Dizziness

Dizziness is a general term that describes feeling unsteady, lightheaded, or having a false sense of motion. It is a symptom, not a disease, and can have many different underlying causes, ranging from simple issues like dehydration to more serious conditions affecting the inner ear, brain, or heart. 

Signs and symptoms

Dizziness can be described in different ways depending on the cause. 

  • Lightheadedness: Feeling faint, woozy, or like you are about to pass out. This can happen when you stand up too quickly.

  • Vertigo: The false sensation that you or your surroundings are spinning or moving. Vertigo often comes from problems with the inner ear.

  • Unsteadiness or loss of balance: Feeling unsteady on your feet or as if you might fall. This can be triggered by walking or moving your head.

  • Wooziness: Feeling heavy-headed or detached from your surroundings.

  • Nausea: An upset stomach or vomiting can accompany dizziness, especially with vertigo or motion sickness.

  • Confusion or disorientation: This can occur in more severe cases. 

When to seek immediate medical help

Because dizziness can sometimes signal a serious medical emergency, it is crucial to seek immediate care if it is accompanied by the following: 

  • Sudden, severe headache

  • Chest pain or a rapid or irregular heartbeat

  • Numbness, weakness, or trouble moving your arms, legs, or face

  • Difficulty walking, stumbling, or trouble with coordination

  • Confusion, slurred speech, or trouble seeing or hearing

  • Loss of consciousness or seizures

  • Persistent vomiting

  • A head injury before the dizziness started 

Diagnosis

To diagnose the cause of your dizziness, a doctor will first ask for a detailed description of your symptoms. 

  • What does the “dizziness” feel like?

  • Does it feel like you or the room is spinning (vertigo)?

  • Does it make you feel lightheaded or off-balance?

  • How often do you experience it, and how long does it last?

  • What triggers it, and does anything make it better or worse? 

Based on your answers, a doctor may perform a physical exam and other tests. 

  • Physical exam: This may include checking your balance, watching your eye movements, checking your blood pressure while you are sitting and standing, and looking for signs of other health conditions.

  • Head movement tests: Maneuvers like the Dix-Hallpike test can be used to help diagnose benign paroxysmal positional vertigo (BPPV).

  • Hearing and balance tests: If an inner ear problem is suspected, you may be referred for specialized testing.

  • Blood tests: These can check for things like low blood sugar, anemia, or dehydration.

  • Imaging tests: For more serious concerns, an MRI or CT scan may be used to examine the brain and rule out conditions like a stroke or brain tumor. 

Treatment

Since dizziness is a symptom, the treatment depends entirely on the underlying cause. 

Immediate relief

  • Sit or lie down: When you feel dizzy, immediately sit or lie down to prevent falling and injury.

  • Move slowly: Avoid sudden head movements or standing up too quickly.

  • Stay hydrated: Drink plenty of water throughout the day, especially if you are active or in hot weather. 

For inner ear problems

  • Epley maneuver: A series of specific head movements can be performed by a doctor or physical therapist to treat BPPV.

  • Vestibular rehabilitation: A physical therapy program that includes exercises to help your brain and body adapt to the signals from your inner ear.

  • Medication: For infections or Meniere's disease, a doctor may prescribe medication to manage symptoms. 

For other causes

  • Medication adjustment: If a medication you are taking is causing dizziness, your doctor may lower the dose or switch you to a different drug.

  • Healthy lifestyle: A balanced diet, adequate sleep, and managing stress can help with dizziness caused by low blood sugar, anxiety, or fatigue.

  • Addressing underlying conditions: Treating issues like low blood pressure, anemia, or heart conditions will often resolve the dizziness

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