Dizziness

Dizziness is a term that is often used to describe two different symptoms: lightheadedness and vertigo.

Light-headedness is a feeling like you might faint.

Vertigo is a feeling that you are spinning or moving, or that the the world is spinning around you. See also: Vertigo-associated disorders

Considerations

Most causes of dizziness are not serious and either quickly get better on their own or are easily treated.

Causes

Light-headedness occurs when your brain does not get enough blood. This may occur if:

  • You have a sudden drop in blood pressure
  • Your body does not have enough water (is dehydrated) because of vomiting, diarrhea, fever, and other conditions
  • You get up too quickly after sitting or lying down (this is more common in older people)

Light-headedness may also occur if you have the flu, low blood sugar, a cold, or allergies.

More serious conditions that can lead to light-headedness include:

  • Heart problems, such as a heart attack or abnormal heart beat
  • Stroke
  • Bleeding inside the body
  • Shock (extreme drop in blood pressure)

If any of these serious disorders is present, you will usually also have symptoms like chest pain, a feeling of a racing heart, loss of speech, change in vision, or other symptoms.

Vertigo may be due to:

Other causes of lightheadedness or vertigo may include:

  • Use of certain medications
  • Stroke
  • Multiple sclerosis
  • Seizures
  • Brain tumor
  • Bleeding in the brain

Home Care

If you tend to get light-headed when you stand up:

  • Avoid sudden changes in posture.
  • Get up from a lying position slowly, and stay seated for a few moments before standing.
  • When standing, make sure you have something to hold on to.

If you have vertigo, the following tips can help prevent your symptoms from becoming worse:

  • Keep still and rest when symptoms occur.
  • Avoid sudden movements or position changes.
  • Slowly increase activity.
  • You may need a cane or other help walking when you have a loss of balance during a vertigo attack.
  • Avoid bright lights, TV, and reading during a vertigo attacks, because they may make symptoms worse.

Avoid activities such as driving, operating heavy machinery, and climbing until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous.

When to Contact a Medical Professional

Call your local emergency number (such as 911) or go to an emergency room if you are dizzy and have:

  • A head injury
  • Fever over 101°F, headache, or very stiff neck
  • Seizures
  • Trouble keeping fluids down
  • Chest pain
  • Heart skipping beats
  • Shortness of breath
  • Weakness
  • Inability to move an arm or leg
  • Change in vision or speech
  • Fainting and losing alertness for more than a few minutes

Call your doctor for an appointment if you have:

  • Dizziness for the first time
  • New or worsening symptoms
  • Dizziness after taking medication
  • Hearing loss

What to Expect at Your Office Visit

Your doctor will perform a physical exam and ask questions about your medical history and symptoms, including:

  • When did your dizziness begin?
  • Does your dizziness occur when you move?
  • What other symptoms occur when you feel dizzy?
  • Are you always dizzy or does the dizziness come and go?
  • How long does the dizziness last?
  • Were you sick with a cold, flu, or other illness before the dizziness began?
  • Do you have a significant amount of stress or anxiety?

Tests that may be done include:

  • Blood pressure reading
  • ECG
  • Hearing tests
  • Balance testing (ENG)
  • MRI

Your health care provider may prescribe medications to help you feel better, including:

  • Antihistamines
  • Sedatives
  • Anti-nausea medication

Surgery may be needed if you have Meniere's disease.

Prevention

If you have a cold, the flu, or other viral illness, drink plenty of fluids to prevent getting dehydrated.

Alternative Names

Light-headedness - dizzy; Loss of balance; Vertigo

References

Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010 Aug 15;82(4):361-8, 369.

Olshaker JS. Dizziness and vertigo. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 12.

Update Date: 5/1/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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