Dizziness

Dizziness is a common description for many different feelings. The feeling of dizziness may be very familiar to you, yet difficult to describe.

Vertigo is a medical term to describe the feeling of spinning, whirling, or motion either of yourself or your surroundings. This is the same feeling you might have after getting off a merry-go-round or after a child’s game of spinning in place. Several diseases of the balance organs of the inner ear can cause vertigo, or it may be a symptom of a tumor or stroke.

• Dizziness may be just mildly annoying or caused by something possibly life threatening.
  
  
• When you might feel dizziness
  
  
  • Fainting or near fainting such as "at the sight of blood" or with emotional upset
    
    
  • Fainting or near fainting from standing up too quickly or standing still too long
    
    
  • Feeling like, "I might pass out."
    
    
  • Weakness during a flu, cold, or other illness
    
    
  • Seasickness or motion sickness
    
    
  • Queasiness, nausea, or vomiting
    
    
  • Confused thinking
    
    
  • Fatigue, tiredness, or daytime sleepiness
    
    
  • Clumsy hands or stumbling walking

Dizziness may be attributed broadly to a number of things. Sometimes, doctors find no specific cause, but dangerous causes always need to be excluded.

• High blood pressure, usually extremely high, causing damage to the brain
  
  
• Low blood pressure, which can have multiple causes ranging from diseases of the heart to bleeding disorders that cause anemia to adverse reactions to medications
  
  
• Heart causes
  
  
  • Heart attack, arrhythmia (irregular heart rhythms), heart rate too fast, heart rate too slow
    
    
  • Weakened, aged, or diseased heart muscle, toxins or drugs affecting the rate or force of the heart
  
  
• Brain causes
  
  
  • Stroke, tumor, headaches, migraines, hyperventilation
    
    
  • Fainting (syncope) - A loss of blood supply to the brain causing loss of consciousness, typically after loss of blood output by your heart
    
    
  • Many things may trigger this infamous "common faint"—emotions, rapidly assuming an upright position, even urination
    
    
  • Dementia or senility - Any illness causing confusion or changed state of mind, such as medications, drugs, or alcohol
  
  
• Medications (Almost all medications list dizziness as a possible side effect.)
  
  
  • Blood pressure medications, sedatives, tranquilizers, antidepressants, pain relievers, some antibiotics
    
    
  • Diuretics, causing dehydration, blood electrolyte changes, heart effects, or direct side effects
  
  
• Metabolic disorders
  
  
  • Hypoxia, low blood oxygen
    
    
  • Low blood sugar (hypoglycemia) including an insulin reaction
    
    
  • Dehydration, from many causes
  
  
• Aging
  
  
  • Reduced capacity for exercise or activity
    
    
  • Reduced ability to compensate for quickly assuming an upright position
    
    
  • Hardening of the arteries (arteriosclerosis) causing decreased blood supply to the brain, heart, and other organs
    
    
  • Weakness, deconditioning
    
    
  • Neuropathy, a progressive dysfunction of the nerves from many illnesses, especially diabetes
  
  
• Other illness
  
  
  • Internal bleeding or hemorrhage, which may go unnoticed
    
    
  • Anemia, or low red blood cell count
    
    
  • Prolonged bed rest, causing weakness, loss of ability to compensate for assuming an upright position
    
    
  • Infections
    
    
  • Endocrine diseases - Hormone-producing organs such as the thyroid, adrenal glands, and pituitary gland affect hydration, salt balance, and function of other organs
  
  
• Psychiatric reasons
  
  
  • Depression, anxiety, or panic disorder
    
    
  • Hyperventilation - Breathing too fast or too deeply, usually from anxiety (This may not be apparent to you or observers. Associated hand and foot cramping increase anxiety and perpetuate a cycle.)
    
    
  • Somatization - The conversion of a mental illness, such as anxiety or depression, into physical symptoms (Often, you may be unaware of the underlying mental illness and insist that you have only physical complaints.)

With dizziness, you may be feeling faint, near passing out, weak, nauseated, confused, tired, clumsy, off balance, or any combination of these.

You may describe a sensation of movement, spinning, rocking, or whirling, of yourself or the room (possible vertigo).

• Just about any symptom or group of symptoms may accompany dizziness. These depend on the ultimate cause.
  
