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Dizziness

The term dizziness is commonly used to describe two different symptoms: light-headedness and vertigo. Dizziness is one of the most common reasons for a person to seek medical care. About 10-15% of patients in day-to-day ENT practice complain of this problem.

Light-headedness

Light-headedness is a feeling as if you are about to faint or pass out. It usually occurs as a result of decreased blood supply to the brain. Some of the causes of light-headedness are:
  •     Sudden drop in blood pressure
  •     High blood pressure
  •     Dehydration as a result of vomiting, diarrhoea, fever, etc.
  •     Anxiety, stress, depression
  •     Bleeding inside the body
  •     Side-effects of certain medications (e.g., those used to control high blood pressure)
  •     Aging
  •     Menopause
  •     Prolonged bed rest
  •     Stroke
  •     Diabetes (due to very high or low blood glucose levels)
  •     Thyroid disease (too much or too little thyroid hormones can cause dizziness)
  •     Heart problems, e.g., heart attack, defective heart valve
  •     Shock (due to severe drop of blood pressure)
 
Vertigo

Vertigo is a feeling that you or your surroundings are spinning or whirling, when there is no actual movement. The feeling is similar to what you experience after getting off a merry-go-round. You may find it difficult to stand or walk, and lose balance and fall. The symptoms of vertigo appear when the central nervous system (brain and spinal cord) receives inconsistent messages from the systems that maintain the balance of the body.

Our sense of balance and orientation to surroundings is maintained by a complex interaction between the following parts of the nervous system:
  •     Inner ears
  •     Eyes
  •     Motion, position, and pressure receptors in the skin, muscles, and joints
  •     Brain and the spinal cord

Causes of vertigo are as follows:
  •     A viral infection of the inner ear (labyrinthitis) that usually occurs after a cold or flu
  •     Injury to the head that damages the inner ear
  •     A tumour affecting the part of the brain that controls movement of voluntary muscles
  •     Migraine headaches
  •     Diseases of the nerves (e.g., multiple sclerosis, syphilis) that affect balance

What are the symptoms of dizziness?
  •     Feeling of weakness and fainting
  •     Feeling that the surroundings are spinning
  •     Nausea and vomiting
  •     Difficulty walking and loss of balance
  •     Changes in vision
  •     Tiredness
  •     Sweating
  •     Headache
Self-care for dizziness
  • Stay calm and rest for a while
  • While getting up from a lying position, sit up for a few minutes till you are comfortable, and then slowly stand up
  • When standing, see to it that there is something firm that you can hold on to, as a support
Precautionary measures for dizziness

If you have a tendency to feel light-headed,
  • minimise your exposure to stressful situations that can cause dizziness
  • avoid medications that you are allergic to
  • avoid sudden and extremes of head motion or turning around from one side to the other
  • minimise the use of products such as caffeine, nicotine, alcohol, which can affect blood circulation to the brain
  • when you are stressed out, avoid activities such as climbing a ladder, driving a vehicle, operating dangerous equipment
  • Get treatment for any infections related to ear, nose, and throat, such as ear infection, cold, flu, sinus congestion, and other respiratory infections

Is dizziness a serious condition?

Dizziness is a common complaint and usually resolves without the need for medical care. However, there are a few warning signs which may indicate that there is a serious underlying problem. Seek medical care immediately if dizziness is accompanied by any of the following signs:
  • Loss of consciousness
  • Feeling dizzy on several occasions or losing alertness for more than a few minutes
  • Dizziness after a head injury
  • Inability to walk straight, weakness in the hands or legs, facial droop, or slurred speech, confusion, changes in vision (these may be signs of stroke or tumour)
  • Seizures
  • Chest: pain (a feeling of squeezing, tightness, or pressure), difficulty breathing, feeling of a pounding heart, etc
  • Fever over 101°F, vomiting, diarrhoea, headache, or very stiff neck

How is dizziness diagnosed?

The first step in finding out the cause of dizziness is to know whether the patient is experiencing light-headedness or vertigo. About 80% of the cases can be diagnosed by taking a detailed history. Questions may be asked about the circumstances that initiate a dizzy spell, associated symptoms (such as fever, nausea, vomiting), any history of head injury or infection, etc. Physical examination and laboratory investigations are done to confirm the diagnosis. The doctor may examine various body systems based on the patient’s complaints and medical history. The common tests ordered may include complete blood count, kidney function tests, thyroid function tests, etc. Other tests such as x-rays, CT scans, MRI, etc, may be indicated depending upon the patient's needs. All patients need not undergo all the tests.

What is the treatment for dizziness?

Dizziness is a symptom of an underlying disease. Treatment is directed towards the underlying cause. Dizziness or light-headedness due to dehydration may require intravenous fluids and medicines to stop vomiting and diarrhoea. Medicines will be prescribed to treat associated fever or other infection. In case of any heart problem, specialised testing and treatment may be needed. Emergency treatment will be required if there is a suspicion of a heart attack or stroke. The patient may require the care of an ENT specialist if dizziness is due to a problem in the ear. Individually tailored exercise programmes are also of considerable value in better management and accelerating full recovery in many cases.

 

 
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