Have you ever visited your doctor complaining of dizziness? Dizziness is a common description for many different sensations. It can be quite mild or extremely debilitating. You might feel light-headed, faint, weak, confused, tired, woozy, giddy, fuzzy, helpless, off-balance, wobbly, or that the room is spinning or twirling around. It might be accompanied by nausea and vomiting. Medical terms for dizziness include vertigo, disequilibrium, or pre-syncope.
Dizziness accounts for more than seven million doctor office visits per year in the United States. It is painless discomfort in the head with many possible causes, and patients are often left dissatisfied with treatments offered. This is because the cause of the dizziness is often not clear, making it difficult to arrive at the correct treatment. However, it is most often a benign and self-limiting disorder; that is, it typically goes away by itself!
What, then, are some causes of dizziness?
- Lightheadedness is the result of too little blood reaching the brain. This occurs with sudden drops in blood pressure; dehydration from diarrhea or vomiting; getting up suddenly from a laying or sitting position leading to a temporary drop in blood pressure; fever; spending too much time in the heat, or lack of fluid consumption/replacement; and musculoskeletal problems, especially focused in the neck.
- Low blood pressure can cause dizziness. This can be caused by multiple conditions (including those mentioned above), ranging from diseases of the heart such as bad heart valves, weak heart muscles or bad heart rhythms; brain disorders such as tumors; hyperventilation from various causes – both physical and emotional; gastrointestinal disorders leading to bleeding that causes anemia; and adverse reactions to medications.
- Ménière’s Disease is a condition that causes fluctuating pressure of the inner ear fluid and results in severe vertigo (dizziness), ringing in the ears, and progressive hearing loss.
Your doctor’s exam for dizziness will begin with detailed questions in an attempt to pin down the cause. Your description will be the most critical step in reaching a diagnosis. A detailed physical exam will start with blood pressure and pulse readings, and will include careful neurological testing such as checking your muscles, senses and gait (walking). Tests may include a brain MRI, EKG of the heart, or blood tests for anemia, diabetes, hypoglycemia, sodium, potassium and vitamin B-12.
Treatment for dizziness will vary, depending on cause. If your complaint is of dizziness when standing, or low blood pressure when standing, the cause is likely dehydration, and the answer can be as simple as increased fluid intake. Certain medications (like diuretics) cause loss of fluids and may need to be stopped. Blood pressure medication can lead to dizziness and may need to be decreased or stopped. If your complaint is poor balance, the problem might lie in the middle ear and the vestibular system. The goal of treatment will be to minimize vertigo and prevent falls, and some types of physical therapy, known as vestibular rehabilitation therapy, may be useful. Often, doctors find no specific cause and simply treat the symptoms with medications like Antivert or Meclizine.
If you find yourself suffering from dizziness, your first simple home remedies will be to drink plenty of water to prevent dehydration, eat frequent meals to prevent hypoglycemia, and move to a standing position more slowly. When, however, should you seek help from your doctor? There are dangerous and life-threatening diseases that can begin with symptoms of dizziness. Here is what you should look out for:
- Any severe first-time imbalance or dizziness
- Dizziness without a cause
- Dizziness after taking newly-prescribed medication
- Any change in an established pattern of dizziness
- Dizziness that is accompanied by loss of neurological function, including loss of strength, feeling, speech, or consciousness. If this is the case, call an ambulance.
I hope that you enjoyed your summer. As always, I wish you continuing good health!
Tags: Dizziness