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DIZZINESS - VERTIGO

What is Dizziness ?

Dizziness is commonly used to describe any feeling of unsteadiness, faintness or light-headedness. Dizziness may be a symptom of stress, anxiety or over-breathing, (hyperventilation). Most people will have felt dizzy at some time in their lives and it rarely suggests a serious disorder, although the symptom can be very unpleasant and disabling. People may use the term dizziness to describe the feeling just before fainting. This usually indicates that the blood pressure is falling. This is a common experience in warm or crowded places such as restaurants, or on standing up too quickly, or when something unpleasant is being done to the patient. Another kind of dizziness is described when people are tired or stressed or anxious. They may feel that they are not fully in touch with what is going on. The ground may feel spongy, and they may feel a bit out of control. Vertigo refers specifically to the condition where the sufferer feels he or his surroundings are moving. This feeling is often one of spinning, similar to the experience on the playground roundabout. This sensation is really an hallucination, and is often accompanied by nausea and vomiting. It can come on very suddenly and may make it impossible for the person to stand up or walk. Any movement usually makes it worse.

How does Dizziness occur ?

Vertigo is usually caused by a fault in the inner ear. The visible part of the ear concerned with hearing is mostly unaffected, but the system of fluid-filled tubes which signals movements of the head to the brain is disturbed. Often, tiny particles settle on seaweed-like hairs floating in the fluid and alter the signals these hairs transmit. In such cases, patients find that looking up, or turning to one side tends to bring on the vertigo. Keeping still allows it to settle. This is called positional vertigo. Meniere’s disease causes brief attacks of vertigo accompanied by noises, (tinnitus) and deafness. This occurs when excess fluid builds up in the inner ear.

Why does Dizziness occur ?

In many cases no cause can be found but it is assumed that a temporary disturbance of the delicate balance mechanism in the inner ear is responsible. This kind of vertigo is common after minor trauma to the head. Sometimes infections in the ear caused by viruses are responsible. Poor circulation of blood to the inner ear or even to the base of the brain may cause some cases of vertigo. It is very unusual for vertigo to indicate that the blood vessels in the neck are being compressed by worn bones in the neck, although sufferers are often told this. Dizziness or vertigo can occur as part of many diseases of the nervous system, but usually, other problems accompany the dizziness and indicate the nature of the disorder.

Treatment Involved for Dizziness

A detailed description of the problem and a careful examination should allow the doctor to decide what variety of dizziness this is and whether a cause can be identified. Occasionally, head scans (CT or MRI) showing the brain and inner ear, or specialised tests of hearing and balance are needed. Drugs to suppress the acute symptoms are useful but should not be prescribed for more than one course. Vestibular exercises help to suppress the abnormal signals which cause the symptoms and a particular movement (the Epley manoeuvre) may be carried out by a doctor to treat positional vertigo. Meniere’s disease may be treated with a low salt diet and diuretics.

During Treatment for Dizziness

Many of the drugs prescribed for treatment may cause drowsiness. It may in any case be unsafe to drive if you are dizzy. The dizziness may get worse before it gets better, and people find it very hard to go out into big open spaces or to move around in supermarkets. They should avoid alcohol.

If Dizziness is Left Untreated

Most cases of dizziness and vertigo will improve within a few days or weeks. Some however will recur, often in a milder form but lasting longer. The vertigo of Meniere’s disease tends to gradually subside, but the deafness and tinnitus may get worse.

Effects on Family of Dizziness

Most cases of vertigo are not inherited although Meniere’s disease may be. The person afflicted with vertigo may find they have lost all confidence, particularly out of doors, and may need a lot of help and encouragement to take up normal activities again. During an acute attack of vertigo, the patient should keep their head still and try to keep their eyes open.