Dizziness is a term which is used to describe a variety of sensations. It is defined as feelings of unsteadiness, wooziness, and lightheadedness; and sensations of moving, spinning, floating, swaying, tilting, or whirling (sensations known as vertigo). These sensations occur even when standing still or lying down.
Many people who experience dizziness find it difficult to explain exactly how it makes them feel. For example, some people who feel dizzy, light-headed, giddy or off-balance describe the feeling as if they, or their surroundings, are spinning around. Doctors use the term vertigo (see below) to describe this spinning, revolving form of dizziness. Others describe feeling “wobbly”, as if they were on a merry-go-round or on a boat on choppy water.
Dizziness can range from fleeting faintness to a severe balance disorder that makes normal functioning impossible. Among adults over 60, about 20 percent have had a dizziness episode that affected their usual activities.
Dizziness may feel like:
- Lightheadedness, as though you might pass out
- Unsteadiness or a loss of balance
- A false sense that you or your surroundings are spinning or moving (vertigo)
- Floating, swimming or heavy-headedness
Dizziness is often temporary and goes away without treatment. As you talk with your doctor about your condition, try to describe your specific symptoms, how the dizziness makes you feel as it is coming on and after it has passed, what triggers it, and how long it lasts. This will help your doctor diagnose the cause and treat it.
Causes
For the body to feel balanced, the brain requires input from the inner ear, eyes, muscles and joints. Since mechanisms for maintaining balance are so complex, finding the exact cause of dizziness is often difficult and requires input from several medical specialties. Dizziness is generally not serious. However, it may be the result from problems associated with the inner ear, brain, or heart. It can also be the result of medications.
A wide range of conditions and diseases can cause dizziness, including –
Inner ear problems – Disorders of the inner ear account for about half of all cases of persistent (ongoing) dizziness. Disorders include Meniere’s disease, benign paroxysmal positional vertigo (BPPV) and vestibular neuritis.
Anxiety disorders – Stress or anxiety may play a role in causing dizziness or, more commonly, may be a contributing factor in dizziness from other causes, such as inner ear disease.
Brain disorders – A common cause of dizziness is migraine, even without the headache that most people associate with a migraine. Very rarely, other causes of dizziness can include stroke or other brain diseases.
Other conditions – Some cases of dizziness are due to underlying medical conditions such as low blood pressure, infection, some heart problems (such as cardiac arrhythmias) and hypoglycaemia (low blood sugar). Drugs that are used to treat conditions such as epilepsy, coronary heart disease and high blood pressure can also cause dizziness in some people.
Unknown causes – Although a cause may not be found in some people, it does not necessarily mean that these people cannot be helped by the appropriate treatment.
Medications are a common source of dizziness. The medicines can include drugs to treat seizure disorders (eg, carbamazepine, phenytoin), drugs to help calm or sleep (sedating drugs/antidepressants), and even drugs used to treat inner ear infections (eg, gentamicin, streptomycin).
Alcohol consumption is another cause of dizziness.
Dizziness caused by aging –
- Reduced capacity for exercise or activity, weakness, and deconditioning
- Reduced ability for the blood circulation to compensate for quickly assuming an upright position (orthostatic hypotension)
- Hardening of the arteries (arteriosclerosis)
- Neuropathy (a progressive dysfunction of the nerves that is caused by different illnesses, especially diabetes)
- Menopause
- Poor eyesight and coordination
- Dementia
Symptoms
Descriptions of dizziness may include:
- A sensation of movement (including spinning), either of yourself or the external environment
- Unsteadiness, including finding it difficult to walk in a straight line
- Light-headedness
- Feeling faint.
Other symptoms that may accompany dizziness include:
- Headache
- Nausea and vomiting
- Ringing or other sounds in the ears (tinnitus)
- Difficulty hearing
- Staggering gait and loss of coordination (ataxia)
- Unusual eye movements, such as flitting of the eyes (nystagmus)
- Finding it difficult to see clearly when moving, for example, when reading a sign while walking or driving.
Treatment
Vestibular rehabilitation – The key treatment for almost all of the conditions that can cause dizziness is vestibular rehabilitation. The aim of vestibular rehabilitation is to help the development of vestibular compensation.
Cawthorne-Cooksey Exercise – The aims of the Cawthorne-Cooksey exercises include relaxing the neck and shoulder muscles, training the eyes to move independently of the head, practising good balance in everyday situations, practising the head movements that cause dizziness, improving general co-ordination, and encouraging natural spontaneous movement.
Gaze stabilization exercises – The aim of gaze stabilization exercises is to improve vision and the ability to focus on a stationary object while the head is moving.
Canalith repositioning procedures (CRP) – Canalith repositioning procedures (CRP) are the key treatment for benign paroxysmal positional vertigo (BPPV). Although most people with BPPV will recover within a few weeks or months, CRP can bring about a rapid recovery after just one or two sessions.
Medications – Medications such as meclizine (Antivert) or benzodiazepines (such as diazepam [Valium], lorazepam [Ativan]) are used to control the spinning feeling associated with dizziness, when vertigo is a possible cause.
Alternative Treatment
Vitamin B6 – This vitamin is essential for the brain and the nervous system to function normally; getting enough is vital for avoiding dizziness.
Vitamin D – The inner ear is partly responsible for your sense of balance, so any ear problems may cause dizziness. Getting enough vitamin D is vital for your ear health.
Vitamin B12 – This is the usual vitamin deficiency suspect if you’re experiencing dizziness. Vitamin B-12’s primary functions are in the formation of red blood cells and the maintenance of a healthy nervous system.
Antioxidants—Antioxidants mitigate the damaging effects of free radicals on tissues, cell membranes, and DNA. Vitamin C, vitamin E, lipoic acid, and glutathione are among the most important antioxidants. Vitamin C has been shown to have a beneficial effect on patients with Ménière’s disease when given in combination with glutathione.
Ginkgo biloba—Researchers have found that dizziness induced by vestibular receptor impairment can be reduced by Ginkgo biloba extract.
Ginger – Ginger, or Zingiber officinale, is a perennial used in cooking and herbal medicine. It’s a traditional remedy for stomach problems, nausea, fever, coughs and diarrhea. The rhizomes are rich in volatile oil, and have antibacterial, cholesterol-lowering, hypoglycemic and anti-ulcer action.
Reference –
https://my.clevelandclinic.org/services/head-neck/diseases-conditions/hic-what-is-dizziness
http://www.dizziness-and-balance.com/disorders/
http://www.aafp.org/afp/2010/0815/p361.pdf
http://www.brainandspine.org.uk/sites/default/files/documents/dizziness_and_balance_problems.pdf