Dizziness (Vertigo)

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What Is Dizziness

Dizziness is a term which individuals use to describe a variety of symptoms that may affect as many as 25% of individuals at some point in their lives. This term may be used to describe a sensation of lightheadedness, faint, weakness, imbalance or spinning, and can occur for a variety of reasons.

Dizziness may occur as a result of panic, anxiety or mood disorder. Sensation of lightheadedness or impending faint (syncope) may suggest underlying cardiovascular abnormalities related to the heart or blood pressure. Metabolic problems such as hormonal imbalance, menstruation, menopause or low blood sugar (hypoglycemia) may also result in dizziness.

Certain medications such as those used to control high blood pressure (antihypertensives) and epilepsy (anticonvulsants), along with certain sedatives and sleeping pills can also contribute to a sensation of dizziness.

What Is Vertigo

Vertigo is a more specific type of dizziness related to changes in those areas of our inner ear (vestibular labyrinth) or central nervous system that control balance and equilibrium. Individuals often describe a sensation of motion of self or surroundings such as spinning, loss of balance, or a feeling of being drunk or tipsy (disequilibrium). Associated symptoms may include hearing change or tinnitus (buzzing or ringing in the ears). This may or not be associated with a feeling of nausea and/or vomiting and may be momentary or persistent, worsened by movement or change in position (motion intolerance). Episodes may come and go for no particular reason. Most often, vertigo is sudden in onset, occurring without warning, such as when arising from bed in the morning.

The Anatomy Of Balance

Balance is maintained by a complex interaction of various parts of our body that have input to the central nervous system. The inner ear monitors changes in direction of movement and acceleration allowing our eyes to focus on our surroundings as we move and are physically active. Our eyes, skin pressure receptors, muscle and joint receptors and the central nervous system (brain and spinal cord), all contribute to our balance and equilibrium.

Dizziness, imbalance or motion intolerance (motion sickness) occurs when the central, nervous system receives conflicting messages from one or more of these areas. This can occur as a result of an inner ear disorder, injury, infection, neurological disease or tumor among others, most of which are not dangerous to our health. Motion sickness or sea sickness is a minor annoyance that usually does not indicate any serious underlying medical condition, although some travelers may be incapacitated by it for several days, even after travel is completed.

Seeing Your Doctor

You may wish to see your doctor if you are experiencing persistent or recurring symptoms of dizziness or vertigo. You will be asked to describe your dizziness, whether it is lightheadedness or a sensation of motion and how long and how often this has occurred. You will also be questioned as to whether there is associated hearing change, tinnitus nausea or vomiting, and as to what circumstance or activity might bring on a dizzy spell. Questions about your general health, any medications you are taking, whether there is a history of recent infection or injury will be asked, along with questions about your ears and neurological system.

Your physical exam will include your ears, nose and throat and tests of nerve and balance function. Because the inner ear controls both balance and hearing, you may require a hearing test (audiogram) if your symptoms suggest an inner ear disorder. Other tests may include special tests of eye movement (nystagmus) after warm and cold water is used to stimulate the inner ear (known as ENG or electronystagmography) and specialized x-rays including either a CT or MRI scan.

Not every patient requires every test. The doctor’s judgment is based on each particular patient. Treatment is individualized to each particular patient as well.

What Can I Do For My Dizziness?

  • Avoid rapid changes in position (lying back quickly or turning from side to side).
  • Avoid extremes in head position (looking up, bending forward, turning or twisting).
  • Eliminate or decrease use of products that impair blood circulation (nicotine, caffeine, salt).
  • Minimize exposure to activities that trigger your dizziness (stress, anxiety, substances that you react or are allergic to).
  • Avoid hazardous activities when you are dizzy (such as driving a car, operating heavy equipment, climbing a ladder).
  • Vestibular therapy – certain individuals may benefit from physiotherapy which is directed at desensitizing the balance system to movements that provoke symptoms.

What Can I Do For Motion Sickness?

  • Sit by the window by the wing in a plane or front seat in a car where the sensation of motion is reduced.
  • Focus on a point in the distance (distant scenery in a car or on the horizon while on the deck of a ship if sailing).
  • Do not read while traveling.
  • Avoid strong odours or spicy or greasy foods before and during travel.
  • Consider use of over the counter medications or naturopathic treatments available to reduce motion sickness (for example, Gravol, Bonamine, Transderm-V patch, Ginger derivatives). Stronger medications such as sedatives may be prescribed by your doctor.

Important To Remember

Most cases of dizziness and motion sickness are temporary and self-treatable. Severe cases and those which persist or become progressively worse need the attention of a physician. Certain individuals require the care of a physician with specialized skill in disorders of the ear, nose and throat, equilibrium and neurological systems.