Dizziness: Lightheadedness and Vertigo
Dizziness: Lightheadedness and Vertigo
Dizziness is a word that is often used to
describe two different feelings. It is important to know exactly what you mean
when you say "I feel dizzy," because it can help you and your doctor narrow down
the list of possible problems.
- Lightheadedness is a feeling that you are about
to faint or "pass out." Although you may feel dizzy, you do not feel as though
you or your surroundings are moving. Lightheadedness often goes away or
improves when you lie down. If lightheadedness gets worse, it can lead to a
feeling of almost fainting or a fainting spell (syncope). You
may sometimes feel nauseated or vomit when you are
- Vertigo is a feeling that you or your surroundings are
moving when there is no actual movement. You may feel as though you are
off balance, spinning, whirling, falling, or tilting. When you have
severe vertigo, you may feel very nauseated or vomit.
You may have trouble walking or standing, and you may lose your balance and
Although dizziness can occur in people of any age, it is more
common among older adults. A fear of dizziness can cause older adults to limit
their physical and social activities. Dizziness can also lead to falls and
It is common to feel lightheaded from
time to time. Brief episodes of lightheadedness are not usually the result of a serious problem. Lightheadedness often is caused by a momentary drop in blood pressure and blood flow to your
head that occurs when you get up too quickly from a seated or lying position
(orthostatic hypotension). Ongoing lightheadedness may mean you have a more serious problem that needs to be evaluated.
has many causes, including:
- Illnesses such as the
flu or colds. Home treatment of your flu and cold symptoms usually will relieve
- Vomiting, diarrhea, fevers, and other illnesses
- Very deep or rapid breathing
- Anxiety and
- The use of tobacco, alcohol, or
A more serious cause of lightheadedness is bleeding. Most of
the time, the location of the bleeding and the need to seek medical care are
obvious. But sometimes bleeding is not obvious (occult bleeding). You may have
small amounts of bleeding in your
digestive tract over days or weeks without noticing
the bleeding. When this happens, lightheadedness and fatigue may be the first
noticeable symptoms that you are losing blood. Heavy menstrual bleeding also
can cause this type of lightheadedness.
Sometimes the cause of
lightheadedness is an abnormal heart rhythm (arrhythmia),
which can cause fainting spells (syncope). Unexplained fainting spells need to
be evaluated by a doctor. You can check your heart rate by taking your pulse .
Many prescription and nonprescription
medicines can cause lightheadedness or vertigo. The
degree of lightheadedness or vertigo that a medicine causes will vary.
Vertigo occurs when there is conflict between
the signals sent to the brain by various balance- and position-sensing systems
of the body. Your brain uses input from four sensory systems to maintain your
sense of balance and orientation to your surroundings.
- Vision gives you
information about your position and motion in relationship to the rest of the
world. This is an important part of the balance mechanism and often overrides
information from the other balance-sensing systems.
- Sensory nerves in your joints allow your brain to keep track
of the position of your legs, arms, and torso. Your body is then automatically
able to make tiny changes in posture that help you maintain your balance
- Skin pressure sensation
gives you information about your body's position and motion in relationship to
- A portion of the
inner ear , called the labyrinth, which includes the semicircular canals,
contains specialized cells that detect motion and changes in position. Injury
to or diseases of the inner ear can send false signals to the brain indicating
that the balance mechanism of the inner ear (labyrinth) detects motion. If
these false signals conflict with signals from the other balance and
positioning centers of the body, vertigo may occur.
Common causes of vertigo include:
- Inner ear disorders, such as
benign paroxysmal positional vertigo (BPPV),
vestibular neuritis, or
- Injury to the ear or
- Migraine headaches, which are painful,
debilitating headaches that often occur with vertigo, nausea, vomiting, and
sensitivity to light, noise, and smell.
- Decreased blood flow
through the arteries that supply blood to the base of the brain
Less common causes of vertigo include:
- A noncancerous growth in the space behind the
- Brain tumors and cancer that has traveled
from another part of the body (metastatic).
Immediate medical attention is needed if vertigo occurs
a change in speech or vision or other loss of function. Vertigo that occurs with loss of
function in one area of the body can mean a problem in the brain, such as a
transient ischemic attack (TIA).
Alcohol and many prescription and nonprescription
medicines can cause lightheadedness or vertigo. These problems may develop
- Taking too much of a medicine (overmedicating).
- Alcohol and medicine interactions. This is a problem, especially
for older adults, who may take many medicines at the same
- Misusing or abusing a medicine or alcohol.
intoxication or the effects of withdrawal.
Check your symptoms to decide if and when you
should see a doctor.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
January 2, 2013
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