Dizziness and Vertigo
In general, the most common causes of dizziness are activities everyone experiences, at least as children, namely running around in circles or riding carnival attractions that spin, loop or twist. These movements cause an asymmetry in the signals that stem from the vestibular system–a sensory system situated on each side of the head in the inner ear compartments–and that are processed in the brain.
But dizziness can also occur as an unprovoked and severe episodic or even constant occurrence–an understandable source of distress for the person experiencing it.
Here is an excerpt from a video interview of Dr B Jaipal Reddy, Consultant Physician (General Medicine & Diabetology) at OMNI Hospitals, Kothapet on Dizziness and Vertigo – causes, self-care and treatment.
Q. What is dizziness? Are dizziness and vertigo the same?
A. Dizziness is a term that describes a range of feelings, such as feeling unsteady, woozy, weak or faint. It is something that most people may experience from time to time. It is rarely the sign of a serious problem. There are ways to relieve dizziness.
Vertigo is a type of dizziness felt like a false sensation of movement. People usually feel that they, their environment, or both are spinning. The feeling is similar to that produced by the childhood game of spinning round and round, then suddenly stopping and feeling the surroundings spin. Occasionally, people simply feel pulled to one side. Vertigo is not a diagnosis. It is a description of a sensation.
Q. What causes dizziness?
A. Dizziness is common in adults, but it is rarely the sign of a serious condition. Dizziness has many possible causes, including:
– problems or conditions that affect the ears such as Meniere’s disease and labyrinthitis
– migraine
– stress or anxiety
– low blood sugar
– dehydration or heat exhaustion
– a fall in blood pressure when you stand up
– problems with the blood flow to your brain
– motion or travel sickness
– vertigo
– viruses and other illnesses
– brain and nerve-related disorders
– Some medicines and alcohol can also make you feel dizzy.
Q. What are the symptoms of dizziness?
A. If you are feeling dizzy or experiencing a ‘dizzy spell’, you will usually feel light-headed, unsteady or unbalanced and you may also feel weak. You might also feel like you’re going to faint.
Q. How are dizziness and vertigo diagnosed?
A. In trying to work out the cause of a person’s dizziness, investigations may include:
– medical history, including careful questioning about the nature of the dizziness
– physical examination, which may include observing eye movements, positional testing and a – blood pressure check
– specialised hearing or balance testing
– CT or MRI scans of the inner ear or brain
Q. What are the types of vertigo?
A. The two main types of vertigo are:
– Peripheral vertigo:
It is caused by a problem in areas of the inner ear or the vestibular nerve, which connects the inner ear and the brain. This is the most common type of vertigo.
– Central vertigo:
It occurs when there is a problem in the brain, particularly in an area of the brain called the cerebellum.
Q. How common is it to experience vertigo?
A. Vertigo is considered a common symptom. Nearly 40 per cent of all adults experience vertigo at least once during their lifetime.
Vertigo is typically more prevalent in older people, but it can affect anyone at any age. Women are slightly more likely to experience vertigo symptoms than men.
Q. What does it feel like to have vertigo?
A. Many people describe vertigo as feeling like the room is spinning. It might cause you to feel like you’re tilted, rocking, unbalanced, or unsteady.
Sometimes, these unpleasant sensations are worse if you’re standing up, walking, or moving your head around. Many people describe these feelings as physically exhausting and taxing. Sometimes, the sensations are so severe that you feel nauseous or experience vomiting.
Symptoms can last a few minutes, or they can persist for hours. Some people have constant, chronic episodes of vertigo. Others have vertigo symptoms that go away and then reappear after some time.
Usually, symptoms of vertigo don’t include light-headedness, fainting, or motion sickness.
Q. What is the relation between vertigo and ear problems?
A. Symptoms of vertigo are often the result of an inner ear (vestibular system) problem. Your inner ear plays a big role in helping you feel balanced.
Inside your ear, there’s a tiny organ called the vestibular labyrinth, which includes semicircular canals that contain fluid and hair-like sensors.
Other structures in the ear, called otolith organs, help monitor the movement and position of your head in relation to gravity. Otolith organs contain small crystals that make you responsive to gravity.
Sometimes, these crystals can break free and move into the semicircular canals. This can irritate the hair cells within the canals and make them more sensitive to head position changes. It can allow for false messages about your body’s position to be sent to your brain.
Basically, inner ear disorders cause your brain to obtain signals from the inner ear that don’t match up with what your eyes and sensory nerves (nerves that send messages to your brain) receive.
Q. What is the treatment for dizziness?
A. Dizziness often gets better without treatment. If you need treatment, it will depend on what is causing your dizziness.
Potential treatment options may include:
– canalith positioning procedures – a special set of exercises designed to remove inner ear ‘crystals’ in benign paroxysmal positional vertigo (BPPV)
– migraine prevention medication
– medication to dampen the sensations of dizziness
– anti-nausea medication
– balancing exercises to ‘retrain’ the nervous system (usually prescribed by a vestibular physiotherapist)
– counselling and cognitive behaviour therapy – where anxiety or stress is a factor.
Q. What are some the self-care tips to treat dizziness?
A. If you are feeling dizzy or light-headed you may find the following advice helpful:
– Rest as much as possible.
– Change positions slowly, especially when you’re standing up after lying down. Try to sit for a couple of minutes before standing up.
– Avoid sudden, fast movements of the head, such as looking up or around too quickly.
– Try to avoid going up or downstairs as you may fall and hurt yourself if you become dizzy whilst on the stairs. If you have to use stairs, hold on to the railing if there is one.
– Avoid driving or operating dangerous equipment or machinery while you feel dizzy as this could be dangerous to yourself and others.
– If you feel faint, try lying down flat. This will allow blood to reach your brain quickly.
Consultant Physician (General Medicine, Diabetology)