| Dizziness
Patients experiencing ‘dizziness’ are many times seen by different types of professionals, including Physicians, Nurses, Audiologists, Physical and Occupational Therapists, and others. This team works together to help determine the cause of your dizziness, and the best way to treat it.
There are many different causes of dizziness, and many ways to describe dizziness. For some, the term ‘dizziness’ means a sensation of motion or spinning (called Vertigo), for others it describes a sensation of being ‘light-headed’ or nauseous. Still others use the word ‘dizzy’ to mean they feel off-balance. If you experience dizziness, the best course of action is to seek medical attention!
It is important to distinguish between these symptoms, as they each are usually caused by different problems. Vertigo (spinning dizziness) usually points to a problem of the Inner Ear (Vestibular System), the nerve that connects the Inner Ear to the Brain (Vestibulochoclear Nerve), or the Brain itself. Many times, feeling light-headed is caused by sudden drops in blood pressure, abnormal heart rhythm, or blood sugar issues. A feeling of being off-balance (Dysequilibrium) may be caused by any number of issues, and the patient needs a thorough evaluation to determine the cause.
Inflammation
Inflammation of various body structures is sometimes the culprit. For example, if someone has a cold, their sinuses may be stuffy, putting pressure on the inner ear. As the inner ear helps us balance, we may become dizzy from this added pressure. If the nerves that lead from the inner ear to the brain become inflamed, this may also cause dizziness, and sometimes tinnitus (ringing or noise in the ears).
Vestibular Neuritis
This condition is an inflammation of the Vestibular Nerve, and is the second most common peripheral vestibular disorder. It is thought to usually be the result of a viral infection. Symptoms include vertigo, nausea, vomiting, oscillopsia, and falling or veering to one side. Symptoms are aggravated with head motion. This condition begins with an acute onset; with symptoms improve over days to weeks.
BPPV "Loose Crystals"
Of the various problems that may cause vertigo, a condition called Benign Paroxysmal Positional Vertigo (BPPV) is by far the most common. Many people refer to this condition as “Loose Crystals”. To understand BPPV, one must first understand the anatomy of the inner ear. The Vestibular System (inner ear) has 2 chambers and 3 semi-circular canals. There are specialized hair cells in each chamber, and at the end of each canal. The entire system is filled with a fluid (Endolymph). As we turn, bend and move or heads, the fluid shifts and the hairs bend. When the hairs bend, and signal is sent to the brain, and depending on how far and fast they bend, the brain interprets the signals to determine which way we are moving. The hair cells in the chambers have crystals (Otoconia) glued on top of them, making them susceptible to the pull of gravity. If these crystals break free and begin to float around in the canals (where they don’t belong) it causes the hairs in the canals to bend. The brain thinks you are spinning, and wants you to see, so begins to move your eyes (Nystagmus). A person with this condition usually sees and feels the room spin whenever they pitch their head back as when looking up, sitting up or lying down, or when rolling in bed. The actual sensation of spinning usually lasts less than 1 minute after position change, although nausea may last longer. Medical professionals trained in treating BPPV usually resolve the issue in the first week of treatment. It is believed viral infections or head traumas are the most likely causes of BPPV.
Orthostatic Hypotension
Patients who have Orthostatic Hypotension will complain of feeling light headed or “woozy” during changes of position, such as lying to sitting, or sitting to standing. They typically do not get dizzy when moving in the other direction (standing to sitting, or sitting to lying). Examination includes checking the blood pressure in 3 different positions. More accurately, the examiner is looking at the change in pressure after moving into each position. (lying to sitting to standing). Drops in Systolic Blood Pressure of 20 mmHg or Diastolic drops of 10 mmHg or more within three minutes of getting up may indicate ‘Orthostatic Hypotension’. Normally when we change positions, we have a reflex of the blood vessels to keep blood in the head. If this reflex does not happen quickly enough, we lose blood pressure in the head (brain), and begin to feel dizzy (light-headed). This sensation will usually pass. Sometimes it requires treatment of Physical Therapy, or an adjustment of medications by the Physician.
Other Conditions
There are many other conditions that may also cause ‘dizziness’. Here is a list of other conditions that may cause dizziness: Acoustic Neuroma (tumors), Brainstem and Cerebellar Lesions, Cardiac Arrhythmia, Central Positional, Vertigo, Cerebellar Toxicity, Cervicogenic, Drug or Medication-Induced Dizziness, Hypoglycemia, Hypertension, Labyrinthine Infarction, Labyrinthitis, Menière’s Disease, MS, Perilymph Fistula, Psychogenic Dizziness, Ototoxicity, Vertebrobasilar Transient Ischemic Attacks (TIA’s), Vestibular Migraine.
As you can see, there are many things that may make someone feel "dizzy". Seeking medical advice is always the best course of action.
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