When you are dizzy, you may feel lightheaded or lose your balance.  Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo

A sudden drop in blood pressure or being dehydrated can make you dizzy. Many people feel lightheaded if they get up quickly from sitting or lying down.  Dizziness usually gets better by itself or is easily treated. However, it can be a symptom of other disorders. Some medications can cause dizziness, or problems with your ear. Motion sickness can also make you dizzy, plus there are many other causes.

Deep inside the ear there is a small network of tubes that are filled with fluid, called the “semicircular canals”. Floating inside that fluid are special calcium deposits, called “otolith organs” and together, these tubes and deposits make up the “vestibular system”.  This system tells your brain what position the body is in and it also helps keep you balanced.

Dizziness is a common reason adults visit their doctors. Frequent dizzy spells or constant dizziness can significantly affect your life. The treatment of dizziness depends on the cause and your symptoms, it is usually effective, but, unfortunately, the problem may recur.

People experiencing dizziness may describe it as a number of sensations, such as a false sense of motion or spinning (vertigo), lightheadedness or feeling faint, unsteadiness or a loss of balance, a feeling of floating, wooziness or heavy-headedness, or like you just finished a spinning ride at the amusement park.  These feelings may be triggered or worsened by walking, standing up, laying down,turning or moving your head. Your dizziness may be accompanied with being nauseated or the dizziness can be sudden that you need to hang on to something, sit or lie down. Each episode may last just seconds or days.

Call 911 or seek emergency medical help if you experience dizziness with a sudden or severe headache, vomiting, a sudden change in speech, vision or hearing; stumbling or difficulty walking, fainting, chest pain or an irregular heart rate, numbness, shortness of breath or seizures.

Consult with your physician at Oklahoma Otolaryngology Associates if you experience recurrent, sudden, severe dizziness or prolonged episodes of dizziness, faintness, lightheadedness or vertigo.  Dizziness has many possible causes, including inner ear disturbance, motion sickness and effects from your medication. Sometimes it is caused by an underlying health condition, such as poor circulation, infection or an injury.

The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause.

Inner ear problems cause vertigo

Your sense of balance depends on the combined input from the various parts of your sensory system. These include:

  • Eyes –which help you determine where your body is in space
  • Sensory nerves –which send messages to your brain about body movement and position
  • Inner ear –which houses sensors that help detect gravity and back-and-forth motion

Vertigo is the false sense that your surroundings are spinning or moving. With inner ear disorders, your brain receives signals from the inner ear that are not consistent with what your eyes and sensory nerves are receiving.

Benign paroxysmal positional vertigo (BPPV) is the condition which causes an intense and brief false sense that you are spinning or moving. These episodes are triggered by a rapid change in head movement, such as when you turn over in bed, sit up or experience a blow to the head. BPPV is the most common cause of vertigo.

Infection due to a viral infection of the vestibular nerve, called vestibular neuritis, can cause intense, constant vertigo. If you also have sudden hearing loss, you may have labyrinthitis.

Meniere’s disease involves the excessive buildup of fluid in your inner ear. It is characterized by sudden episodes of vertigo lasting as long as several hours. You may also experience fluctuating hearing loss, ringing in the ear and the feeling of a plugged ear.

Migraines may have episodes of vertigo or other types of dizziness even when they’re not having a severe headache. Such vertigo episodes can last minutes to hours and may be associated with headache as well as light and noise sensitivity.

 Other problems that cause dizziness

You may feel dizzy, faint or off balance if your heart is not pumping enough blood to your brain.  Some neurological disorders — such as Parkinson’s disease and multiple sclerosis — can lead to progressive loss of balance.  Dizziness can be a side effect of certain medications — such as anti-seizure drugs, antidepressants, sedatives and tranquilizers. In particular, blood pressure lowering medications may cause faintness if they lower your blood pressure too much.  Certain anxiety disorders may cause lightheadedness or a woozy feeling often referred to as dizziness. These include panic attacks and a fear of leaving home or being in large, open spaces (agoraphobia).  Those people with Low blood sugar (hypoglycemia) and those who use insulin may experience dizziness but may be accompanied by sweating and anxiety. If you are active in hot weather, or if you don’t drink enough fluids, you may feel dizzy from overheating (hyperthermia) or from dehydration.

Older adults are more likely to have medical conditions that cause dizziness, especially a sense of imbalance.

Initially, your family doctor or primary care physician should be seen with this condition. He or she you may refer you to Oklahoma Otolaryngology Associates (ENT).

Here’s some information to help you get ready for your appointment.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet. If you are scheduled for vestibular testing, your doctor will provide instructions regarding any medications to withhold the night before and what to eat on the day of testing.

  • Be prepared to describe your dizziness in specific terms.When you have an episode of dizziness, do you feel like the room is spinning, or like you are spinning in the room? Do you feel like you might pass out? Your description of these symptoms is crucial to helping your doctor make a diagnosis.  It is helpful to write down what you were doing before the episode and a specific description of your episode.
  • List all your health conditions or symptoms on the history form,including any that may seem unrelated to your dizziness. For example, if you have felt depressed or anxious recently, this may be important information for your doctor.
  • List key personal information,including any major stresses or recent life changes.
  • Make a list of all prescription and over-the-counter medications including herbs,vitamins or supplements which you are taking.
  • Be prepared, list questions to askyour doctor.Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For dizziness, some basic questions to ask your doctor include:
  • What’s the most likely cause of my symptoms?
  • Are there any other possible causes for my symptoms?
  • What tests do you recommend?
  • Is this problem likely temporary or long lasting?
  • Is it possible my symptoms will go away without treatment?
  • What treatment options might help?
  • Do I need to follow any restrictions? For example, is it safe for me to drive?
  • Is there a generic alternative to the medicine you’re prescribing?
  • Do you have any brochures or other printed material that I can take home with me?
  • What websites do you recommend?

