Suddenly the room slowly starts to spin, the floor seems to slip out from under your feet, and your head feels like a heavy emptiness that makes you want to sit down right where you are. The word "dizziness" hides at least several different conditions, and which one is yours determines who to see and what to check.
One Word — Different Sensations
Dizziness is one of the most common and at the same time most challenging complaints for a doctor, because it can be a symptom of a wide variety of diseases: neurological and psychiatric, cardiovascular diseases, certain blood disorders, and diseases of the eyes and ear. That is why the first diagnostic task is to clarify the nature of the complaint. Specialists usually classify it into one of four clinical types.
- Systemic, or vestibular, dizziness — a sensation of rotation, falling, tilting, or swaying of one's own body or surrounding objects. It is often accompanied by nausea, vomiting, increased sweating, impaired hearing and balance, as well as oscillopsia.
- Presyncope — nausea, gradual faintness, and "lightness" in the head, often with pale skin, rapid heartbeat, darkening of vision, and increased sweating. The most common causes are subclavian steal syndrome, heart disease, and orthostatic hypotension.
- Balance disturbance — unsteadiness, instability when walking, a "drunken" gait, sometimes together with paresis, reduced sensation, and discoordination. Such manifestations occur during walking and are absent in lying and sitting positions.
- Psychogenic dizziness — hard-to-describe sensations that do not correspond to other types: "fog," "heaviness" in the head, a feeling of intoxication, nausea. It is most often observed in anxiety, conversion disorders, or depression.
Most Common Causes
The most common cause of vertigo is problems of the inner ear that affect balance. Among them are benign paroxysmal positional vertigo (BPPV), when specific head movements trigger an attack; labyrinthitis — an infection of the inner ear caused by a cold or flu virus; vestibular neuritis — inflammation of the vestibular nerve; Meniere's disease — a rare condition of the inner ear that is sometimes accompanied by ringing in the ear (tinnitus) or hearing loss. Other causes of vertigo are migraine and certain medications, whose side effects can be checked in the instructions. Sometimes the cause remains unknown.
Dizziness often resolves after treatment of another condition. Among such causes are ear infection, migraine, dehydration or heat exhaustion, stress or anxiety, low blood sugar due to diabetes, iron-deficiency anemia, and motion sickness in transport.
If you feel dizzy when standing up abruptly from a sitting or lying position, the likely cause is a sudden drop in blood pressure (orthostatic hypotension). If the feeling of unsteadiness is accompanied by hearing loss and ringing in the ears, this points to inner ear problems. And unsteadiness or a sensation of rotation with nausea, sometimes after a cold or flu, occurs with labyrinthitis.
What the Doctor Will Ask and What They Will Check
During the appointment, the doctor will ask about your symptoms to determine the possible cause. A simple test may be performed — a quick transition from a sitting to a lying position to check balance, which may provoke symptoms. If needed, you will be referred to a specialist for further examinations. In the case of vertigo, the doctor will also assess whether it is caused by an infection and, if necessary, prescribe treatment or exercises to correct balance — the specific approach is determined by the doctor.
When to Call an Ambulance Immediately
Call an ambulance immediately — 103 or 112 — if dizziness is accompanied by double vision or vision loss, hearing loss, speech impairment, weakness, numbness, or tingling in an arm or leg. Likewise, call an ambulance right away for a person who cannot be woken up.
If vertigo is accompanied by a severe headache, severe nausea or vomiting, a very high temperature, or a feeling of heat, cold, or chills, this is a reason to seek emergency care the same day. If dizziness does not go away or returns, you find it harder to hear, ringing in the ears appears, or other symptoms occur, this is a reason to make a routine appointment with your family doctor.
During dizziness, do not drive, do not climb a ladder, and do not operate dangerous machinery.
This material is for reference and does not replace a doctor's consultation — you can figure out which type of dizziness is yours together with a specialist.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer