Dizziness (vertigo)
Dizziness changes your sense of
balance and can increase your risk of falling. There are three main
types of dizziness. The word dizzy is used to
describe everything from feeling faint or lightheaded to feeling weak or
unsteady. Dizziness that creates the sense that you or your surroundings
are spinning or moving is called vertigo.
Keeping your sense of balance depends
on your brain processing a variety of information from your eyes, your
nervous system and your ears. However, if your brain can't process
signals from all of these locations, if the messages are contradictory,
or if the sensory systems aren't functioning properly, you may
experience loss of balance.
Dizziness is the third most common
reason people over age 65 visit their doctors. Aging increases the risk
of developing any of several conditions that may cause dizziness.
Although it may be disabling and incapacitating, dizziness rarely
signals a serious, life-threatening condition.
Signs and symptoms
Characteristics
of dizziness may include:
Causes
Under normal
circumstances, your sense of balance is controlled by a number of
signals that your brain receives from several locations:
-
Eyes.
No matter what position you're in, visual signals help you determine
where your body is in space and how it's moving.
-
Sensory nerves.
These are in your skin, muscles and joints. Sensory nerves send messages
to your brain about body movements and positions.
-
Inner ear.
The organ of balance in your inner ear is the vestibular labyrinth. It
includes loop-shaped structures (semicircular canals) that contain fluid
and fine, hair-like sensors that monitor the rotation of your head. Near
the semicircular canals are the utricle and saccule, which contain tiny
particles called otoconia. These particles are
attached to sensors that help detect gravity and back-and-forth motion.
Good balance
depends on at least two of these three sensory systems working well. For
instance, closing your eyes while washing your hair in the shower
doesn't mean you'll lose your balance. Signals from your inner ear and
sensory nerves help keep you upright.
However, if your
central nervous system can't process signals from all of these
locations, if the messages are contradictory, or if the sensory systems
aren't functioning properly, you may experience loss of balance.
Dizziness may
have a number of potential causes. These may include:
Vertigo
Vertigo — the false sense of motion or spinning — is the most common
symptom of dizziness. Sitting up or moving around may make it worse.
Sometimes vertigo is severe enough to cause nausea and vomiting.
Vertigo usually
results from a problem with the nerves and the structures of the balance
mechanism in your inner ear (vestibular system), which sense movement
and changes in your head position. Abnormal rhythmic eye movements (nystagmus)
almost always accompany vertigo. Causes of vertigo may include:
-
Benign paroxysmal
positional vertigo (BPPV).
BPPV involves intense, brief episodes of dizziness associated with a
change in the position of your head, often when you turn over in bed or
sit up in the morning. It occurs when particles of calcium carbonate
crystals (otoconia) break loose and fall into the wrong part of the
canals in your inner ear. When these particles shift, they stimulate
sensors in your ear, producing an episode of vertigo. Doctors don't know
what causes BPPV, but it may be a natural result of aging. Trauma to
your head also may lead to BPPV.
-
Inflammation in the
inner ear (acute vestibular neuronitis or labyrinthitis).
Signs and symptoms of inflammation of the inner ear include sudden,
intense vertigo that may persist for several days, with nausea and
vomiting. It can be incapacitating, requiring bed rest to minimize the
signs and symptoms. Fortunately, vestibular neuronitis generally
subsides and clears up on its own. Although the cause of this condition
is unknown, it may be a viral infection.
-
Meniere's disease.
This disease involves the excessive buildup of fluid in your inner ear.
It may affect adults at any age and is characterized by sudden episodes
of vertigo lasting 30 minutes to an hour or longer. Other symptoms
include the feeling of fullness in your ear, buzzing or ringing in your
ear (tinnitus), and fluctuating hearing loss. The cause of Meniere's
disease is unknown.
-
Vestibular migraine.
The cause of vertigo may be a migraine. People who experience a
vestibular migraine are very sensitive to motion. Dizziness and vertigo
caused by a vestibular migraine may be triggered by turning your head
quickly, being in a crowded or confusing place, driving or riding in a
vehicle, or even watching movement on TV. A vestibular migraine also may
cause feelings of imbalance or unsteadiness, hearing loss, "muffled"
hearing, or ringing in your ears (tinnitus). For most people with a
vestibular migraine, vertigo doesn't happen at the same time as the
headache. In fact, migraine-associated vertigo may occur without an
actual migraine. Attacks of migrainous vertigo can last from a few
minutes to several days.
-
Acoustic neuroma.
An acoustic neuroma is a noncancerous (benign) growth on the acoustic
nerve, which connects the inner ear to your brain. Symptoms of an
acoustic neuroma may include dizziness, loss of balance, hearing loss
and tinnitus.
-
Rapid changes in
motion. Riding on a roller
coaster or in boats, cars or even airplanes may on occasion make you
dizzy.
Feeling of
faintness (presyncope)
Presyncope is the medical term for feeling faint and lightheaded
without losing consciousness. Sometimes nausea, pale skin and a sense of
dizziness accompany a feeling of faintness. Causes of presyncope
include:
-
Drop in blood
pressure (orthostatic hypotension).
A significant drop in your systolic blood pressure — the higher number
in your blood pressure reading — may result in lightheadedness or a
feeling of faintness. It can occur after sitting up or standing too
quickly.
-
Inadequate output of
blood from the heart.
Conditions such as partially blocked arteries (atherosclerosis), disease
of the heart muscle (cardiomyopathy), abnormal heart rhythm (arrhythmia)
or a decrease in blood volume may cause inadequate blood flow from your
heart.
Loss of
balance (disequilibrium)
Disequilibrium is the loss of balance or the feeling of unsteadiness
when you walk. Causes may include:
-
Inner ear
(vestibular) problems.
Abnormalities with your inner ear can cause you to feel like you are
floating, have a heavy head or seem unsteady in the dark.
-
Balance disorders.
Failing vision and nerve damage in your legs (peripheral neuropathy) are
common in older adultsand may result in difficulty maintaining your
balance.
-
Joint and muscle
problems. Muscle weakness
and osteoarthritis — the type of arthritis that involves wear and tear
of your joints — can contribute to loss of balance when it involves the
weight-bearing joints.
-
Medications.
Loss of balance can be a side effect of certain medications, such as
seizure drugs, sedatives and tranquilizers.
Lightheadedness
Feeling lightheaded is the feeling of being "spaced out" or having the
sensation of spinning inside your head. It can also give you the
sensation that if your lightheadedness worsens, you might lose
consciousness. Causes may include:
-
Vestibular disorders.
These abnormalities of your inner ear can lead to illusions of motion
and make you feel like you're floating.
-
Anxiety disorders.
Certain anxiety disorders such as panic attacks and a fear of leaving
home or being in large, open spaces (agoraphobia) may cause
lightheadedness.
-
Hyperventilation.
Abnormally rapid breathing that often accompanies anxiety disorders may
make you feel lightheaded.
Dizziness (vertigo)
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