What is dizziness?

Dizziness is a term often used to describe several somewhat different feelings. It can be the feeling that you are spinning. It also can be a milder feeling of being unsteady, lightheaded, or woozy. Vertigo is the term used for when you feel that the room is spinning. It is important for you to explain to your doctor what you mean by dizziness.

How does it occur?

Dizziness is not a disease. It is a symptom or a signal that the balance mechanism in your inner ear is not working properly or that there is a disturbance in your brain.

Vertigo can be triggered by holding your head in certain positions, which is called benign positional vertigo. (Benign means not tending to become worse and not life- threatening.) It is the position of the head that causes vertigo, not the movement of it.

A momentary fall in the flow of blood to your brain, such as when you stand up too fast or change your position, is usually called pre-syncope or near fainting.

What causes dizziness?

Most often, dizziness is only minor and temporary and the cause cannot be found.

Sometimes dizziness is caused by a specific infection or disease. For example, one possible cause is labyrinthitis, which is inflammation of the fluid-filled chamber of your inner ear. Meniere's disease, which affects the inner ear, can also trigger dizziness.

Dizziness also can be caused by tiredness, stress, fever, anemia, heart block, low blood sugar, and stroke. Feeling faint may be brought on by drugs used to treat high blood pressure.

Dizziness may be psychological in origin. It may be caused by hyperventilation in anxious people, depression, or agoraphobia, which is the fear of open spaces.

Older people who have atherosclerosis (hardening of the arteries) or osteoarthritis of the joints in the neck (which may cause pressure on nerves and blood vessels) may experience vertigo when they suddenly move their heads or look up. Dizziness occurs more often in the elderly than in other age groups and may not be caused by disease.

Rare causes of dizziness include tumors or infections in the brain, multiple sclerosis, or bleeding between the outer two linings that cover the brain.

What are the symptoms?

Some of the most common symptoms of dizziness are a sense that you are spinning, the sense that the room is spinning, or the feeling that you might fall.

Mild dizziness may occur when you move your head to certain positions, and it may last less than a minute.

Severe dizziness may last a few minutes to many hours. It can be accompanied by:

• loss of balance and falling to the ground

• loss of hearing

• blurred vision

• nausea and vomiting

• ringing in the ears

• sweating

• fainting.

How is it diagnosed?

Your doctor will ask you to describe your dizziness and how it occurs in as much detail as you can. He or she will want to know about any other symptoms or medical problems you are having. Your doctor may deliberately try to make you feel dizzy by asking you to repeat actions or movements that cause your dizziness.

If disease is the suspected cause, your doctor will examine your ears, eyes, and nervous system. Your doctor also may order a computed tomography (CT) scan of the brain, in which x-rays are taken of your brain at several different angles. These x-rays are then combined by a computer to give a detailed view that may show any growths or injury.

What is the treatment?

The treatment will depend on the cause of your dizziness. Your doctor will want to treat the underlying cause. For example, if you have Meniere's disease, the doctor may want you on a low-salt diet. Your doctor may prescribe antibiotics if he or she suspects you have an infection.

If no cause can be found for your dizziness, your doctor may prescribe medication to help stabilize the structures in your inner ear responsible for balance. These drugs are generally antihistamines, such as drugs you take for motion sickness.

For mild dizziness that lasts for more than a few days, your doctor may want you to start walking as much as possible to allow your body and other senses to compensate for the loss of balance in your inner ear.

For severe, disabling cases that have not responded to medication and exercise, surgery may be needed.

How long will the dizziness last?

Depending on the cause, mild dizziness will usually last 1 to 2 weeks. It may also be momentary. More severe dizziness can last 4 to 6 weeks.

How can I take care of myself?

For mild dizziness, the best thing for you to do is lie down, relax, and wait for the dizziness to go away. Also try to avoid those positions or activities that cause the dizziness. Move slowly, especially when standing up.

When should I call the doctor?

Call your doctor if you have severe, prolonged, or repeated attacks of dizziness despite taking your medication and following other measures your doctor has ordered.

In addition, if you have symptoms along with dizziness, such as loss of hearing, you should call the doctor. If these other symptoms are double vision, blindness, or numbness or weakness on one side of your face or body, call your doctor immediately.