Seven Causes of Dizziness and Vertigo
What's going wrong?
Many people experience some form of dizziness in their lifetime. It's a common reason for a trip to the doctor. Unfortunately, there are numerous causes of dizziness and vertigo, so pinning down the culprit can be tricky.
It's helpful for the doctor to know what you mean by "dizzy." Are you talking about a sensation within yourself, or a feeling that the world around you is moving?( vertigo.) How long does the dizziness last? Does anything seem to set it off? How did the problem first present itself?
There are times it seems fun to make yourself dizzy - look how children giggle on the park roundabout, or how people queue for rides at a fairground. It's no laughing matter when you experience dizzines out of the blue, or feel "drunk" trying to carry on normal life.
This is an overview of some, but by no means all, causes of dizziness and vertigo, along with links for further information. For tips on coping with the problem, try reading Eight ways to cope when you're dizzy.
Please see your doctor for further help and diagnosis.
SEVEN CAUSES OF DIZZINESS AND VERTIGO
Inflamation of the inner ear, most often caused by a virus. Labyrinthitis sometimes follows another infection, such as a sore throat or the flu. The onset can be quite sudden and dramatic, with room-spinning vertigo and nausea or vomitting. Your sense of balance can go haywire, from having trouble walking straight, to a milder floaty feeling. It can also lead to tinnitus - ringing in the ears- and a degree of hearing loss, with a sensation of fullness or pressure in the ear. You may feel drunk or hungover without using alcohol.
The effects of the virus usually settle on their own, though this may take a while. If the infection is bacterial, treatment with antibiotics will be needed. In the short term, certain drugs can help reduce the dizzy sensation and nausea. However, dampening the dizziness makes it harder for the brain to learn how to overcome the faulty signals. Keeping as active as possible once the early stage has passed should help the compensation process. Although it may be uncomfortable, it's worth persisting with normal activities. Most people recover quickly with no lasting problems.
For those who suffer longer term difficulty, a great website is www.labyrinthitis.org.uk
How labyrinthitis develops
This condition is similar to labyrinthitis, but does not affect hearing, or lead to tinnitus. It only involves the vestibular nerve, not the auditory nerve. Again, usually attributed to a virus, though it's possible that a disruption of blood flow to the nerve could be a cause. As with labyrinthitis, it can result in permanent nerve damage, and problems with balance, which the brain will most likely learn to overcome.
For those who have difficulty recovering, and as with labyrinthitis, treatment using vestibular rehabilitation therapy (VRT) may prove useful. Referral by a doctor to a clinic specialising in VRT is recommended. There are exercises available on the internet, but having a professional show you the correct method is very useful. The wii fit balance board is an aid in rehab for balance function, and can be beneficial. It's best to start gently and build up time practising. Recovery can be a slow process, but perseverance pays.
Damage to nerves can show up during the caloric test for dizziness, though the test doesn't diagnose all inner ear conditions.
Benign Paroxysmal Positional Vertigo - BPPV
Tiny particles become misplaced in the semicircular canal of the inner ear, exaggerating response to movement. This results in short burst of vertigo, usually lasting a matter of seconds. Movement such as looking up, turning to the side, or rolling over in bed are likely to bring on symptoms.
The condition may resolve itself over time, or you could be offered treatment with a procedure to help move the particles from the area - the Epley Maneuver. This involves specific head movements, illustrated in the video below.
The Epley maneuvre
Meniere's disease usually comes in attacks of vertigo, sickness, and loss of hearing, though not everyone experiences hearing loss. Attacks can last several hours,and are of an unpredictable nature. They may come without warning, though some people have a sense that one's about to happen. Between attacks you may feel normal, or experience imbalance.
Living with such a variable condition is very difficult. Over time, the attacks may change in presentation, eventually lessening in dizziness. Often the hearing loss becomes worse. The disease has no cure at present but can generally be controlled with the aid of drugs. Reducing salt intake is also advised, as the body is sensitive to fluid levels.
Acoustic Neuroma (Vestibular Schwannoma)
A benign (non cancerous) growth on the acoustic nerve, this is a rare cause of dizziness and one-sided hearing loss. Sometimes there will also be a degree of facial numbness, and possibly tinitus. An MRI scan can diagnose this problem.
The tumour is usually slow growing, symptoms will gradually increase. It is rarely life threatening, and will not spread to other parts of the body. This can be treated, if need be, by radiotherapy or surgical removal.
Also known as orthostatic hypotension, this is a problem with blood pressure dropping when changing position, for example rising from a chair, tilting your head back, or bending to pick something up. It can cause a "headrush" type dizziness, blurred vision, and even fainting. Certain prescription drugs, including some anti-depressants and hypertension (high blood pressure) pills, may have a side effect of inducing the condition.
Postural hypotension becomes more common with age. Making sure you have enough to drink is important, to help keep blood volume sufficient. It's best to take time rising from a chair or bed, so the circulation has time to adjust. Falls in older people can be a risk. The condition should be assessed by a doctor.
Migraine Associated Vertigo - MAV
If you have a personal or family history of migraine, it's worth considering this as a cause for dizziness and vertigo. Most people think of headache when migraine is mentioned, in fact a headache is not always present. Sometimes a person has had bad headaches in the past, then think they've outgrown the problem, but it can present in a different way.
If you suspect migraine, it's worth keeping a food diary to look for triggers. Common culprits are caffeine, citrus, strong cheese, chocolate, and red wine. Some people find they are affected by certain weather conditions, such as heavy rain or storms. Flourescent lights can be a cause. Ladies may find problems worsen around the time of menstruation, as hormones can be a contributing factor.
There's no specific test for migraine, more a process of elimination . It may be worth discussing migraine preventatives, such as beta-blockers, with your doctor to use on a trial basis. If you see an improvement while on the medication, that's likely to mean migraine is the culprit.
Whatever the cause of dizziness and/or vertigo, it's an unpleasant sensation to deal with. Having a diagnosis and being able to understand what's happening is helpful. Hopefully, treatment or further advice will then be available.
It's worth noting that a person can have more than one condition causing their symptoms. For example, someone may have vestibular neuritis, and also migraine associated vertigo, or BPPV. Treating each element brings the best results.
As previously stated, the points included here are not a full list of causes. Please see a doctor for medical help.