Dizziness

Overview

There are many causes of dizziness (blood pressure, balance disorders, etc.). Dizziness can either be experienced as a non-specific feeling such as light-headedness or as the sensation of spinning, turning in circles or travelling in a lift. If you have an attack of dizziness, you should lie down, raise your legs and drink cool water.

Symptoms

Main symptoms

• Motion sickness or rotary vertigo: like riding a carousel
• Staggering vertigo: like being on a ship
• Elevator vertigo: like going up and down in a lift
• Being light-headed, feeling dizzy or giddy
• Uncertain gait / standing on shaky feet

Other symptoms

• Nausea / vomiting
• Headaches
• Ringing / buzzing in the ear (tinnitus)
• Signs of paralysis, difficulty speaking
• Field of vision “blacks out”
  

Causes and treatment

Causes

There are many causes of dizziness. The “type” of dizziness can help with the diagnosis. This list mentions the most common causes, but isn't exhaustive.

• Rotary / staggering / elevator vertigo: indicate a disorder of the balance system
  • Positional vertigo
  • Inflamed acoustic nerve (known as vestibular neuronitis)
  • Ménière's disease (disorder of the inner ear)
  • Diseases affecting the brain stem or cerebellum, or a stroke

• Being light-headed, dizzy, on shaky legs: many possible causes outside the balance system
  • Low blood pressure
  • Heart arrhythmia

Further treatment by your doctor / in hospital

As dizziness can have many causes, there are many different examinations. A clear-cut trigger can't always be identified. The cause of dizziness dictates the treatment.

Possible tests

• Neurological examinations (e.g. finger-to-nose test, walking on a line, etc.)
• ENT examinations (e.g. warm/cold water in ear, Frenzel goggles, hearing test, etc.)
• Electrocardiogram (ECG)
• Schellong test (measurement of blood pressure in lying and standing positions)
• Blood sampling (blood salt levels, number of red blood cells, etc.)
• MRI (magnetic resonance imaging)

Possible therapies

• Special reposition manoeuvres for positional vertigo (e.g. Epley manoeuvre)
• Anti-inflammatory medication for inflamed auditory nerve
• Stabilisation of blood pressure
• Medication for heart arrhythmia

What can I do myself?

• Sit or lie down during an attack of dizziness in order to avoid injuries caused by falling
• Elevate the legs
• Drink cool water
• Look straight ahead

Prevention

• Drink enough
• Regular exercise

When to see a doctor?

• Prolonged attacks of dizziness
• Frequently recurring attacks of dizziness
• Additional complaints such as severe headaches, signs of paralysis or sudden difficulty speaking
• Known prior cardiovascular disorders (e.g. atrial fibrillation)
• Previous history of a stroke

Synonyms

dizziness, vertigo, rotary vertigo, elevator vertigo, staggering vertigo, staggering, giddy, dizzy