Giddiness and dizziness describe feeling imbalanced, lightheaded, unsteady, as if you are about to faint. It is important to distinguish between feeling dizzy from experiencing vertigo. There are different causes for these types of sensations. Dizziness can be a symptom of vertigo. Vertigo is the sensation of your surrounding spinning. Both giddiness and vertigo are often accompanied by nausea or vomiting.
While giddiness can have a severe impact on the persons well-being and ability to go on about their daily lives, it is not a diagnosis, but a symptom of some other underlying condition.
The underlying condition could be just an overexertion or something serious such as stroke. Most often giddiness is caused by either neurological or innerear issues.
Some symptoms of giddiness may include:
- Feeling faint or lightheaded
- Feeling unsteady and imbalanced
- Feeling like the surrounding is moving or spinning
- Feeling woozy or heavy-headed
In addition to balance issues, some symptoms of vertigo may include :
- Motion sickness
- Tinnitus, or ringing in the ear
- Nystagmus, or an uncontrollable eye movement
It is important to note that there are two types of vertigo that can occur : peripheral and central vertigo. Peripheral vertigo is caused by an issue in the inner ear, while central vertigo is caused by a brain damage, including brain injury, stroke, tumors, or infection.
What are the causes ?
Some of the major causes of vertigo include :
- Benign Paroxysmal Positional Vertigo – one of the most frequent condition seen causes for the feeling of giddiness. The patient experiences a spinning sensation with mild to severe giddiness, It is caused by problems with the inner ear.
- Hypotension - or a low blood pressure (lower than 90 mmHg/ 60mmHg).
- Hypoglycemia – or low blood sugar (less than 70 mg/dL).
- Inner ear problems due to irritation or inflammation of the inner ear can cause balance problems and giddiness.
- Circulatory problems leading to a reduction in blood supply and, therefore, oxygen supply to all parts of the body.
- Motion sickness
- Dehydration .
- Overexertion or excessive exercise
- Head Injury – can be very serious, if the person is experiencing dizziness after a head injury they should go to the emergency room as soon as possible.
- Stroke is caused when the blood supply to the brain is disrupted.
- Neurological Problems, such as Multiple Sclerosis or Parkinson’s can manifest as giddiness
- Vestibular Neuritis and Labyrinthitis are the conditions of inflammation of nerves. Vestibular neuritis involves the vestibular nerve, while labyrinthitisis involves the inflammation of both the vestibular nerve and the cochlear nerve.
- Anxiety Disorders can elevate stress hormone called cortisol, and can impact the vestibular system function that controls imbalance
- Side Effect of Certain Medications a lot of allergy and pain medications can cause dizziness
When you should consult a doctor ?
Dizziness is not a problem in itself, but can be a symptom of an underlying health problem. When it occurs frequently or for prolonged periods of time, it is important to consult a neurologist.
Vertigo accompanied by the following symptoms prompts an appointment with a medical professional
- Drooping of the Eyes or a Mouth
- Head Injury
- Hearing Loss
- Blurred Vision
- High Fever
- Loss of Consciousness
- Numbness or Tingling
- Ongoing Vomiting
- Speech Difficulties
Usually a physical exam is first performed to determine the cause of the giddiness or dizziness.
Dizziness can often resolve on its own within a couple weeks, however, if it does not our neurologists can help find the root cause and develop a custom treatment plan that would address the symptoms as well as the underlying issue. Treatment can include medication or medical techniques.
Epley maneuver can be used for Benign Paroxysmal Positional Vertigo (BPPV). As BPPV is caused by the inner ear issue, this technique involves canaliths repositioning. Canaliths are calcium crystals that help detect motion, when the crystals detach in the semicircular canals, they may send incorrect signals to the brain causing vertigo. This technique is a series of movements that cause the crystals in the ear to be dislodged from the ear canals thus resolving vertigo. It can be done by a neurologist, an audiologist or a physical therapist.
Sometimes BPPV requires medication to be resolved. This would include anticholinergics, antihistamines or sleep aids.
Balance therapy. You may learn specific exercises to help make your balance system less sensitive to motion. This physical therapy technique called vestibular rehabilitation. It is used for people with dizziness from inner ear conditions such as vestibularneuritis.
When dizziness is caused by circulatory issues, the treatment can involve medications or procedures that help regulate heart rate. In case of tachycardia-bradycardia syndrome, when the heart rate vacillates between beating too quickly or too slowly, ablation or pacemaker implantation can resolve the giddiness.
Dizziness caused by medication requires an adjustment in the dosage or in severe cases, a change of medication altogether. This would have to be done in consultation with the treating doctor.
Simple measures such as healthyt diet and hydration are a good start for addressing giddiness.
Psychiatric and neurological conditions, such as anxiety or migraines can be addressed with medication and lifestyle changes. Stress relief and balance improvement practices such as yoga and meditation, as well as Tai Chi can also help. It is advised to avoid salt, caffeine, tobacco and alcohol as these may exacerbate dizziness symptoms.
Michael Gudleski,PA was interviewed for this article.
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