Dizziness Explained

Dizziness can be described in many ways, such as feeling lightheaded, unsteady, giddy, a floating sensation, or form of motion sickness with associated nausea.

Vertigo is a specific type of dizziness that is described as an illusion of movement of oneself or the environment.

Dizziness, vertigo, and motion sickness all directly connect to the realm of equilibrium and balance.

Your sense of balance is maintained through the interactions of various body parts that constitute the nervous system:

  • The inner ear (also called the labyrinth) monitors the directions of motion, such as turning, rolling, forward-backward, side-to-side, and up-and-down motions
  • The eyes monitor where the body is in space (i.e., upside down, right side up, etc.) and also track directions of motion
  • The pressure receptors in the joints of the lower extremities and the spine, determine which parts of the body are down and touching the ground
  • The muscle and joint sensory receptors track which aspects of the body are moving
  • The central nervous system (the brain and spinal cord), processes all the information from the four other systems to maintain balance and equilibrium

The symptoms of dizziness and motion sickness occur when the central nervous system receives conflicting messages from other body systems.

Causes of Dizziness

Dizziness can be caused by various factors such as poor circulation, inner ear disease, medication usage, injury, infection, allergies, or neurological disease.

Vertigo is experienced after a change in head position such as lying down, turning in bed, looking up, or stooping. It lasts about 30 seconds and ceases when the head is still. It is due to a dislodged otololith crystal entering one of the semicircular balance canals. It can last for days, weeks, or months. An Otolaryngologist will often perform the Epley Maneuver, a common repositioning treatment, to help alleviate symptoms. BPPV is the most common cause of dizziness after (even a mild) head injury.

If the brain does not receive enough blood flow, a person will start to feel lightheaded. Most people have experienced this phenomena as a result of standing up quickly from a lying down or sitting position. Unfortunately, some people feel light-headed on a routine basis due to poor circulation. This could be caused by arteriosclerosis or hardening of the arteries, and it is commonly seen in patients who have high blood pressure, diabetes, or high levels of blood fats (cholesterol). It is sometimes seen in patients with inadequate heart function, hypoglycemia (low blood sugar), or anemia (low iron).

Certain drugs also decrease the blood flow to the brain, especially stimulants such as nicotine and caffeine. Excess salt in the diet also leads to poor circulation. Sometimes circulation is impaired by spasms in the arteries caused by emotional stress, anxiety, and tension.

If the inner ear fails to receive enough blood flow, vertigo, a specific type of dizziness, often occurs. The inner ear is extremely sensitive to any changes connected to the degree of blood flow.

Anxiety can cause an individual to feel dizzy or lightheaded. Hyperventilation, unconscious over breathing, can lead to a feelings of panic, dizziness, or tingling in the face, hands, or feet. Instruction regarding correct breathing techniques may be required.

A number of nerve related diseases can affect balance, such as multiple sclerosis, syphilis, tumors, etc. Your doctor will be able to run various tests to determine if one of these diagnoses is causing your symptoms.

Meniere’s disease: An inner ear disorder with attacks of vertigo (lasting hours), nausea, or vomiting, and tinnitus (loud noise) in the ear, which often feels blocked or full. There is usually a decrease in hearing as well.
Some individuals with a prior classical migraine headache history can experience vertigo attacks similar to Meniere’s disease. Usually there is an accompanying headache, but symptoms can also occur without it.

Viruses often attack the inner ear and can cause acute vertigo without hearing loss, known as vestibular neuronitis, that can last for days. However, mastoiditis, a known bacterial infection, can migrate into the inner ear and cause complete destruction of both the hearing and equilibrium functioning ability of that ear. This condition is known as Labyrinthitis.

A skull fracture that damages the inner ear produces a profound and incapacitating vertigo with nausea and hearing loss. The consequential symptom of dizziness will often last for several weeks then slowly start to improve as the other (normal) side takes over.

Some people experience dizziness and/or vertigo attacks when they are exposed to foods or airborne particles (such as dust, molds, pollens, dander, etc.) to which they are allergic.

Prevention Tips – Dizziness

  • Avoid rapid changes in position
  • Avoid rapid head motion (especially turning or twisting)
  • Eliminate or decrease use of products that impair circulation (tobacco, alcohol, caffeine, and salt)
  • Minimize stress and avoid substances to which you are allergic
  • Get enough fluids
  • Treat infections, colds, flu, and sinus congestion

Prevention Tips – Motion Sickness

  • Do not read while traveling
  • Avoid sitting in the rear seat
  • Do not sit in a seat facing backward
  • Do not interact with another traveler who is currently having motion sickness
  • Avoid strong odors and spicy or greasy foods immediately before and during your travel
  • Talk to your doctor about medications

Treatments for Dizziness

Dizziness is usually treatable, if your doctor is able to determine the specific cause of your symptoms and implement the most appropriate method of treatment.

The doctor will ask you to describe your dizziness, answer an array of questions about your general health, and examine your ears, nose, and throat.

Some of the following routine checks or tests might be performed:

  • Blood pressure
  • Nerve and balance function (rotational chair testing, posturography, Epley maneuver)
  • Hearing Test
  • Imaging of head (CT or MRI)
  • Techniques to stimulate inner ear (ENG electronystagmography or VNG videonystagmography)
  • Blood tests

Your doctor will determine the best treatment strategy based on your specific symptoms and the root cause of them.

Signs medical attention is needed

Consult your doctor if you:

  • Have never experienced dizziness before
  • Experience a difference in symptoms you have had in the past
  • Suspect that medication is causing your symptoms
  • Experience hearing loss or balance concerns

Call 911 or go to an emergency room if you experience:

  • Dizziness after a head injury
  • Fever over 101°F, headache, or very stiff neck
  • Convulsions or ongoing vomiting
  • Chest pain, heart palpitations, shortness of breath, weakness, a severe headache, inability to move an arm or leg, change in vision or speech
  • Fainting and/or loss of consciousness