Dizziness

Feeling unsteady or dizzy can happen due to poor circulation, vertigo, injury, infection, allergies, or neurological disease. Dizziness is treatable but it is important for your doctor to help you determine the cause so that the correct treatment is used.

What is dizziness?
Dizziness can be described in many ways, such as feeling lightheaded, unsteady, or giddy. Vertigo is a type of dizziness experienced as an illusion of movement of self or the environment and is usually unpleasant. Dizziness, vertigo, and motion sickness all relate to the sense of balance and equilibrium. Your sense of balance is maintained by a complex interaction of the following parts of the nervous system:

• The inner ears
• The eyes
• The skin pressure receptors in the joints and spine
• The muscle and joint sensory receptors, which tell what parts of the body, are moving.
• The central nervous system

The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems.

What causes dizziness?

Circulation: If your brain does not get enough blood flow, you feel lightheaded. Almost everyone has experienced this on occasion when standing up quickly from a lying down position. However, some people have light-headedness from poor circulation on a frequent or chronic basis. It is commonly seen in patients who have high blood pressure or diabetes.  It is sometimes seen in patients with inadequate heart function, low blood sugar, or low iron. If the inner ear fails to receive enough blood flow, the more specific type of dizziness occurs, that is, vertigo. The inner ear is very sensitive to minor alterations of blood flow and all of the causes mentioned for poor circulation to the brain apply specifically to the inner ear.

Vertigo: Benign paroxysmal positional vertigo (BPPV), labyrinthitis, and Menier's syndrome (fluctuating hearing usually in one ear, pressure in the ear, ringing in one ear, and attacks of spinning), and some forms of migraine are all causes of vertigo. BPPV occurs when you change the position of your head (typically lying down or sitting up), while inner ear infections can cause labyrinthitis.

Infection: Viruses can attack the inner ear and its nerve connections to the brain. This can result in severe vertigo

Consult your doctor if you:

• have never experienced dizziness before,
• experience a difference in symptoms you have had in the past,
• suspect that medication is causing your symptoms, or
• experience hearing loss.

How will my dizziness be treated?
The doctor will ask you to describe your dizziness and answer questions about your general health. Along with these questions, your doctor will examine your ears, nose, and throat. Some routine tests will be performed to check your blood pressure, nerve and balance function, and hearing. Possible additional tests may include a CT or MRI scan of your head, special tests of eye motion after warm or cold water or air is used to stimulate the inner ear (ENG - electronystagmography or VNG - videonystagmography), and in some cases, blood tests or a cardiology (heart) evaluation. Your doctor will determine the best treatment based on your symptoms and the cause of them.

Prevention tips

• Avoid rapid changes in position.
• Avoid rapid head motion (especially turning or twisting).
• Eliminate or decrease use of products that impair circulation, e.g., tobacco, alcohol, caffeine, and salt.
• Treat infections, including ear infections, colds, flu, sinus congestion, and other respiratory infections

Remember: Most cases of dizziness and motion sickness are mild and self-treatable. However, severe cases and those that become progressively worse deserve the attention of a doctor with specialized skills in diseases of the ear, nose, throat, equilibrium, and neurological systems.

This information is provided by the American Academy of Otolaryngology - Head and Neck Surgery, Inc., (AAO-HNS) and the American Academy of Otolaryngology - Head and Neck Surgery Foundation, Inc. (AAO-HNSF) for educational purposes only. Any information provided in this website should not be considered medical advice or a substitute for a consultation with an Otolaryngologist - Head and Neck surgeon or other physician.