Dizziness is a word that is often used to describe two different feelings. It is important to know exactly what you mean when you say “I feel dizzy,” because it can help you and your doctor narrow down the list of possible problems.
- Lightheadedness is a feeling that you are about to faint or “pass out.” Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Lightheadedness often goes away or improves when you lie down. If lightheadedness gets worse, it can lead to a feeling of almost fainting or a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are lightheaded.
- Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are off balance, spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall.
Although dizziness can occur in people of any age, it is more common among older adults. A fear of dizziness can cause older adults to limit their physical and social activities. Dizziness can also lead to falls and other injuries.
It is common to feel lightheaded from time to time. Brief episodes of lightheadedness are not usually the result of a serious problem. Lightheadedness often is caused by a momentary drop in blood pressure and blood flow to your head that occurs when you get up too quickly from a seated or lying position (orthostatic hypotension). Ongoing lightheadedness may mean you have a more serious problem that needs to be evaluated.
Lightheadedness has many causes, including:
- Illnesses such as the flu or colds. Home treatment of your flu and cold symptoms usually will relieve lightheadedness.
- Vomiting, diarrhea, fevers, and other illnesses that cause dehydration.
- Very deep or rapid breathing (hyperventilation).
- Anxiety and stress.
- The use of tobacco, alcohol, or illegal drugs.
A more serious cause of lightheadedness is bleeding. Most of the time, the location of the bleeding and the need to seek medical care are obvious. But sometimes bleeding is not obvious (occult bleeding). You may have small amounts of bleeding in your digestive tract over days or weeks without noticing the bleeding. When this happens, lightheadedness and fatigue may be the first noticeable symptoms that you are losing blood. Heavy menstrual bleeding also can cause this type of lightheadedness.
- Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Vertigo is the sensation of spinning, while lightheadedness is typically described as near fainting, and weakness.
- Some of the conditions that may cause lightheadedness in a patient include low blood pressure, high blood pressure, dehydration, medications, postural or orthostatic hypotension, diabetes, endocrine disorders, hyperventilation, heart conditions, and vasovagal syncope.
- Vertigo is most often caused by a problem in the balance centers of the inner ear called the vestibular system and causes the sensation of the room spinning. It may be associated with vomiting. Symptoms often are made worse with position changes. Those with significant symptoms and vomiting may need intravenous medication and hospitalization.
- Vertigo is also the presenting symptom in patients with Meniere’s Disease and acoustic neuroma, conditions that often require referral to an ENT specialist. Vertigo may also be a symptom of stroke.
- Most often, dizziness or lightheadedness is a temporary situation that resolves spontaneously without a specific diagnosis being made.
Causes of Dizziness
Common causes of dizziness include inner-ear disorders, medications, and alcohol.
Dizziness is often a result of vertigo. It can also be caused by a problem in the inner ear, where balance is regulated. The most common cause of vertigo and vertigo-related dizziness is benign paroxysmal positional vertigo (BPPV). This causes short-term dizziness when a person changes positions quicklyfor instance, when sitting up in bed.
Dizziness and vertigo can also be caused by Meniere’s disease (which causes fluid buildup in the ear), migraine, or acoustic neuroma, a benign growth on the nerve connecting the inner ear to the brain. Very rarely, vertigo could be caused by a stroke, brain hemorrhage, multiple sclerosis, or another neurological disorder.
Other causes of dizziness include:
- sudden drop in blood pressure, as may occur upon standing suddenly
- heart muscle disease
- decrease in blood volume
- neurological conditions
- side effect from medications
- anxiety disorders
- anemia (low iron)
- hypoglycemia (low blood sugar)
- ear infection
- heat stroke
- excessive exercise
- motion sickness
Symptoms of Dizziness
People experiencing dizziness may describe it as any of a number of sensations, such as:
- A false sense of motion or spinning (vertigo)
- Lightheadedness or feeling faint
- Unsteadiness or a loss of balance
- A feeling of floating, wooziness or heavy-headedness
These feelings may be triggered or worsened by walking, standing up or moving your head. Your dizziness may accompanied by nausea or be so sudden or severe that you need to sit or lie down. The episode may last seconds or days and may recur.
How is Dizziness diagnosed?
Rapid evaluation and treatment may be necessary if doctors suspect a serious cause of dizziness.
The doctor will ask detailed questions and take a history to define the type of dizzy feeling. The patient’s description of the dizzy feeling may be the most important detail. The patient will be given a detailed physical exam to further define likely causes.
Tests ordered will be based on the diseases suggested by the patient’s history and results of the physical exam.
- In the emergency department, the patient may be placed on a heart monitor, electrocardiogram (ECG) may be performed, and blood studies may be ordered. Sometimes specialized tests such as a CT scan or a cardiac stress test may be ordered.
- Rarely, the patient may have to have surgery to treat internal bleeding or hemorrhage, if this is the cause for the symptoms.
- The patient may be hospitalized or sent to a physician specialist depending on the possible causes.
- The doctor may find no specific cause for the dizziness, but will attempt to exclude other serious diseases.
Home Care Treatment
If you tend to get light-headed when you stand up:
- Avoid sudden changes in posture.
- Get up from a lying position slowly, and stay seated for a few moments before standing.
- When standing, make sure you have something to hold on to.
If you have vertigo, the following tips can help prevent your symptoms from becoming worse:
- Keep still and rest when symptoms occur.
- Avoid sudden movements or position changes.
- Slowly increase activity.
- You may need a cane or other help walking when you have a loss of balance during a vertigo attack.
- Avoid bright lights, TV, and reading during vertigo attacks because they may make symptoms worse.
Avoid activities such as driving, operating heavy machinery, and climbing until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous.
What is the Medical Treatment for dizziness?
Treatment varies widely and depends on the cause of the patient’s dizziness. Dizziness is often a symptom of other medical conditions. Treating the underlying illness or condition can improve the symptoms of dizziness. Some common treatments for conditions that cause dizziness include:
- If a serious medical problem is found to be the cause of a person’s dizziness, such as a heart attack or stroke, an emergency blood transfusion, intervention, or surgery may be needed.
- IV fluids may be given to treat dehydration.
- The patient may receive medications to control fever or treat infection.
- The patient may be given oxygen if they are short of breath or hyperventilating.
- If blood tests reveal abnormal blood chemistry (electrolyte levels), this will be corrected.
- Medications such as meclizine (Antivert) or benzodiazepines (such as diazepam [Valium], lorazepam [Ativan]) are used to control the spinning feeling associated with dizziness, when vertigo is a possible cause.