Dizziness means a sensation of imbalance. It is classified into two categories: vertigo, which is the sensation of spinning accompanied by a loss of balance, and light-headedness, the feeling of being about to faint.
Causes
Dizziness is often caused by a reduced blood supply to the brain, which may be due to low blood pressure or to dehydration caused by diarrhoea, fever or vomiting. Older people may experience light-headedness when they stand up suddenly from a sitting or lying position. Light-headedness may also be related to influenza, low blood pressure, sweating, colds or allergies. Vertigo, the sensation that objects are spinning around you, is often related to inner ear problems. Other conditions leading to VERTIGO include heart disease and heart attacks, and in these cases patients may develop symptoms such as chest pain, loss of speech and changes in vision.
The most common causes of dizziness are:
- Benign paroxysmal positional vertigo (BPPV) - characterised by temporary dizziness when the position of the head changes, without hearing loss. It is caused by head trauma, surgery on the middle ear, in particular on the stapes, and by ageing.
- Labyrinthitis– Inflammation of the inner ear that usually occurs after a viral, bacterial, fungal or toxic infection.
- Ménière's disease – A disorder of the inner ear that causes significant hearing loss, tinnitus and dizziness. The disease may affect one or both ears.
- Tumours of the inner ear:cause tinnitus, hearing loss, dizziness and balance problems. Inner ear trauma
- Inner ear trauma
- Barotrauma causes damage to the inner ear and dizziness because of pressure differences between the middle and the inner ear
Symptoms
You may experience a spinning sensation closely associated with a loss of balance. Other symptoms include reduced hearing and tinnitus. Nausea and vomiting may accompany vertigo, leading to dehydration and weakness.
Diagnosis
Your doctor will carry out a complete physical examination and may ask about accompanying symptoms, including your medical history. Your doctor will check your blood pressure and may request an ECG as well as neurological tests in order to ensure the necessary treatment. Hearing tests may be recommended to confirm that the middle ear and the auditory nerve are functioning properly and to identify the cause of the dizziness.
Treatment
Dizziness is a symptom and not a disease, and if it is not treated in time it can lead to serious health problems.
Treatment addresses the underlying conditions of the illness.
- Dehydration – Drink as much fluid as possible or receive intravenous infusions
- Fever or infections – medication for fever or antibiotics prescribed for the treatment of infections
- If the dizziness is due to heart disease or to anxiety disorders, the appropriate treatment may be initiated.
- Vertigo caused by BPPV or labyrinthitis can often be treated with vestibular rehabilitation exercises. These involve positioning and manipulating the patient's head in order to move the crystals out of the semicircular canals, which in this way helps to reduce the inflammation
- Medication such as diazepam and antihistamines may be prescribed to reduce inflammation within the vestibular system
- Your doctor may recommend a soft collar that limits movement of the head
- Antiviral medication such as aciclovir or valaciclovir may be prescribed for viral infections that cause labyrinthitis
- Surgery may be necessary in patients with acoustic neuroma or with an anatomical disorder of the ear.
Prevention
Some of the measures that help prevent dizziness are:
- Stand up slowly from a sitting or lying position, as this changes blood pressure.
- Drink as much water or fluid as possible to prevent dehydration
- Eat regularly
- Follow a low-salt diet
- Treat ear infections, colds, influenza and other respiratory infections that may cause dizziness
- Make your home safe so that serious injury is prevented should you fall to the floor
- Avoid products such as coffee, alcohol or tobacco.