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Episode number: 
713
Transcript: 
Dizziness (transcript)

(Source: NIH / MedlinePlus) 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. Most causes of dizziness are not serious and either quickly get better on their own or are easily treated.

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:

  • Benign positional vertigo, a spinning feeling that occurs when you move your head
  • Labyrinthitis, a viral infection of the inner ear that usually follows a cold or flu
  • Meniere's disease, a common inner ear problem

Other causes of lightheadedness or vertigo may include:

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

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.

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.

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: 5/1/2011

Updated 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.

Source: NIH / MedlinePlus

Key Point 1

Dizziness is a vague word that can mean different things to different people.  You’d be amazed how much a good history can tell you, so a good interview must be done to find the root of the problem.

Key Point 2

Dizziness is very common.  Even though there are many effective treatments, often many people just suffer with it in silence.  It is important to work with your doctor to get a diagnosis so you can get a treatment that works.

Medline Plus

Medline Description: 

Conduct an off-site search for Dizziness from MedlinePlus.  These up-to-date search results are based on search terms specific to Second Opinion Key Points.

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