Alternate Names: Vertigo; Loss of balance; Lightheadedness - dizzy
Considerations: Most causes of dizziness are minor. Vertigo (a spinning sensation or the feeling that the room around you is moving) often indicates an inner ear problem.
Serious disorders rarely cause dizziness, but it can occur. Dizziness can result from insufficient blood flow and oxygen supply to the brain and spinal cord, such as can be caused by a rapid drop in blood pressure. Serious disorders that can cause dizziness (note: they usually also cause other symptoms) include heart problems such as a valve disorder or heart attack, stroke, and severe hypotension or shock.
Dizziness can also be caused by a poorly functioning balance mechanism of the inner ear. The balance mechanism also helps control eye movements, so often the environment seems to be spinning around (vertigo). Most dizziness and vertigo has no definite cause and is commonly attributed to a viral infection of the inner ear.
Lightheadedness is a fainting feeling that often accompanies the flu or a common cold. Lightheadedness without other symptoms is usually not serious.
Most fainting spells are not dangerous, but if there is any question call for medical help. Sudden loss of consciousness (vasovagal faint) happens more easily when a person is upright. A simple faint is rarely preceded by symptoms such a pain, pressure, constriction in the chest or shortness of breath--just by weakness, giddiness and nausea.
Dizziness should not be confused with seizures; however, the onset of seizures can cause dizziness.
Common Causes:
- severe pain
- hyperventilation
- headache
- injury
- fright
- low blood pressure
- getting blood drawn
- strenuous coughing
- straining during a bowel movement or bladder emptying
- standing up too quickly after lying down or sitting especially in older people (see hypotension)
- viral infection of the inner ear
- alcohol intoxication
- pressure on the carotid sinus in the neck (a shirt collar may be too tight)
- medications, especially tranquilizers, many heart drugs, anticonvulsants, aspirin, Dilantin, Gentamycin, narcotics, sedatives, Streptomycin and almost every preparation that is used to treat high blood pressure - (antihypertensives, including nitroglycerin) in cardiac patients
- heart beating too slow (below 30 times a minute) or too fast (around 200 times a minute)
- hyperventilation
- classical migraine or common migraine
- drug abuse and dependence
- drug allergies
- middle ear surgery or trauma
- tympanic membrane perforation
- ear diseases (otitis media, labyrinthitis, mastoiditis, cholesteatoma, vestibular neuronitis)
- visual impairment
Home Care: Follow prescribed treatment for the underlying cause.
The feeling of lightheadedness upon standing is one of the most common causes of temporary blackout or faintness and becomes more frequent with increasing age. Avoid sudden changes in posture.
A persistent lightheaded feeling without other symptoms is often due to anxiety, rather than a brain tumor or other hidden disease. Often people have to learn to live with this problem.
Call If:
- there has been complete loss of consciousness.
- the room seems to spin around (vertigo).
- dizziness is preventing daily activities.
- medication is the suspected cause. Talk to your health care provider before taking the next dose of medication.
- lightheadedness lasts for more than 3 weeks.
- other symptoms are also present, especially chest pain, numbness and tingling, or other serious symptoms.
What To Expect: The medical history will be obtained and a physical examination performed.
Medical history questions documenting dizziness in detail may include:
- quality
- Does dizziness occur with a change in body position?
- How severe is the dizziness?
- Does the room seem to move (vertigo)?
- time pattern
- When did it begin?
- Is the person always dizzy?
- Does dizziness come and go (episodic)?
- How long does it last (how many hours)?
- Did another illness develop after the dizziness began?
- How much later did the illness develop:
- associated complaints
The physical examination may include emphasis on the heart, head, ears, and nervous system.
Diagnostic tests that may be performed include:- blood pressure measurements and tests
- ECG
- hearing tests
- neurological tests
- balance testing (ENG) may be required.
After seeing your health care provider:
You may want to add a diagnosis related to dizziness to your personal medical record.
