Dizziness

(vertigo, disequilibrium, lightheadedness)

Vision, touch, hearing, the vestibular system in the inner ear, and multiple areas of the brain all contribute to helping maintain balance and orientation in space. Damage to any of these senses or areas can cause dizziness.

When dizziness occurs, its important to identify the sensation clearly. For example, with true vertigo, an illusion of motion, you feel as if you are spinning or that the room is spinning around you, it often provokes nausea and vomiting. Vertigo is most likely to arise from the vestibular portion of the inner ear, the nerve connecting the inner ear to the brain, or the brain itself. It may result from motion sickness, an inner ear infection, allergic rhinitis, high doses of certain drugs, Meniere's disease, a blow to the head, tumors, or, less commonly, multiple sclerosis.

Disequilibrium, often referred to as dizziness of the feel, is an unsteady feeling, as though you might fall. If you wear reading glasses, you may have experienced a comparable sensation after removing them quickly. The problem often stems from a neurologic abnormality, such as a degenerative nerve disorder, but use of alcohol or certain medications may also be factors.

The sensation of lightheadedness is difficult to describe precisely; most people say simply that they feel dizzy. Lightheadedness often derives from anxiety or another psychological cause. It may happen in conjunction with hyperventilation, or overbreathing; this occurs when a person breathes too rapidly or deeply, taking in more than the usual amount of oxygen and thereby upsetting the body's balance of oxygen and carbon dioxide.

Diagnostic Studies and Procedures

The extent of a diagnostic evaluation depends upon the suspected cause of the dizziness. Tests range from an ear examination, if the vestibular system of the inner ear is involved, to CT scans or MRI and other procedures, if a brain disorder is suspected.

Medical Treatments

Therapy for dizziness depends upon the underlying cause.

Nonprescription drugs such as dimenhydrinate and meclizine or prescription drugs such as scopolamine (Transderm Scop), which is administered through a skin patch usually worn behind the ear may prevent dizziness from motion sickness. Antibiotics generally take care of dizziness when it is caused by an inner ear infection.

A change in medication or dosage usually alleviates any dizziness from medication; aspirin, tranquilizers, antimalarial drugs, certain antibiotics and anti-convulsants, and anti-hypertensive drugs are common offenders. (Ringing in the ears frequently precedes such an episode of dizziness.)

In the case of Meniere's disease, prescription diuretics may reduce fluids in the labyrinth section of the ear. During an attack, prescription anti-nausea drugs may be helpful.

Surgery can sometimes cure dizziness caused by a tumor along the nerve leading from the inner ear to the brain.

Alternative Therapies

Acupressure. There are two methods used to alleviate dizziness: Apply pressure with a thumb and index finger against the inside of the eye sockets between the eyebrows. Or use a thumb to press between the first and second metatarsal bones of your foot, located about two inches in from the angle where your big and second toes meet.

Herbal Medicine. Ginger is reputed to prevent and alleviate dizziness related to motion sickness, although scientific studies have not documented this. The herb can be taken as fresh ginger tea, two to four capsules of powdered ginger, or slices of candied ginger.

Meditation and Self-Hypnosis. These and other relaxation therapies, such as visualization, can ease anxiety and the lightheadedness it may cause.

Nutrition Therapy. A very low-fat diet has helped some people with inner ear problems and Meniere's disease. Improvement has been noted within two to three weeks of reducing fat to less than 10 percent of calories and increasing intake of fruits, vegetables, and whole-grain products.

Self-Treatment

If you are prone to dizziness, avoid abrupt movements that can bring it on. Get out of bed in stages, sitting for a minute or so before standing up. Don't become overly hungry -- eat several small meals a day. Abstain from alcohol and reduce your intake of caffeine, which can promote hyperventilation. If you do hyperventilate, you can restore a normal balance of oxygen and carbon dioxide by breathing in and out of a small paper bag.

Other Causes of Dizziness

Sometimes dizziness or lightheadedness that leads to fainting is a sign of a heart rhythm disturbance, a heart valve disease, or orthostatic hypotension, a sudden drop in blood pressure when one abruptly changes positions. Vasovagal syndrome, a condition characterized by extreme sensitivity of the vagus nerve in the chest and abdomen, can also cause dizziness and fainting.