Dizziness, Vertigo and Lightheadedness – A discussion of possible causes

shutterstock_134577920Patients present to the urgent care or medical clinic with dizziness quite frequently.  Finding the cause is sometimes challenging.  Hopefully a discussion on the topic will answer some questions if you or someone you know has dizziness/vertigo.

Dizziness:  often described as feeling that you are spinning or tiliting, or that you are about to fall or pass out.  Dizziness can also cause you to feel light headed or have difficulty walking straight.

Vertigo:  A specific type of dizziness that causes a sense of spinning, dizziness, swaying or that you are moving or the world is moving around you.  Several different issues within the inner ear or brain can cause vertigo.  Some of these issues are not serious and others are more concerning.

These feelings can last days, hours or just seconds and can come and go.  It may feel worse when you change positions (roll over or stand up) or move your head.  You may also feel nauseated or vomit, have a headache and be sensitive to light or noise, have double vision, have a racing heart

Causes:  Possible causes include:

1)   Inner ear problems – infection in the vestibular system, or small pieces of calcium can cause dizziness

2)   Meniere’s disease

3)   Benign paroxysmal positional vertigo

4)   Medications

5)   Migraine headaches

6)   Stroke or TIA

7)   Bleeding in the brain

8)   Brain tumor

9)  Heart problems such as low blood pressure or a rapid heart rate

10)  Motion sickness from a boat ride or similar motion

11)  Infection such as a bladder infection (especially in the elderly

When to seek help:  Warning signs that should prompt you to speak with a medical provider include:

1)   New or severe headache

2)   Fever greater than 100.4 degrees F

3)   Trouble seeing or double vision

4)   Trouble talking or hearing

5)   Weakness of an arm or leg

6)   Inability to walk without assistance

7)   Passing out

8)   Numbness or tingling

9)   Chest pain

10)  Persistent vomiting

11)  The patient is elderly

12)  The patient has had a stroke in the past

13)  The patient has high blood pressure, diabetes or smokes

Treatment:  The treatment is tailored to the individual patient and the cause of their dizziness/vertigo.  In addition to treating the underlying cause, other treatments may include:

1)   An antihistamine such as Benadryl or meclizine

2)   Anti-nausea medications such as Phenergan or Zofran

3)   Eply maneuver:  If the problem is due to benign positional vertigo due to small stones in the inner ear being out of place.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.


I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

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