Ian Purcell MD PhD Monali Patel MD Otoneurology Call 858 223 2172
Educational Resources
Patient education

Dizziness

Dizziness can mean spinning (vertigo), lightheadedness, or unsteadiness, and each points toward different causes.

At a glance

Symptoms
Spinning, lightheadedness, unsteadiness, or a floating feeling
Common causes
Inner ear disorders, migraine, blood pressure changes, medications
How it's diagnosed
Detailed history, examination, and targeted vestibular testing
Treatment
Depends on the cause: maneuvers, medication, or rehabilitation

Overview

Welcome to our neurology clinic's informational guide on dizziness. As a condition that affects many, understanding the different types and potential causes is crucial for effective management and treatment.

Dizziness is an umbrella term that describes various sensations such as feeling faint, woozy, weak, or unsteady. Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo.

Dizziness
Dizziness: Exploring the Differential Diagnoses

Types of Dizziness

  1. Vertigo: Characterized by a sensation of spinning or moving. Causes include inner ear disorders, Meniere's disease, and benign paroxysmal positional vertigo (BPPV).
  2. Disequilibrium: A sense of imbalance or unsteadiness, often without spinning. It can be due to conditions affecting the inner ear, brain, sensory nerve pathways, or muscles.
  3. Presyncope (Near-fainting): The feeling of lightheadedness or weakness that may lead to fainting, often cardiovascular in origin.
  4. Lightheadedness: A vague, floating sensation possibly related to psychological factors or dehydration.

Causes and risk factors

  • Inner Ear Issues: Many cases of dizziness are caused by problems within the inner ear, which plays a crucial role in maintaining balance.
  • Neurological Disorders: Conditions like Parkinson's disease, multiple sclerosis, or migraines can lead to dizziness.
  • Cardiovascular Conditions: Blood circulation issues such as low blood pressure, arrhythmias, or carotid artery disease can cause dizziness.
  • Medications: Some medications can have side effects that include dizziness or balance problems.
  • Anxiety or Stress: Psychological factors can contribute to sensations of dizziness or lightheadedness.

Diagnosis

Our clinic employs a comprehensive approach to diagnose the cause of dizziness, which may include:

  • Patient History: Understanding the specific characteristics of your dizziness, triggers, duration, and associated symptoms.
  • Physical Examination: Focusing on the neurological and vestibular systems.
  • Diagnostic Tests: Such as blood tests, hearing examinations, balance tests, and imaging studies to pinpoint the underlying cause.

Treatment

Treatment strategies are tailored to the underlying cause of dizziness and may include:

  • Medication: To address specific causes such as inner ear infections, Meniere's disease, or migraines.
  • Physical Therapy: Vestibular rehabilitation is particularly effective for certain types of balance disorders.
  • Lifestyle Modifications: Including hydration, diet changes, and activity adjustments to manage symptoms.
  • Surgery: In rare cases, surgical intervention may be necessary to treat underlying issues causing dizziness.

Testing that can help

Testing is chosen from your history and examination. These are the tests most often used here.

DizzyDoctor Vertigo Recording GogglesHigh-resolution infrared video goggles used to document eye movements during dizziness and positional vertigo evaluation.Videonystagmography (VNG)A comprehensive eye-movement test battery used to evaluate vestibular and oculomotor function.Computerized Dynamic Posturography (CDP)Balance platform testing that measures how vision, vestibular input, and body sensation contribute to postural control.
Specialty care: Vestibular DisordersVestibular disorders encompass a range of conditions affecting the vestibular system, which is crucial for maintaining balance and spatial orientation.Benign Paroxysmal Positional Vertigo (BPPV)Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo: brief spinning set off by changes in head position, caused by loose crystals in the inner ear.Vestibular MigraineVestibular migraine is a common cause of recurrent vertigo, in which migraine affects the balance system, with or without a headache.Orthostatic HypotensionOrthostatic hypotension is a drop in blood pressure on standing that can cause lightheadedness, blurred vision, or fainting.

When to seek urgent care

Call 911 or go to the nearest emergency department if dizziness or imbalance starts suddenly together with any of the following, since these can be signs of a stroke or another emergency:

  • Weakness or numbness of the face, arm, or leg, especially on one side
  • Trouble speaking or understanding speech
  • Double vision or sudden loss of vision
  • A sudden, severe headache
  • Inability to walk or stand
  • Chest pain, fainting, or a seizure

Further reading

This article is for general education and does not replace a medical evaluation. Testing and treatment are chosen for each patient after a full history and examination.