DIZZINESS

Dr Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes

Dizziness is the feeling of being light-headed, woozy, or unbalanced. It affects the sensory organs, specifically the eyes and ears, so it can sometimes cause fainting. Dizziness is not a disease, but rather a symptom of various disorders.
Vertigo and disequilibrium may cause a feeling of dizziness, but those two terms describe different symptoms. Vertigo is characterised by a spinning sensation, as if the room is moving. It may also feel like motion sickness, or as if leaning to one side. Disequilibrium is a loss of balance or equilibrium. True dizziness is the feeling of light-headedness, or nearly fainting.

Dizziness is common, and its underlying cause usually is not serious. Occasional dizziness is not something to worry about. However, in cases of experiencing repeated episodes of dizziness for no apparent reason or for a prolonged period, then this need to be explored further with the help of a health care provider.

CAUSES OF DIZZINESS
Common causes of dizziness include a migraine, medications, and alcohol. It can also be caused by a problem in the inner ear, where balance is regulated.
Dizziness is often a result of vertigo as well. The most common cause of vertigo and vertigo-related dizziness is benign positional vertigo (BPV). This causes short-term dizziness when someone changes positions quickly, such as sitting up in bed after lying down.
Meniere’s disease can also trigger dizziness and vertigo. This causes fluid to build up in the ear with associated ear fullness, hearing loss, and tinnitus.
Another possible cause for dizziness and vertigo is an acoustic neuroma. This noncancerous tumour forms on the nerve that connects the inner ear to the brain.
Some other possible causes of dizziness include:
* Sudden drop in blood pressure
* Heart muscle disease
* Decrease in blood volume
* Anxiety disorders
* Anaemia (low iron)
* Hypoglycaemia (low blood sugar)
* Ear infection
* Dehydration
* Heat stroke
* Excessive exercise
* Motion sickness
In rare cases, multiple sclerosis, a stroke, a malignant tumour, or another brain disorder could cause dizziness.

SYMPTOMS OF DIZZINESS
People experiencing dizziness may feel various sensations, including:
* Light-headedness or feeling faint
* A false sense of spinning
* Unsteadiness
* Loss of balance
* Feeling of floating or swimming
Sometimes dizziness is accompanied by nausea, vomiting, or fainting.

WORRISOME SYMPTOMS OF DIZZINESS
* Repeated bouts of dizziness.
* Dizziness after a head injury
* Dizziness with headache
* Neck ache
* High fever
* Blurred vision
* Hearing loss
* Difficulty speaking
* Numbness or tingling
* Droopiness of the eye or mouth
* Loss of consciousness
* Chest pain
* Ongoing vomiting
These symptoms could indicate a serious health problem, so it is important to seek medical attention as soon as possible.

DIAGNOSIS
Health care providers can narrow down the cause of dizziness and any other symptoms by performing a thorough clinical history and a physical examination. They will ask you questions about the dizziness, including:
* When it occurs
* In what situations
* The severity of symptoms
* Other symptoms that occur with the dizziness
An examination of the eyes and ears, neurological physical exam, observation of posture, and performing tests to check balance are helpful during the diagnosis process. Depending on the suspected cause, an imaging test such as a CT scan or MRI might be recommended.
In some cases, no cause for dizziness is determined.

TREATMENTS FOR DIZZINESS
Treatment for dizziness focuses on the underlying cause. In most cases, home remedies and medical treatments can control the cause of dizziness. For example:
* Inner-ear issues may be managed with medications and at-home exercises that can help control balance.
* BPV can be resolved with manoeuvres that can help alleviate symptoms. Surgery is an option for patients whose BPV is not otherwise controlled.
* Meniere’s disease is treated with a healthful low-salt diet, occasional injections, or ear surgery.
* Migraines are treated with medications and lifestyle changes, such as learning to identify and avoid migraine triggers.
* Medication and anxiety-reducing techniques can help with anxiety disorders.
* Drinking plenty of fluids can help when dizziness is caused by excessive exercise, heat, or dehydration.

HOME REMIDIES
Follow these tips if experiencing recurrent bouts of dizziness:
* Sit or lie down immediately when you feel dizzy, and rest until the dizziness goes away. This can prevent the possibility of losing one’s balance, which may lead to falling and serious injury.
* Use a cane or walker for stability, if necessary.
* Always use handrails when walking up or down the stairs.
* Do activities that improve balance, such as yoga, meditation and Tai Chi.
* Avoid moving or switching positions suddenly.
* Avoid driving a car or operating heavy machinery if you frequently experience dizziness without warning.
* Avoid caffeine, alcohol, and tobacco. Using these substances may trigger dizziness or make it worse.
* Drink at least eight glass of water a day, get seven hours or more of sleep, and avoid stressful situations.
* Eat a healthful diet that consists of vegetables, fruits, and lean proteins to help prevent dizziness.
* Change medication or lower its dose if it is causing side effects of dizziness.
* Take an over-the-counter medication, such as meclizine (Antivert) or an antihistamine, for nausea along with dizziness. These medications may cause drowsiness, so do not use them when there is a need to be active or productive.
* Rest in a cool place, and drink water if the dizziness is being caused by overheating or dehydration.

PROGNOSIS
Most cases of dizziness clear up on their own once the underlying cause is treated. In rare cases, dizziness can be a sign of a more serious health problem. Dizziness may result in complications when it causes fainting or a loss of balance. This can be especially dangerous when a person is driving or operating heavy machinery. Use caution if there is a feeling of an episode of dizziness coming on.