Dizziness is a term that is used to describe a wide range of symptoms. These include lightheadedness, faintness, confusion, spinning, and feeling giddy or unsteady.
Dizziness is not a very precise term. When someone complains of dizziness, the healthcare professional will need to know more exactly what the individual is experiencing. Many people use the term dizzy to describe a feeling that occurs right before passing out. Others use it to describe a feeling as though the room is spinning around - a condition known as "vertigo". The causes of dizziness range from trivial to very serious.
The first thing a healthcare professional needs to know is what the person actually means by the term dizzy
Other questions about the feeling of dizziness can help to determine the cause: How long has it been going on?How often does it occur?Is it associated with fainting, nausea, vomiting, or confusion?Is it related to certain activities or body positions?Does the person feel as though he or she or the room is spinning? Is the person taking any medications or illegal drugs?Does the person have any other medical conditions?Are there any problems with movement or coordination?Are there feelings of anxiety along with the dizziness?Is the person hyperventilating or breathing very fast and heavily?
Any other associated symptoms that the person can think of may be important and should be told to the healthcare professional.
Common conditions that may cause dizziness include the following: aging, which may cause a mild sensation of dizziness during activityanemia, a low red blood cell countbeing overheated, which commonly makes people feel "woozy" or may even cause them to pass outcongestive heart failure, a condition in which a weakened heart is unable to pump enough blood to the braindrug use or withdrawal, such as alcohol withdrawal or marijuana usefear, anxiety, or emotional distressinner ear problems, such as labyrinthitis or Meniere's disease, which can cause vertigo, a type of dizziness in which a person feels that the room is spinninglow blood pressure, especially if a person stands up too quickly low blood sugar, or hypoglycemialow oxygen or blood flow to the brain, which may happen during a strokemedications used to treat high blood pressure, coronary artery disease, seizures, infections, and anxietynervous system disorders, such as seizures, Parkinson's disease, multiple sclerosis, or a brain tumorpsychological conditions, such as depression and anxiety
Other causes are possible as well. In some cases, no cause can be found.
Prevention of dizziness is related to the cause. Some episodes can be prevented simply by sitting up first, then slowly standing, especially if an individual has been in bed for a long time with illness or surgery. Dizziness that results from drug use or withdrawal can be prevented by avoiding the specific drug. Low blood sugar can often be avoided by eating regular meals. However, many causes cannot be prevented.
Sometimes the cause of dizziness is obvious from the medical history and physical exam. In other cases, further tests may be needed. Low blood sugar can be detected with a blood test. Blood pressure should be measured both lying down and immediately after standing. The second reading should be considerably lower if the dizziness is occurring because a individual's blood pressure fails to compensate quickly enough for the change in position. This happens frequently in elderly individuals.
A special X-ray test called a cranial CT scan, may be done if a stroke or brain tumor is suspected. A test to measure brain waves, called an electroencephalogram (EEG), may be done if seizures are suspected. Many other tests are possible depending on the suspected cause.
Those who feel dizzy may injure themselves or others if they are not careful. Most long-term effects are related to the cause. For example, dizziness from low blood pressure is usually easy to correct and causes no long-term effects in many people. Dizziness due to a brain tumor may cause death.
Dizziness is not contagious and usually poses no risk to others. However, those who are dizzy may injure others. For example, a person who becomes dizzy while driving a car may have a crash.
Treatment is directed at the cause of the dizziness. Medications can reduce dizziness in some cases. Examples include antihistamines such as diphenhydramine (i.e., Benadryl) and sedatives such as diazepam (i.e., Valium).Individuals with low blood pressure may need to stop taking blood pressure medication or have the type or dose of medication changed.Those who have anemia may need a blood transfusion to build up their red blood cell counts.Those with an infection may need antibiotics.If a brain tumor is the cause, a person may need surgery, chemotherapy, or radiation therapy.
Antibiotics may cause allergic reactions or stomach upset. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic. Blood transfusions may cause infections or allergic reactions.
If the cause is treated and the dizziness goes away, no further treatment may be needed. This is usually the case if the cause is a medication and the person stops taking it. In other situations, dizziness may persist and require further treatment and monitoring.
Those with dizziness need to be careful, as they may injure themselves or others. People who are dizzy should not drive or participate in other possibly dangerous activities. Further monitoring depends on the cause of the dizziness. For example, those with anemia may need their blood counts checked to see if they have returned to normal. Any new or worsening symptoms should be reported to the healthcare professional.
Harrison's Principle of Internal Medicine, 1998, Fauci et al.