What is Dizziness?
Dizziness is not an illness. It is rather a generalised term used for various symptoms by patients, says Dr Jyoti Bala Sharma, Director – Neurology, Fortis Hospital, Noida. “Dizziness means different things to different patients. Most commonly, it is used to describe Vertigo which is the feeling that the environment around you is spinning, making one feel faint or lightheaded, as if about to collapse or being unsteady,” she explains.
Dr Charu Goel Sachdeva, HOD and Consultant – Internal Medicine, HCMCT Manipal Hospital, Dwarka describes dizziness as a “feeling of lightheadedness.” According to her, feeling dizzy can be a “floating sensation”, which could lead to imbalance.
While we all know what it is like to feel dizzy and woozy in the head, it is also important to understand the underlying causes behind these sensations. Let us find out what they are.
Benign causes
“Normal causes can be related to either your ear problem like an ear infection, or a medical condition known as benign positional vertigo where there is a change in movement and position of the head, feelings of dizziness could be experienced. Or you could be having a condition known as inner ear disease where the fluid balance in the inner ear is affected. That could lead to certain sounds in the ear, hearing loss and these could be some benign conditions that lead to dizziness,” says Dr. Sachdeva.
Apart from peripheral vertigo or dizziness caused by internal ear disturbance, Dr. Sharma discusses dizziness caused by central vertigo, which is a clinical condition, associated with the problem in the part of the brain that controls balance. According to the doctor, the condition may be accompanied by other symptoms like slurring of speech, tingling, numbness and unsteady gait etc.. Early detection and treatment of stroke with clot dissolving medicine prevents permanent disability.
Other common causes of dizziness are very high fever, hot weather, low blood sugar, side effect of certain medicines, low iron level (anaemia), drop in blood pressure when you stand up ( orthostatic hypotension) or problems with heart rate – going too fast or slow or irregular.
When should you be concerned?
While occasional dizziness may not be serious or life-threatening, constant feeling of confusion or frequent episodes of lightheadedness could mean something more concerning.
Dr. Sachdeva believes the more serious conditions associated with dizziness could be neurological, associated with symptoms such as imbalance, headache, recurrent vomiting, double vision. “These could be related to stroke, clot, hemorrhage or even tumour in the balance centers of the brain. Certain tumors like acoustic neuroma, they can also lead to dizziness,” she elaborates.
In addition, one may also experience dizzy spells due to acute dehydration, heat stroke, blood loss due to an injury and hyper bulimia associated with very low blood pressure.
Another reason why you may experience dizziness could be problems related to the heart.
Heart arrhythmias may decrease the blood flow in your brain and body, leading to various symptoms including heart palpitations, dizziness and even death. Sometimes, even acute coronary events could lead to dizziness, leading to high blood pressure and cardiac failure. Dr. Sachdeva emphasizes on observing the associated symptoms that come along with dizziness. She says, if somebody experiences dizziness accompanied with breathlessness, chest pain, alternation in their blood pressure or pulse, or any kind of sweating, it could point to a cardiological issue, which will need medical assistance. Basic checks such as MCG or MRI scans, neurological evaluation can be done to see what could be the possible cause.
Certain medications can cause dizziness too
Certain medications come with possible side effects, of which dizziness could be a common reaction.
According to Dr. Sachdeva, some medication can lead to a fall in blood pressure, which could cause dizziness, especially in the elderly population who take multiple antihypertensives. “This needs to be seen very carefully, so that these medications can be adjusted. Certain drugs, alcohol, too much coffee sometimes can cause dizziness,” she adds.
How to know if our dizziness is more serious than it seems?
“The differences depend on what the associated symptoms are,” shares Dr. Sachdeva. “Mostly, if they are benign they could be related to any ear infection or ear related problems, could be related to cervical spondylitis – and those won’t be very serious causes. If anybody is experiencing a severe dizziness which is not going away, and there are associated symptoms like vomiting, double vision, imbalance then it should be taken very seriously as medical attention needs to be given,” she explains.
“Dizziness should not be taken lightly”
Most often we overlook episodes of dizziness, which is okay because often the underlying causes are not that serious. But Dr. Sachdeva recommends monitoring the symptom – whether it is persistent, recurrent, if it has any associated symptoms including falling unconscious, disequilibrium, or headaches.
The treatment of dizziness may vary depending on the condition a person is suffering from, the doctor opines. For instance, if someone suffers from a heatstroke, they can take plenty of cool fluids, sit in shade, lie down for some time, check blood pressure and pulse. If the symptoms persist, then seeking medical attention is advised, advises the doctor.
“Sometimes simple medication may be required such as popping a certain drug might help or providing good hydration may help. If there is a heat stroke, taking cool water or resting in the shade might help. If it’s an ENT or ear related cause where the condition known is benign vertical vertigo, then certain maneuvers also help with controlling dizziness,” she explains.
Dr. Sharma believes peripheral vertigo can be managed by vestibular suppressant medicines and vestibular repositioning exercises.
As far as central vertigo is concerned, common causes involve stroke and migraine, which according to the doctor can be managed if detected early and treated with clot dissolving medicines that prevent permanent disability.
