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Dizziness


Overview, Causes, & Risk Factors

Dizziness is a term that is used to describe a wide range of symptoms. These include lightheadedness, faintness, confusion, spinning, and feeling giddy or unsteady.

What is going on in the body?

Dizziness is not a very precise term. When someone complains of dizziness, the healthcare provider will need to know what a person means. Many people use the term dizzy to describe a feeling that occurs right before passing out. Others use it to describe feeling as though they or the room is spinning. Causes range from mild to serious.

What are the causes and risks of the symptom?

Common conditions that may cause dizziness include the following:

  • aging, which may cause a mild sensation of dizziness during activity
  • anemia, or a low red blood cell count
  • being overheated, which commonly makes people feel "woozy" or may even cause them to pass out
  • congestive heart failure, a condition in which a weakened heart is unable to pump enough blood to the brain
  • drug use or withdrawal, such as alcohol withdrawal or marijuana use
  • fear, anxiety, or emotional distress
  • inner ear problems, such as labyrinthitis or Meniere's disease, which can cause vertigo, a type of dizziness in which a person feels that the room is spinning
  • low blood pressure
  • low blood sugar, or hypoglycemia
  • low oxygen or blood flow to the brain, which may happen during a stroke
  • medications used to treat high blood pressure, coronary artery disease, seizures, infections, and anxiety
  • nervous system disorders, such as seizures, Parkinson's disease, multiple sclerosis, or a brain tumor
  • psychological conditions, such as depression and anxiety
  • Other causes are possible as well. In some cases, no cause can be found.


    Symptoms & Signs

    What other signs and symptoms are associated with this symptom?

    The first thing a healthcare provider needs to know is what the person actually means by the term dizzy. Other questions about the feeling of dizziness can help to determine the cause:

  • How long has it been going on?
  • How often does it occur?
  • Is it associated with fainting, nausea, vomiting, or confusion?
  • Is it related to certain activities or body positions?
  • Does the person feel as though he or she or the room is spinning?
  • Is the person taking any medications or illegal drugs?
  • Does the person have any other medical conditions?
  • Are there any problems with movement or coordination?
  • Are there feelings of anxiety along with the dizziness?
  • The person should tell the healthcare provider about any other symptoms because these may be important, too.


    Diagnosis & Tests

    How is the symptom diagnosed?

    Diagnosing the cause of dizziness starts with a medical history and physical exam. This may be all that is needed to figure out the cause. In other cases, further tests may be needed.

    For example, a blood glucose test may be done to look for low blood sugar. Measuring the blood pressure can detect low blood pressure. A special X-ray test, called a cranial CT scan, may be done if a stroke or brain tumor is suspected. A test to measure brain waves, called an electroencephalogram or EEG, may be done if seizures are suspected. Many other tests are possible depending on the suspected cause.


    Prevention & Expectations

    What can be done to prevent the symptom?

    Prevention of dizziness is related to the cause. For example, dizziness that results from drug use or withdrawal can be prevented by avoiding the specific drug. Low blood sugar can often be avoided by eating regular meals. However, many causes cannot be prevented.

    What are the long-term effects of the symptom?

    Those who feel dizzy may injure themselves or others if they are not careful. Most long-term effects are related to the cause. For example, dizziness from low blood pressure is usually easy to correct and causes no long-term effects in many people. Dizziness due to a brain tumor may cause death.

    What are the risks to others?

    Dizziness is not contagious and usually poses no risk to others. However, those who are dizzy may injure others. For example, a person who becomes dizzy while driving a car may have an accident.


    Treatment & Monitoring

    What are the treatments for the symptom?

    Treatment is directed at the cause of the dizziness.

  • Medications can reduce dizziness in some cases. Examples include antihistamines such as diphenhydramine and sedatives such as diazepam.
  • Individuals with low blood pressure may need to stop taking blood pressure medication or have a change in their dose.
  • Those who have anemia may need a blood transfusion to build up their red blood cell counts.
  • Those with an infection may need antibiotics.
  • If a brain tumor is the cause, a person may need surgery, chemotherapy, or radiation therapy.
  • What are the side effects of the treatments?

    Antibiotics may cause allergic reactions or stomach upset. Surgery carries a risk of bleeding, infection, and allergic reaction to the anesthesia. Blood transfusions may cause infections or allergic reactions.

    What happens after treatment for the symptom?

    If the cause is treated and the dizziness goes away, no further treatment may be needed. This is what usually happens, for example, when the cause is a medication and the person stops taking the medication. In others, dizziness may persist and require further treatment and monitoring.

    How is the symptom monitored?

    Those with dizziness need to be careful, as they may injure themselves or others. People who are dizzy should not drive or participate in other possibly dangerous activities. Further monitoring depends on the cause of the dizziness. For example, those with anemia may need CBC blood tests to make sure their blood counts have returned to normal. Any new or worsening symptoms should be reported to the healthcare provider.


    Attribution

    Author:Adam Brochert, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:03/30/01
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:03/01/01

    Sources

    Harrison's Principle of Internal Medicine, 1998, Fauci et al.


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