dizziness may arise from serious conditions, it is advisable to seek medical treatment. Alternative treatments can often be used alongside conventional medicine without conflict. Potentially beneficial therapies include nutritional therapy, herbal remedies, homeopathy, aromatherapy, osteopathy, acupuncture, acupressure, and relaxation techniques.
To prevent dizziness, nutritionists often advise eating smaller but more frequent meals and avoiding caffeine, nicotine, alcohol, foods high in fat or sugar, or any substances that cause allergic reactions. A low-salt diet may also be helpful to some people. Nutritionists may also recommend certain dietary supplements:
– Magnesium citrate, aspartate or maleate: for dizziness caused by magnesium deficiency.
– B-complex vitamins, especially vitamin B12: for dizziness caused by deficiency of these essential vitamins.
The following herbs have been used to treat dizziness symptoms:
– Ginger: for treatment of dizziness caused by nausea.
– Ginkgo biloba: may decrease dizziness by increasing blood flow to the brain.
Homeopathic therapies can work very effectively for dizziness, and are especially applicable when no organic cause can be identified. They are chosen according to the patient’s specific symptom profile:
– Aconite: for feeling light-headed from postural hypotension (getting up too quickly)
– Coccolus: for motion sickness or syncope
– Conium maculatum: for feeling dizzy while looking at rapidly-moving images.
– Gelsemium: for feeling light-headed and out of balance, often associated with influenza or stage fright.
– Petroleum: for dizziness upon standing up too fast and headache before and after a storm.
Aromatherapists recommend a warm bath scented with essential oils of lavender, geranium, and sandalwood as treatment for dizziness. This therapy can have a calming effect on the nervous system.
An osteopath or chiropractor may suggest manipulations or adjustments of the head, jaw, neck, and lower back to relieve pressure on the inner ear.
Acupressure may be able to improve circulation and decrease the symptoms of vertigo. The Neck Release,
which involves pressing on five pairs of points on the shoulder blades and neck, is helpful for dizziness associated with migraine headaches.
Relaxation techniques, such as yoga, meditation, and massage therapy for relieving tension, are popularly recommended methods for reducing stress.
Treatment of dizziness is determined by the underlying cause. If an individual has a cold or influenza, a few days of bed rest is usually adequate to resolve dizziness. Other causes of dizziness, such as mild vestibular system damage, may resolve without medical treatment. If dizziness continues, drug therapy may be required to treat such underlying illnesses as high blood pressure, arteriosclerosis, nervous conditions or diabetes. A physician may also prescribe antibiotics if ear infections are suspected. Selective serotonin reuptake inhibitors (SSRIs) have recently been shown to relieve dizziness in patients who have psychiatric symptoms. When other measures have failed, surgery may be suggested to relieve pressure on the inner ear. If the dizziness is not treatable by drugs, surgery, or other means, physical therapy may be used and the patient may be taught coping mechanisms for the problem.
The outcome of treatment depends on the cause of dizziness. Controlling or curing the underlying factors usually relieves the dizziness itself. In some cases, the symptoms disappear without treatment. In a few cases, dizziness can become a permanent disabling condition.
Most people learn through experience that certain activities will make them dizzy and they learn to avoid them. For example, if reading in a car produces motion sickness, reading should be postponed until after the trip. Changes in diet can also cut down on episodes of dizziness in susceptible people. For example, persons with Meniere’s disease may avoid episodes of vertigo by leaving salt, alcohol, and caffeine out of their diets. Reducing blood cholesterol can help diminish arteriosclerosis and indirectly treat dizziness. Daily multiple vitamin and mineral supplements may help prevent dizziness caused by deficiencies of these essential nutrients. Relaxation techniques can help ward off tension and anxiety that can cause dizziness.
Some cases of dizziness cannot be prevented. Acoustic neuromas, for example, are not predictable or preventable.
Acoustic neuroma-A benign tumor that grows on the nerve leading from the inner ear to the brain. As the tumor grows, it exerts pressure on the inner ear and causes severe vertigo.
Autonomic nervous system-The part of the nervous system that controls such involuntary body functions as breathing and heart beat.
Electronystagmography-A method for measuring the electricity generated by eye movements. Electrodes are placed on the skin around the eye and the individual is subjected to a variety of stimuli so that the quality of eye movements can be assessed.
Meniere’s disease-A disease of the labyrinth in the ear, characterized by dizziness, hearing loss, ringing in the ears, and nausea.
Syncope-Dizziness or brief loss of consciousness resulting from an inadequate flow of oxygenated blood to the brain.
Vertigo-Dizziness associated with a sensation of whirling or spinning.
Vestibular system-The area of the inner ear that helps maintain balance.
Alternative approaches designed to rebalance the body’s energy flow, such as acupuncture and constitutional homeopathy, may be helpful in cases where the cause of dizziness cannot be pinpointed.