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Dizziness

General Information for Patients


Dizziness may be due to a variety of causes and can refer to one feeling lightheaded, unbalanced, faint or even the feeling that the whole room is spinning.  Common causes for dizziness can include low blood pressure, dehydration, medication or an inner ear disturbance.

While dizziness is used to describe a number of different symptoms, a doctor will need to understand the exact nature of your symptoms and the circumstances in which they occur to give you proper medical advice.

Lightheadedness is normally a feeling of dizziness that usually goes away upon lying down. Prolonged  lightheadedness due to low blood pressure can cause fainting spells or lead to a feeling of almost fainting.

Vertigo on the other hand is characterised by the feeling that  you or your surroundings are moving. This may also be associated with a sense of imbalance and in severe cases, vertigo may be associated with nausea and vomiting. Vertigo may be short lived and mild or prolonged and severe for some hours.

If you're concerned about your condition, speak to us today.
 
 

Causes of Vertigo


Inner Ear Inflammation (Acute Vestibular Neuritis)
A symptom of inflammation of the nerve to the inner ear is the sudden onset of intense vertigo that may require you to remain in bed for several days. You will most likely experience nausea and a difficulty in maintaining your balance. If you experience sudden hearing loss as well, this condition is known as Labyrinthitis.

This condition generally subsides on its own in a few days. Medical treatment involves fluid replacement and anti-nausea medication. Steroids, given for a short time may also help recovery.  


Benign paroxysmal positioning vertigo (BPPV):
The most common cause of vertigo, BPPV is usually experienced during the night when you’re getting into bed, turning over in bed or when sitting up in the morning. BPPV is characterised by an Intense but brief period of vertigo.


Uncompensated peripheral vestibular lesion:
The inner ear balance mechanisms are known by the term vestibular. The inner ear vestibular system has connections to the central nervous system or brain. As the  inner ear lies outside the brain, encased within the bony structure of the skull, it is called peripheral vestibular.

This naming enables brain causes of dizziness or vertigo to be distinguished  from peripheral or inner ear causes. A viral infection of the inner ear nerves due to Herpes Simplex is the most common cause of acute disabling peripheral vestibular dizziness. This is associated with a sense of things spinning or moving, nausea, and sometime vomiting and marked unsteadiness.

Although very disabling almost all affected patients recover over days and weeks.  Although the inner ear may not return to normal the brain recognises any loss of function and makes appropriate changes to prevent symptoms. On occasion, with intercurrent illness or tiredness the brain may not compensate as well and a patient may develop mild intermittent symptoms. This may  includes dizziness  resulting from a moving visual scene, e.g. as a passenger in a moving car.


Phobic postural vertigo, or chronic subjective dizziness and most recently renamed; Perceptual phobic postural dizziness:
This  is a  common cause of persistent dizziness. In hospital dizziness units it may account for the second most common cause of dizziness seen. There may also be spontaneous or movement induced short lived vertigo.  The condition may arise with or without an underlying vestibular abnormality.

Symptoms may have a situational occurrence, ie they  may be an association with a busy visual environment or stress. This can lead to a fear of undertaking normal activities, hence the word “phobic”. Patients often become hypervigilant as to normal balance symptoms and seem to have reset their software balancing mechanisms into a high monitoring mode. Treatment involves ensuring there is no other abnormality, reassurance with explanation and physiotherapy to help reset the balance mechanisms.


Bilateral vestibular failure:
In this condition there is loss of inner ear function on both sides and the brain is not able to compensate as well as when  there is only partial loss of function on one side. Resulting symptoms include unsteadiness with blurred vision (oscillopsia) on head movement.  Bilateral vestibular failure most commonly arises from undefined causes but can occur with certain intravenous antibiotics (Gentamicin) and also in association with degenerative diseases of the brain.  
 

If you're concerned about your condition, speak to us today.