Dizziness

Introduction

Dizziness is not a disease in its own right, but a symptom that can be caused by an imbalance or disturbance in the stimuli received by the sensory organs (eyes, inner ears and sense of touch and depth) and their transmission. Dizziness can also be caused by a lack of oxygen and nutrients, intoxication, a circulatory disorder or low blood pressure in the brain itself. Mental problems or medication can also cause dizziness. In the case of dizziness, spatial orientation or balance is disturbed, and hearing and visual disturbances as well as nausea and vomiting can accompany the unpleasant disorder. The frequency of dizziness increases with age.

Symptoms

The symptoms of vertigo usually occur when a visual stimulus does not correspond with the expected movements of one's own body or the environment. This leads to an attack of vertigo, during which those affected stand or walk unsteadily and may even fall. Other symptoms of a vertigo attack include nausea, vomiting and ringing in the ears. Trembling of the eyeballs, also known as nystagmus, can also occur. Other accompanying symptoms such as headaches, visual disturbances, numbness in the legs, palpitations or irregular heartbeat, blackness before the eyes, unconsciousness, and anxious or sad mood can occur. Dizziness can be temporary or chronic.

Dizziness attacks occur spontaneously or are triggered by stimuli.
 

Course

How the dizziness progresses depends on the causes. As a rule, dizziness disappears by itself within a short time. If the dizziness persists for months or even years, there is usually an underlying psychological problem, as this type of dizziness is rarely caused by a physical illness.

Causes

Dizziness has several causes. Experts differentiate between four different forms of dizziness. In all forms of dizziness, the eyes, the deep receptors in the muscles and the organ of balance in the inner ear are stimulated by movements. The brain processes these stimuli. If the brain is unable to categorise these stimuli or if the brain is unable to do so due to a functional disorder, dizziness occurs.

Dizziness can be a normal physical reaction or a pathological one. Physical dizziness is a so-called sensory dizziness and occurs due to the body's protective mechanisms. Dizziness signals to the brain the situation of the body and at the same time a possible "danger" (for example, rapidly changing movement and acceleration on a roundabout or a ship). Pathological vertigo also occurs in the form of stimulus vertigo or lesion vertigo (as a result of an injury).

It is also possible that the brain itself no longer processes the sensory impressions correctly. This can be caused by circulatory disorders or intoxication. Mental problems can also cause dizziness.

Diagnosis

If dizziness is present, the doctor will use various tests to check the functionality of the person's vestibular system and their ability to hear. At the same time, the specialist will try to determine which form of vertigo is involved. The doctor then categorises the symptoms into the following four forms of vertigo, which can further narrow down the diagnosis depending on the duration and accompanying symptoms:

• Rotational vertigo ("it's like spinning on a merry-go-round"): This is usually caused by benign positional vertigo.
• Vertigo for seconds/threatening to faint ("as if I'm about to fall over" or blackness before the eyes"): This includes, for example, orthostatic hypotension (a regulatory disorder of blood pressure that occurs when changing to an upright position).
• Spatial unsteadiness ("strange feeling in the head, groggy, feeling of swaying"): May indicate positional vertigo, a circulatory or metabolic disorder.
• Gait instability ("staggering gait with lunges that cannot be triggered by head movements"): Caused, for example, by polyneuropathy (nerve damage as a result of blood sugar disease or high blood pressure).

Dizziness can also be triggered by visual stimuli. In this case, movement stimuli perceived by the eye and the expected acceleration of the body (e.g. big screen cinemas or flight simulators) contradict each other. Dangerous avoidable courses are rare and can be caused by acute circulatory disorders in the brain or cardiac arrhythmia.

Treatment

The type of treatment depends on the cause of the dizziness. In most cases, the dizziness disappears on its own after a while. Depending on the cause of the dizziness, medication, physiotherapy or psychotherapy can support the treatment of the dizziness. In rare cases, surgery is necessary to eliminate the dizziness.

Prevention

Dizziness cannot be prevented. If the dizziness is caused by a disease, only the disease can be treated to prevent further attacks of dizziness.