Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness.
Dizziness is a common medical complaint, affecting 20–30% of persons.[
]
-
Vertigo is the sensation of spinning or having one's surroundings spin about them. Many people find vertigo very disturbing and often report associated nausea and vomiting.
-
Presyncope describes lightheadedness or feeling faint; the name relates to syncope, which is actually fainting.
-
Disequilibrium is the sensation of being off balance and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.
-
Non-specific dizziness such as persistent postural-perceptual dizziness may be psychiatric in origin. It is a diagnosis of exclusion and can sometimes be brought about by hyperventilation.
[
]
Mechanism and causes
Many conditions cause dizziness because multiple parts of the body are required for maintaining balance including the
inner ear,
human eye,
,
human skeleton, and the
nervous system.
Thus dizziness can be caused by a variety of problems and may reflect a focal process (such as one affecting balance or coordination) or a diffuse one (such as a toxic exposure or low
perfusion state).
Common causes of dizziness include:
-
Inadequate blood supply to the brain due to:
-
A sudden fall in blood pressure
-
Heart problems or artery blockages
-
, such as vitamin B12 deficiency anemia, iron deficiency anemia
-
Loss or distortion of vision or sensory cue
-
Standing too quickly/prolonged standing
-
Disorders of the inner ear
-
Dehydration
-
Distortion of brain/nervous function by medications such as and
-
Dysfunction of cervical proprioception
-
Side effects from other prescription drugs, such as proton-pump inhibitors
Diagnosis
Differential diagnosis
Dizziness may occur from an abnormality involving the brain (in particular the
brainstem or
cerebellum),
inner ear, eyes, heart, vascular system, fluid or blood volume, spinal cord, peripheral nerves, or body
electrolytes. Dizziness can accompany certain serious events, such as a concussion or brain bleed,
epilepsy and seizures (convulsions),
stroke, and cases of
meningitis and
encephalitis. However, the most common subcategories can be broken down as follows: 40% peripheral vestibular dysfunction, 10% central nervous system lesion, 15% psychiatric disorder, 25% presyncope/disequilibrium, and 10% nonspecific dizziness.
Some vestibular pathologies have symptoms that are comorbid with mental disorders.
While traditional medical teaching has focused on determining the cause of dizziness based on the category (such as vertigo vs. presyncope), research published in 2017 suggests that this analysis is of limited clinical utility.
Medical conditions that often have dizziness as a symptom include:
Disequilibrium
In medicine, disequilibrium refers to impaired equilibrioception that can be characterised as a sensation of impending fall or of the need to obtain external assistance for proper locomotion. It is sometimes described as a feeling of improper tilt of the floor, or as a sense of floating. This sensation can originate in the inner ear or other motion sensors, or in the central nervous system. Neurologic disorders tend to cause constant vertigo or disequilibrium and usually have other symptoms of neurologic dysfunction associated with the vertigo. Many medications used to treat seizures, depression, anxiety, and pain affect the vestibular system and the central nervous system which can cause the symptom of disequilibrium. (1990). 040990077X, Butterworths. 040990077X
See also
-
Balance disorder
-
Broken escalator phenomenon
-
Persistent postural-perceptual dizziness
-
Coriolis effect (perception)
-
Equilibrioception
-
Ideomotor phenomenon
-
Illusions of self-motion
-
Motion sickness
-
Postural orthostatic tachycardia syndrome
-
Proprioception
-
Persistent postural-perceptual dizziness
-
Seasickness
-
Spatial disorientation
-
The spins, a state of dizziness and disorientation due to intoxication
-
Vertigo
External links
