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.
What is going on in the body?
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.
What are the causes and risks of the symptom?
Common conditions that may cause dizziness include the following:
- aging, which may cause a mild sensation of dizziness during activity
- anemia, a low red blood cell count
- being overheated, which commonly makes people feel "woozy" or may even cause them to pass out
- congestive heart failure, a condition in which a weakened heart is unable to pump enough blood to the brain
- drug use or withdrawal, such as alcohol withdrawal or marijuana use
- fear, anxiety, or emotional distress
- inner 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 spinning
- low blood pressure, especially if a person stands up too quickly
- low blood sugar, or hypoglycemia
- low oxygen or blood flow to the brain, which may happen during a stroke
- medications used to treat high blood pressure, coronary artery disease, seizures, infections, and anxiety
- nervous system disorders, such as seizures, Parkinson's disease, multiple sclerosis, or a brain tumor
- psychological conditions, such as depression and anxiety
Other causes are possible as well. In some cases, no cause can be found.
What can be done to prevent the symptom?
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.
How is the symptom diagnosed?
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.
Long Term Effects
What are the long-term effects of the symptom?
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.
What are the risks to others?
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.
What are the treatments for the symptom?
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.
What are the side effects of the treatments?
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.
What happens after treatment for the symptom?
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.
How is the symptom monitored?
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.