Dizziness

One in six Americans
are affected by neurological disorders

Dizziness will occur at least once in the lives of 70% of the U.S. population. According to the National Institutes of Health (NIH), over 90 million Americans (age 17 and older) have experienced a dizziness or balance problem at some point in their lives. The NIH also reports that balance disorder is one of the two most common diagnoses among short-stay hospital admissions in people over the age of 65.

Approximately 50% of all dizziness is caused by inner ear disturbances, 5% by medical problems, 5% by neurological problems, and 15% by psychological disturbances.  The remaining 25% has no known cause. Most causes of dizziness are not serious and either go away quickly on their own or are easily treated.

Dizziness: Symptoms

Dizziness is a vague term describing a variety of sensations including:

  • Lightheadedness
  • Feeling as if you might faint
  • Being unsteady
  • Losing balance
  • Feeling that either you or the room is spinning or moving (vertigo)
  • Nausea
  • Fatigue
  • Difficulty concentrating

The exact symptoms depend on the cause of the dizziness:

  • Meniere’s disease: Symptoms include recurrent, severe attacks of vertigo, deafness and ringing in the ears.
  • Benign positional vertigo (BPV): Symptoms include episodes of vertigo triggered when the person’s head is moved into specific positions.
  • Viral labyrinthitis: Symptoms include the sudden onset of severe vertigo, nausea, vomiting, and the need to remain still. It is often preceded by a cold or flu-like illness. This condition is thought to be caused by a viral infection of the inner ear.
  • Migraine: Dizziness is one of many symptoms migraneurs experience.

In rare cases, dizziness or feeling unsteady can be a sign of stroke, multiple sclerosis, seizures, a brain tumor, or bleeding in the brain. In these cases, other symptoms usually accompany the dizziness or imbalance.

Dizziness: Diagnosis

We use our eyes, feet, and inner ear to maintain balance. If one of the three systems isn’t working, dizziness and imbalance is likely to occur. Therefore, it is necessary to first determine which system is not working properly before developing a course of treatment.

You may be evaluated by both an ENT (ear, nose and throat) specialist and a neurologist. Based on your medical history and examination findings, your physicians may require further tests to complete a full evaluation.

Diagnostic tests that may be performed include:

  • Complete blood count
  • Metabolic profile with electrolytes
  • Blood pressure measurements and tests
  • Electrocardiogram (ECG)
  • Hearing tests
  • Balance tests (ENG)
  • Magnetic resonance imaging (MRI)

Dizziness: Treatment

Treatments for dizziness vary according to the cause or underlying condition:

  • A drug called betahistine, formulated to reduce the frequency and severity of attacks, may help patients with Meniere’s disease. Very rarely, in severe cases, inner ear surgery may be necessary to treat this disorder.
  • Aspirin may be prescribed for patients who experience decreased blood supply to the base of the brain.
  • Viral labyrinthitis may respond to injections of drugs such as prochlorperazine and cyclizine, which often reduce the nausea, vomiting and dizziness.

Additionally, physical therapy helps many patients improve their balance, decrease dizziness, and restore normal functioning.

Most causes of dizziness are not serious, and many get better quickly without treatment. Many people find relief simply by avoiding the activities that make them dizzy. For example, getting up slowly after sitting or lying down can help.

Dizziness: Resources

MedlinePlus
U.S. National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894

The Mayo Clinic

Massachusetts Eye and Ear Infirmary
243 Charles Street
Boston, MA 02114
Tel: 617-523-7900
TDD: 617-523-5498

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