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DIZZINESS AND VERTIGO

Dizziness Disorders
Common Myths About Dizziness
Help is available

Dizziness is a broad term used to explain how we feel when our sense of balance is not quite right. The term encompasses a variety of sensations that can mean different things to different people. If you have ever been dizzy, you may have found it difficult to describe exactly how it made you feel. Some people who report feeling dizzy say they feel as if everything is spinning around them, or as if they are spinning or turning themselves. This is what doctors usually mean when they refer to vertigo. Others describe feeling wobbly or unsteady as if they were on a boat. And still others may describe their dizziness as a feeling of "floating", lightheadedness or "giddiness".

Dizziness can be caused by a number of different factors, including a variety of problems within the balance control mechanism itself. How we control our balance is a complex process involving many different parts of the body. This process, as well as the physical problems that can develop, is described under "How You Control Your Balance?"

Dizziness Disorders

Dizziness or vertigo can be caused by a disturbance in a particular part of the inner ear - the vestibular system. This is the part of your balance system that provides your brain with information about changes in head movement with respect to the pull of gravity. When your vestibular system is not working properly, the result may be dizziness, vertigo, imbalance, disorientation and possibly nausea and vomiting.
Some specific disorders known to cause dizziness and/or vertigo are listed below in alphabetical order:

Acoustic neuroma is loosely defined as a tumor on the nerve from the inner ear to the brain. Patients with this disorder may experience a gradual hearing loss, ringing or buzzing in the ears and dizziness. A sensation of pressure and fullness may also be present.

Arteriosclerosis, a hardening or narrowing of blood vessels that supply blood to the brain, may cause decreased blood flow, resulting in dizziness.

Benign Paroxysmal Positional Vertigo (BPPV) is a balance and dizziness disorder caused by a problem in the vestibular system of the inner ear which forms part of the balance organs. Small particles or crystals become detached from their normal location in the inner ear and interfere with the normal function of the vestibular system. As the name indicates, the vertigo, which can be intense, comes on suddenly following certain movements of the head. This type of vertigo comes and goes and, if left untreated, may be recur for years.

"Central" or neurological vertigo refers to dizziness that results from problems in the balance centers of the brain, rather than the ear. This type of dizziness is generally much less common than dizziness caused by inner ear problems. Strokes, multiple sclerosis, brain tumors or cysts and deformities of the upper spine or the back of the brain are all possible causes.

Hyperventilation can cause temporary dizziness and sometimes occurs when you are exercising strenuously or if you hold your breath when you are under stress.

Labyrinthitis is an inflammation, usually caused by a virus, of the labyrinth, the part of the inner ear that contains the organs of balance.

Meniere's disease is a condition in which repetitive attacks of vertigo are accompanied by pressure in the ears, buzzing or ringing, and partial hearing loss that can fluctuate during an episode.

Osteoarthritis, a joint disease, can affect the neck or cervical area of the spine. Openings in the neck vertebrae contain arteries, which supply the brain with blood. When these openings narrow as a result of osteoarthritis, blood flow to the brain is restricted, resulting in dizziness.

Ototoxicity is caused by exposure to, or ingestion of a particular substance which damages the auditory and inner ear system. Ototoxicity may result in irreversible damage to hair cells in the inner ear and/or vestibular system, which may cause vertigo, vision problems, hearing loss, gait unsteadiness and imbalance.

Peripheral fistula is a leakage of inner ear fluid to the middle ear. It can occur after a head injury or physical exertion or without a known cause (rarely).

Peripheral vestibular disorders refers to all forms of dizziness caused by inner ear problems, including BPPV, labyrinthitis and Meniere's disease. The term is commonly used when a doctor knows the problem is in the inner ear, but is unable to be more specific.

Post-traumatic vertigo is dizziness resulting from a head injury, concussion or whiplash.

Postural hypotension is indicated by symptoms of lightheadedness or blackouts, and is typically experienced when rising from a lying or sitting position.

Tinnitus is buzzing or ringing in the ears and can occur with dizziness or may be a symptom by itself.

Vascular vertigo is dizziness caused by problems with the blood supply to the inner ear or the balance centers of the brain. This can occur in people who suffer from migraine or those who are overweight, smoke, have high blood pressure or don't get enough exercise.

Vestibular neuronitis is an infection of the vestibular nerve, generally viral.

Viral labyrinthitis is a viral inflammation of the inner ear. It causes dizziness/vertigo which may last days or weeks, usually following a cold or flu.

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Common Myths About Dizziness

Dizziness is one of the leading patient complaints reported to doctors, second only to lower back pain. Historically, it has been very difficult to determine the cause of dizziness symptoms, but medical advances in the last twenty years have significantly improved the diagnosis and treatment of dizziness disorders. Because dizziness and/or vertigo can be so difficult to diagnose, however, a number of erroneous "causes" are often incorrectly assigned to symptoms of dizziness.

Myth: "Your dizziness is caused by anxiety; you just need to relax."
Fact: While someone with dizziness may be feeling anxious about their dizziness, which can magnify the unpleasant sensations, anxiety is not the underlying cause for the dizziness. If you are suffering from persistent symptoms of dizziness and/or vertigo that do not go away within a reasonable amount of time, it is a sign that there is something wrong and you should consult with a qualified clinician.

Myth: "Your dizziness is caused by your imagination and it's only in your head."
Fact: While you may find it difficult to describe your symptoms to your friends, family or doctor, your symptoms should not be discounted as imaginary. Your feelings of dizziness or unsteadiness are quite real and are a symptom of an underlying problem.

Myth: "Your dizziness is just part of getting older."
Fact: This is not true. Dizziness can be the result of a number of factors including injuries, degenerative diseases and other physical ailments, as explained under "How You Control Your Balance." Elderly patients who suffer from dizziness, are not the same as their healthy, age-matched counter parts. In fact, symptoms of dizziness are not normal at any age and are a sign that there is something wrong.

Myth: "Your dizziness is simply a hormone imbalance."
Fact: Someone may have a hormone imbalance due to a variety of physical factors, which can cause nausea, fatigue, or "hot flashes", but a hormone imbalance per se does not usually result in symptoms of dizziness.

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Help is available

The dizziness, lightheadedness, unsteadiness or vertigo sensations you may feel are very real. Specific causes can be identified with an appropriate medical evaluation and tests conducted by a qualified clinician. The great news is that, once identified, most dizziness disorders can be successfully treated.

If you are suffering from dizziness or vertigo, it is important that you seek out medical professionals who are qualified in this area. There are specialists who are equipped to conduct the necessary medical tests to determine the cause of your dizziness and prescribe the best treatment for you. A listing of clinicians is included on this web site, as well as a list of additional resources.

If your doctor would like more information about dizziness disorders, we refer him or her to our clinical web site, www.onbalance.com.

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