Dizziness and Vertigo
Dizziness is lightheadedness, feeling like you might faint, being unsteady, loss of balance, or vertigo (a feeling that you or the room is spinning or moving). Most causes of dizziness are not serious and either quickly resolve on their own or are easily treated.Vertigo is a sensation of motion or spinning that leads to dizziness and discomfort. Vertigo is not the same as light-headedness. People with vertigo feel as though they are actually spinning or moving, or that the environment itself is spinning.
Common Causes
Lightheadedness happens when there is not enough blood getting to the brain. This can happen if there is a sudden drop in your blood pressure or you are dehydrated from vomiting, diarrhea, fever, or other causes. Many people, especially as they get older, experience lightheadedness if they get up too quickly from a lying or seated position. Lightheadedness often accompanies the flu, common cold, or allergies.
More serious conditions that can lead to lightheadedness include heart problems (such as abnormal heart rhythm or heart attack), stroke, and severe drop in blood pressure (shock). If any of these serious disorders is present, you will usually have additional symptoms like chest pain, a feeling of a racing heart, loss of speech, change in vision, or other symptoms.
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There are two types of vertigo:
- Peripheral vertigo occurs if there is a problem with the part of the inner ear that controls balance (vestibular labyrinth or semicircular canals) or with the vestibular nerve, which connects the inner ear to the brainstem.
- Central vertigo occurs if there is a problem in the brain, particularly in the brainstem or the cerebellum (back part of the brain).
- Multiple sclerosis
- Blood vessel disease
- Migraine
- Drugs (anticonvulsants, aspirin, alcohol)
The primary symptom is a sensation that you or the room is moving or spinning. With central vertigo, there are usually other symptoms associated with the condition that is causing the vertigo. Associated symptoms include the following:
- Double vision
- Difficulty swallowing
- Facial paralysis
- Slurred speech
- Weakness of the limbs
- The spinning sensation may cause nausea and vomiting in some people.
Signs and tests
A physical exam may reveal eye movement problems, lack of coordination and balance, weakness, or sensory loss. These signs may suggest a central cause.
Nystagmus (involuntary eye movements) and hearing loss may be present in both central and peripheral vertigo.
Tests to determine the cause of vertigo may include:
- Head CT
- MRI scan of head and MRA scan of blood vessels of the brain
- Caloric stimulation (tests eye reflexes)
- Electronystagmography
- EEG, evoked auditory potential studies
- Lumbar puncture
- Blood tests
Home Care
If you tend to get lightheaded when you stand up, avoid sudden changes in posture.
If you are thirsty or lightheaded, drink fluids. If you are unable to keep fluids down from nausea or vomiting, you may need intravenous fluids. These are delivered to you at the hospital.
Most times, benign positional vertigo and labyrinthitis go away on their own within a few weeks. During attacks of vertigo from any cause, try to rest and lie still. Avoid sudden changes in your position as well as bright lights. Be cautious about driving or using machinery.
Some vertigo can be reduced by working with a physical therapist. Medications from your doctor may help you feel better.
Such medications include antihistamines, sedatives, or pills for nausea. For Meniere's disease, surgery may be necessary.
Treatment
Medications to treat peripheral vertigo may include:
- Antihistamines (such as meclizine)
- Anticholinergics
- Benzodiazepines
- Promethazine (to treat nausea and vomiting)
Try to avoid head positions that cause vertigo. Use caution in situations such as driving, walking, or operating heavy equipment. Even short episodes of vertigo may be dangerous.
Prevention
Promptly treat ear infections, colds, flus, sinus congestion, and other respiratory infections. This may help prevent labyrinthitis and Meniere's disease.
If you have a cold, the flu, or other viral illness, drink plenty of fluids to prevent getting dehydrated.
Informations obtained from National Institute of Health.