Dizziness, a common reason for adults to consult their providers, refers to a number of sensations, such as feeling faint, lightheaded, weak or unsteady.
Frequent dizzy spells or a constant sensation of dizziness can significantly diminish your quality of life. Dizziness that creates a false sense of moving or spinning around you is known as vertigo. Dizziness rarely indicates a life-threatening condition. But persistent bouts of dizziness warrant a discussion with your provider.
Be aware that dizziness can occur as a side effect of some medications, such as antidepressants, sedatives, tranquilizers and anti-seizure drugs. Even blood pressure medications, if they lower your blood pressure too much, can cause a feeling of faintness or lightheadedness. A dramatic drop in blood pressure, creating a feeling of lightheadedness, can occur from sitting up or standing too quickly. This is known as orthostatic hypotension.
Although a number of conditions can trigger dizziness or vertigo, it’s important to identify exactly what’s causing it. Short bouts of dizziness may be due to benign paroxysmal positional vertigo (BPPV). “If your vertigo only lasts for a few seconds at a time, and if it is brought on by turning your head or rolling over in bed, you most likely have BPPV, in which the crystals in your inner ear are dislodged,” said Mina Le, MD, an otolaryngologist at Hackensack Meridian Mountainside Medical Group in Hackensack, NJ. Your provider can confirm the diagnosis. The Epley maneuver, in which the head is turned from side to side to reset the inner ear crystals, is a simple and effective solution.
“If your vertigo is from middle ear fluid, you likely have trouble hearing, and it may sound like you’re underwater,” she said. Symptoms may also include pain or pressure in the affected ear. “The problem commonly begins after a head cold,” she said. “A physician can look at your eardrum to confirm this diagnosis. You will get antibiotics if it’s an acute infection, and decongestants and nasal balloon therapy if it’s chronic.”
Episodes of vertigo that can extend for several hours and are debilitating can interfere with your daily routine and may indicate Meniere’s disease. “Meniere’s disease is characterized by distinct episodes of spinning vertigo, usually with nausea and vomiting, that are accompanied by a roaring sound, a fullness in your ears and hearing loss,” Le said.
“Treatment begins with a low-salt diet, reduction of caffeine, and diuretic pills to decompress the inner ear,” Le said. “Migraines are a common concurrent diagnosis that Meniere’s patients need to address in managing the disease.”
Another source of vertigo is vestibular neuritis, an inflammation of a nerve in the inner ear. “Vestibular neuritis is a self-limited illness in which you are essentially confined to bed with severe vertigo that causes nausea and vomiting, but it improves in a few days and is gone in a few weeks,” she said. The condition typically results from a viral infection, so rest and time are appropriate treatments. Meclizine, an over-the-counter medication, can help with dizziness symptoms.
However, if your vertigo can’t be attributed to any of the above conditions and persists for days, occurring time and again, it is most likely the result of vestibular migraine, according to Le. “The first step is to identify and remove common migraine triggers such as stress, poor sleep, sensory overload and food elements such as MSG, preservatives, alcohol and caffeine. If that’s not enough, you may be started of a preventative [sic] medication,” Le said.
If you’re experiencing symptoms of dizziness or lightheadedness that have persisted over a period of weeks or longer, it’s important to consult your provider and work to determine the source of the problem. Once the cause of the condition is identified, your provider can provide guidance on appropriate treatments.