  
  • Head symptoms
    
    
  • Faintness or actual faint
    
    
  • Near passing out
    
    
  • Weak
    
    
  • Confused
    
    
  • Tired
    
    
  • Off balance
    
    
  • Headache
    
    
  • Head pressure
    
    
  • Face numbness or weakness
    
    
  • Facial droop
    
    
  • Eye pain
    
    
  • Vision changes or loss
    
    
  • Blind spots
    
    
  • Twinkling lights
    
    
  • Dry mouth
    
    
  • Ringing in ears
    
    
  • Decreased hearing
  
  
• Chest
  
  
  • Chest pain
    
    
  • Tightness, squeezing, or pressure
    
    
  • Burning
    
    
  • Shortness of breath
    
    
  • Palpitations
    
    
  • Jaw pain
  
  
• Abdomen
  
  
  • Nausea
    
    
  • Vomiting
    
    
  • Pain
    
    
  • Cramping
  
  
• Extremities (arms and legs)
  
  
  • Tingling
    
    
  • Pins-and-needles
    
    
  • Weakness
    
    
  • Clumsiness
    
    
  • Weak pulses
    
    
  • Fast, slow, or irregular pulses

Dangerous, life-threatening illness may start only with dizziness. Call a doctor if any of the following occur:

• Any first time or new instances of dizziness
  
  
• Dizziness without a clear or certain cause
  
  
• Any change in an established dizzy pattern
  
  
• Worsening or new symptoms
  
  
• Dizziness after taking newly prescribed medications, or recent changes in previous prescriptions

Call an ambulance unless you are certain of the cause of the dizziness, or unless the feeling goes away quickly.

• Dizziness may be the only symptom of a heart attack or stroke.
  
  
• If you have a possibility of heart disease, or known heart disease, an ambulance may save your life.
  
  
• All dizziness with loss of consciousness needs emergency evaluation.

Rapid evaluation and treatment may be necessary if doctors suspect a serious cause of dizziness.

• Doctors will ask detailed questions to define the type of dizzy feeling.
  
  
  • Your description of the dizzy feeling may be the most important detail.
    
    
  • Your history may be the only clue, because often your evaluation takes place after the dizzy symptoms have gone.
    
    
  • Other symptoms may give evidence of possible causes.
  
  
• You will be given a detailed physical exam to further define likely causes.
  
  
• The doctor will want to exclude causes as well. For example, simply finding a strong and regular heartbeat excludes the cause as being a weak or irregular heartbeat.
  
  
• Tests you undergo will be based on the diseases suggested by your history and results of your physical exam.
  
  
  • Doctors may include tests for less likely but dangerous illnesses or diseases.
    
    
  • In the Emergency Department, you may be given a heart monitor, an ECG, and blood work if suggested by the history of the dizziness or the physical exam.
    
    
  • Sometimes, specialized tests such as a CT scan or cardiac stress test may be scheduled. Rarely, you may have surgery, to treat internal bleeding or hemorrhage, for example.
  
  
• You may be hospitalized or sent to a specialist depending on the possible causes.
  
  
• Doctors may find no specific cause, but instead exclude serious diseases.

• Dizziness may be a symptom of something dangerous and should always be discussed with a doctor.
  
  
• At home, try to do the following:
  
  
  • Get plenty to drink, have regular meals, and get plenty of rest.
    
    
  • Standing up more slowly may help dizziness associated with position change.
    
    
  • Reassurance can help an anxious person who feels dizzy.
    
    
  • Make your home safe for a chronically dizzy person.
    
    
  • Banisters, a walker or cane, and tub mats provide orientation.
    
    
  • Secure rugs and carpeting to avoid falls.
    
    
  • A doctor can recommend resources for a professional home-safety consultant visit.

Treatment depends on the cause of your dizziness.

• Doctors may start emergency treatment, perhaps for heart attack or stroke, an emergency blood transfusion, or surgery.
  
  
• Often, IV fluids clear up dehydration.
  
  
• You may receive medications to control fever or treat infection.
  
  
• You may be given oxygen right away.
  
  
• A blood test may show you have low blood sugar.
  
  
• Other treatments for a specific disease may be started.
  
  
• Sometimes, the only treatment may be a discussion of a likely cause and home safety.

Most causes of dizziness are harmless, and the problem goes away on its own. Sometimes dizziness will be the only symptom of serious disease, the course of which may be life threatening or easily treatable.

Some dizziness may be attributed to aging blood vessels or nerves. You may have to learn to live with it.

Timely and careful evaluation of dizziness offers the best outcome, whatever the cause.

dizziness, vertigo, syncope, faint, disequilibrium, imbalance, lightheadedness, blackout