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Dizziness is defined as a disorientation in space, a sense of
unsteadiness, a feeling of movement within the head such as giddiness or a
swimming sensation, lightheadedness or a whirling sensation. Dizziness changes
your sense of balance and can increase your risk of falling.
There are three main types of dizziness:
- Faintness/lightheadedness
- Vertigo
- Disequilibrium
What is the difference between faintness and vertigo?
Faintness is the feeling of a lack of strength with a sensation of impending
loss of consciousness. Vertigo is a sensation of spinning or whirling, or a
hallucination that the room is spinning. Disequilibrium is a feeling of falling
to one side or the other. It causes a loss of balance.
What can cause faintness?
Since mechanisms for maintaining balance are so complex, finding the exact
cause of dizziness is often difficult and requires input from several medical
specialties. Dizziness can be caused by a problem associated with the inner ear,
brain, or heart.
An impairment of circulation is a common cause; blood loss or dehydration, as
well as heart problems, can impair circulation. However, low blood sugar, low
oxygen levels in the blood, acute infections, and drug reactions can also cause
lightheadedness. Anxiety can also manifest itself as dizziness.
What can cause vertigo?
Vertigo tends to have a specific cause. The cochlea is the organ in the
inner ear that senses changes in the position of the head. Disorders of the
cochlea, of the nerve supply of the cochlea, or of the areas of the brain that
interpret this information result in the sensation of spinning. Headaches,
specifically types of migraines, are another common cause of vertigo.
Inner ear disorders--Inner ear disorders account for the majority of balance problems.
Meniere's Disease--This problem is associated with the fluid balance
regulating system in the ear. Symptoms include episodic attacks of tinnitus
(ringing in the ear), ear fullness, hearing loss, and severe attacks of vertigo
accompanied by nausea and vomiting. This condition can be treated with changes
in diet and medications. Surgery may be recommended if medical treatment is not
successful.
Benign positional vertigo--A condition caused by damage to the sensory
units of the balance portion of the inner ear. Symptoms include a spinning sensation
or lightheadedness brought on by changes in body position. Benign positional
vertigo is typically treated with medications and by having the patient learn
and apply balance techniques.
Vestibular neuritis (Labyrinthitis)--This condition is caused by the
inflammation of the nerve cells in the balance portion of the inner ear. The
main symptom is sudden onset of sustained vertigo. Treatments include
medications to relieve symptoms of dizziness and nausea as well as balance
rehabilitation.
Autoimmune inner ear disease--This condition is more common in people who
have other autoimmune diseases such as lupus and arthritis. Symptoms include
sudden hearing loss in both ears. Medical treatment includes tapered steroid
therapy over one or two months.
Perilymph fistula--This disorder may occur after a sudden change in
barometric pressure, such as that experienced in airplane landings. The change
in pressure can cause a rupture in one of the membranes that separate the middle
and inner ear. Symptoms include hearing loss, vertigo, lightheadedness, and ear
pressure. Often the rupture heals on its own. If it does not heal, surgery may
be required.
Dizziness due to aging--Common symptoms of dizziness associated with aging include lightheadedness,
a spinning sensation, giddiness, wooziness, or unsteadiness. Forty percent of
patients over age 60 have experienced dizziness severe enough to affect
their daily activities. Age-related dizziness can be minimized by making
lifestyle changes such as:
- Sitting on edge of the bed for several minutes before standing
- Turning or changing positions slowly
- Never walking in the dark and using a night light or turning on
a light before entering a room.
- Keeping medical conditions under control.
- Using a cane or walker for more severe problems.
How can these conditions be treated?
In general, faintness/lightheadedness can be treated by treating its
underlying cause. For example, if vomiting and diarrhea are causing a person to
become dehydrated, then rehydrating the person will alleviate the dizziness.
Likewise, treating the underlying heart condition or anemia will fix the problem
for those conditions.
For vertigo, frequently treatment with certain medications can alleviate
symptoms. Medications such as meclizine (Antivert), scopolamine (Isopto Hyoscine),
and diazepam (Valium) will help when the cochlea is affected. However, if the
patient has a problem in the brain or the nerve connected to the cochlea, different medications may help.
When should I see my doctor?
If dizziness is persistent or severe, seek the advice of a
physician. Only when the cause is obvious (such as dehydration or infection),
the symptoms are minor, and the cause readily treatable with various home remedies
should you treat the problem on your own.
If you are in any way incapacitated by dizziness, then you should see a
physician as soon as possible. If you lose consciousness, have chest pain or
shortness of breath associated with dizziness, go to an emergency
room immediately.
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