What to expect from your doctor

Your doctor will likely ask you a number of questions about your dizziness, such as:

  • Can you describe what you felt the first time you had an episode of dizziness?
  • Is your dizziness continuous, or does it occur in spells or episodes?
  • If your dizziness occurs in episodes, how long do these episodes last?
  • How often do your dizziness episodes occur?
  • When do your dizzy spells seem to happen, and what triggers them?
  • Does your dizziness cause the room to spin or produce a sensation of motion?
  • When you feel dizzy, do you also feel faint or lightheaded?
  • Does your dizziness cause you to lose your balance?
  • Are your symptoms accompanied by a ringing or fullness in your ears (tinnitus) or trouble hearing?
  • Does your vision blur?
  • Is your dizziness made worse by moving your head?
  • What medications, vitamins or supplements are you taking?

What you can do in the meantime

If you tend to feel lightheaded when you stand up, take your time making changes in posture. If you have had episodes of dizziness while driving, arrange for alternate transportation while you are waiting to see your doctor.

If your dizziness causes you to feel like you might fall, take steps to reduce your risk. Keep your home well lit and free of hazards that might cause you to trip and fall. Avoid area rugs and exposed electrical cords. Place furniture where you are unlikely to bump into it and use nonslip mats in the bathtub and on tile floors.

Most people visiting their doctor because of dizziness will first be asked about their symptoms and medications and then be given a physical examination. During this exam, your doctor will check how you walk and maintain your balance and how the major nerves of your central nervous system are working.

You may also need a hearing test and balance tests, including:

  • Eye movement testing.Your doctor may watch the path of your eyes when you track a moving object. And you may be given an eye motion test in which cold and warm water or air are placed in your ear canal.
  • Head movement testing.If your doctor suspects your vertigo is caused by benign paroxysmal positional vertigo, they may do a simple head movement test called the Dix-Hallpike maneuver to verify the diagnosis.
  • This test tells your doctor which parts of the balance system you rely on the most and which parts may be giving you problems. You stand in your bare feet on a platform and try to keep your balance under various conditions.

In addition, you may be given blood tests to check for infection and other tests to check heart and blood vessel health.

Dizziness often gets better without treatment. Within a couple of weeks, the body usually adapts to whatever is causing it.

If you seek treatment, your doctor will base it on the cause of your condition and your symptoms. It may include medications and balance exercises. Even if no cause is found or if your dizziness persists, prescription drugs and other treatments may make your symptoms more manageable.

Therapy

  • Head position maneuvers.A technique called canalith repositioning (or Epley maneuver) usually helps resolve benign paroxysmal positional vertigo more quickly than simply waiting for your dizziness to go away. It can be done by your doctor, an audiologist or a physical therapist and involves maneuvering the position of your head. It’s usually effective after one or two treatments. Before undergoing this procedure, tell your care provider if you have a neck or back condition, a detached retina or blood vessel problems.
  • Balance therapy.You may learn specific exercises to help make your balance system less sensitive to motion. This physical therapy technique is called vestibular rehabilitation. It is used for people with dizziness from inner ear conditions such as vestibular neuritis.
  • This type of therapy may help people whose dizziness is caused by anxiety disorders.

Surgical or other procedures

  • Your doctor may inject your inner ear with the antibiotic gentamicin to disable the balance function. The unaffected ear takes over that function.
  • Removal of the inner ear sense organ.A procedure that’s rarely used is called labyrinthectomy. It disables the vestibular labyrinth in the affected ear. The other ear takes over the balance function. This technique may be used if you have serious hearing loss and your dizziness hasnot responded to other treatments.

Dizziness usually goes away on its own. If you tend to experience repeated episodes of dizziness, consider these tips:

  • Be aware of the possibility of losing your balance which can lead to falling and serious injury.
  • Avoid moving suddenly and walk with a cane for stability.
  • Fall-proof your home by removing tripping hazards such as area rugs and exposed electrical cords. Use nonslip mats on your bath and shower and tile floors. Use good lighting.
  • Sit or lie down immediately when you feel dizzy. Lie still with your eyes closed in a darkened room if you are experiencing a severe episode of vertigo.
  • Avoid driving a car or operating heavy machinery if you experience frequent dizziness without warning.
  • Avoid using caffeine, alcohol, salt and tobacco. Excessive use of these substances can worsen your symptoms.
  • Drink enough fluids, eat a healthy diet, get enough sleep and avoid stress.
  • If your dizziness comes with nausea, try an over-the-counter (nonprescription) antihistamine, such as meclizine (Antivert) or one containing dimenhydrinate (Dramamine). These may cause drowsiness. Non-drowsy antihistamines arenot as effective.
  • If your dizziness is caused by overheating or dehydration, rest in a cool place and plenty of drink water or a sports drink (Gatorade, Powerade, etc).

When to seek help

  • You should seek help immediately if you have dizziness or vertigo along with any of the following:
  • New or severe headache
  • Temperature greater than 100.4ºF (38ºC)
  • Seeing double or having trouble seeing clearly
  • Trouble speaking or hearing
  • Weakness in an arm or leg
  • An inability to walk without assistance
  • Passing out
  • Numbness or tingling
  • Chest pain
  • Vomiting that will not stop
  • In addition, you should seek help immediately if you have vertigo that lasts for several minutes or more if you:
  • Are an older adult
  • Have had a stroke in the past
  • Have risk factors for stroke (high blood pressure, diabetes, smoking)
  • If you have dizziness or vertigo that comes and goes but you do not have any of the above problems, make an appointment with your OOA physician.