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Dizziness

People use the word dizzy to describe a variety of sensations. Some people use the word dizzy to refer to feeling lightheaded or faint. Others use it when they feel imbalance or a spinning sensation (vertigo). Dizziness is a symptom. Mild dizziness, or lightheadedness, can occur when you move your head side to side, or just change the position of your head, or get up from sitting or lying down. This type of dizziness lasts a minute or less. Dizziness that lasts minutes, hours or days can be more serious. Other symptoms that can occur with this type of dizziness include loss of balance (with a risk for falls), unsteady gait, hearing loss, nausea, ringing in the ears (tinitis) and blurry vision.

Problems with your inner ear's balance mechanism, certain medications and medical conditions can cause dizziness. Upper respiratory allergies affecting your ears and motion sickness may also cause dizziness. Dizziness may also be caused by depression, agoraphobia or hyperventilation. Older adults may have dizziness when they suddenly move their heads or look up, because of atherosclerosis or osteoarthritis of the neck. Rarely, dizziness is caused by a brain tumor or multiple sclerosis.

Our sense of balance depends on brain's receiving information from our eyes, nerves in our skin, muscles and joints, and organs of the inner ear. Dizziness can be a symptoms of a problem with one or more of these systems.

Lightheadedness

When you are lightheaded, you may feel woozy or as if you are going to pass out. Problems with the inner ear, anxiety and hyperventilation may cause lightheadedness. Some people feel lightheaded for a moment when they get up from a sitting or lying position too quickly. This dizziness, called postural or orthostatic hypotension, is caused by a drop in blood pressure to the brain when you change position. It usually passes very quickly. You can take steps to avoid it. Before you get up, sit on the edge of the bed or chair to get your bearings. As you stand up, tighten your leg muscles. This causes more of your blood to flow toward your brain. Other possible causes of feeling lightheaded include dehydration and heart problems or anxiety. If you have been diagnosed with high blood pressure or heart problems and feel lightheaded, tell your doctor.

Balance Problems

When you have balance problems, you may not be able to walk straight. Your feet may feel unsteady, and you may feel like you are going to fall. The risk of injury makes balance problems dangerous. Poor balance is often related to aging of the inner ear's balance mechanisms, decreased sensation in the nerves of the leg and foot joints, arthritis and poor vision. If you have poor balance and your feet feel unsteady, call your doctor. To keep yourself from falling, leave a light on at night, remove area rugs that could cause you to trip and use a cane or walker.

Vertigo

Vertigo makes you feel as if objects around you are spinning or moving. It may also cause nausea, vomiting or blurry vision. Vertigo is usually temporary and not life threatening. It is caused by a disorder of the balance mechanism of the inner ear such as labyrinthitis, benign positional vertigo and Meniere's disease.

Labyrinthitis

Labyrinthitis is an inflammation of the inner ear. It may be caused by a virus. The symptoms are a sudden onset of severe vertigo, often accompanied by nausea, vomiting and involuntary movements of the eyes. A person may have these symptoms suddenly during the day or may wake up with them. The severe spinning sensation may last for several days, usually goes away on its own and may never return. It usually takes up to several months to disappear. During this time, some people experience a spinning sensation while moving their head in a specific direction or holding it in certain positions. This is called benign positional vertigo.

Benign Positional Vertigo

Benign positional vertigo is brief periods of vertigo caused by changes in the position of your head. It is the most common cause of dizziness in adults. It happens when crystals of calcium carbonate, normally present inside the balance mechanism of the inner ears, break off and fall into an areas where they can cause vertigo. The vertigo occurs when a person is looking up or down or side to side or is rolling over in bed. The spinning sensation usually lasts less than a minute. It can occur anywhere from once a day to every time a person moves his or her head. Benign positional vertigo may follow labyrinthitis, Meniere's Disease, head trauma, prolonged bed rest or extended periods of anesthesia, or it can appear without any apparent cause. It usually goes away on its own in about 4 months. If you have severe spinning sensations, talk to your doctor. Benign positional vertigo can be treated with repositioning (Epley) maneuvers

Meniere's Disease

Meniere's disease occurs when fluid pressure in the inner ear builds up. The pressure of the fluid affects both the balance and hearing organs of the inner ear. It is a common condition that can affect adults of all ages. It produces recurring episodes of vertigo with fluctuating hearing loss and pressure, fullness and a ringing or buzzing sound (tinnitus), usually in one ear. It may occur with nausea and vomiting. Symptoms can come and go, may be mild or severe and usually last for several hours or days. Episodes can occur as often as every day or as infrequently as every 10 years. Between episodes, most people with Meniere's disease feel normal. If you have dizziness with hearing loss, see your doctor.

Self-Care Steps for Dizziness

  • Take your time getting up if you have dizzy spells when you rise quickly from sitting or lying positions.

  • When an episode of dizziness or vertigo strikes, slowly move to a sitting or reclining position. You'll be less likely to fall and injure yourself. If you feel faint or if your vision begins to go dark, sit with your head between your knees.

  • Drink more fluids to avoid dehydration and help maintain your blood pressure.

  • Avoid caffeine, alcohol and smoking.

  • Avoid driving.

  • Use relaxation techniques to combat anxiety. Breathe deeply and slowly.

  • If you feel an episode of vertigo coming on, keeping your eyes open and focused on a stationary object may lessen the symptoms.

  • If others in your household also have dizziness, headache, or nausea and vomiting, it may be carbon monoxide poisoning. Get out of the house, call your gas company, and go to the hospital.

Decision Guide for Dizziness

Symptoms/Signs

Action

Occasional light-headedness or dizziness when first standing or getting out of bed

 Use self-care

Vertigo (perception of movement – either the person is moving or the environment is moving ) that lasts for more than 3 days

 See provider

Vertigo (perception of movement – either the person is moving or the environment is moving ) with nausea and vomiting

 See provider

Dizziness with fever, hearing loss, ringing ears, or ear pain

 See provider

Dizziness with head injury or severe headache

 Call 911

Dizziness with numbness or weakness of arms or legs or loss of control of bowels or bladder

 Call 911

Dizziness with blurred or double vision, loss of hearing, or slurred speech

 Call 911

Dizziness with symptoms of shock (rapid pulse; rapid, shallow respirations; cool, clammy, pale skin)

 Call 911

Dizziness with chest pain or pressure

 Call 911

Publication Source: Well Advised, Second Edition, Text copyright © 2003 Park Nicollet Institute
Online Editor: Sinovic, Dianna
Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Online Medical Reviewer: Lambert, J.G. M.D.
Online Medical Reviewer: Ryan, Matthew W., MD
Date Last Reviewed: 2/10/2006
Date Last Modified: 2/13/2006