Dizziness is a term that is used to describe a wide range of symptoms. These include lightheadedness, faintness, confusion, spinning, and feeling giddy or unsteady.
What is going on in the body?
Dizziness is not a very precise term. When someone complains of dizziness, the doctor will need to know what a person means. Many people use the term "dizzy" to describe a feeling that occurs right before passing out. Others use it to describe when they feel as though they or the room is spinning. Causes range from mild to serious.
What are the signs and symptoms of the condition?
The first thing a doctor needs to know is what the person actually means by "dizzy." Other questions about the feeling of dizziness can help to determine the cause:
The person should tell the doctor about any other symptoms because these may be important, too.
- How long has it been going on?
- How often does it occur?
- Is it associated with fainting, nausea, vomiting, or confusion?
- Is it related to certain activities or body positions?
- Does the person feel as though he or she or the room is spinning?
- Is the person taking any medications or illegal drugs?
- Does the person have any other medical conditions?
- Are there any problems with movement or co-ordination?
- Are there feelings of anxiety along with the dizziness?
What are the causes and risks of the condition?
Common conditions that may cause dizziness include:
Other causes are possible as well. In some cases, no cause can be found.
- low blood pressure
- low blood sugar, or hypoglycaemia
- fear, anxiety, emotional distress, or being overheated, which commonly make people feel "woozy" or even pass out
- low oxygen or blood flow to the brain, which may happen during a stroke. This may also occur due to certain heart conditions, which may make the heart unable to pump enough blood to the brain. Low blood counts, or anaemia, may also reduce the amount of oxygen that gets to the brain.
- middle ear problems, such as labyrinthitis or Meniere's disease. These conditions cause vertigo, a type of dizziness in which a person feels that the room is spinning.
- drug use or withdrawal, such as alcohol withdrawal or marijuana use
- medications used to treat high blood pressure, coronary artery disease, seizures, infections and anxiety
- psychological conditions, such as depression and anxiety
- nervous system disorders, such as seizures, Parkinson's disease, multiple sclerosis or a brain tumour
- old age, which may cause a mild sensation of dizziness during activity
What can be done to prevent the condition?
Prevention is related to the cause. For example, dizziness from drug use or withdrawal can be prevented by avoiding the specific drug. Low blood sugar is usually only a problem in people with diabetes and can often be avoided by eating regular meals. Many causes cannot be prevented.
How is the condition diagnosed?
Diagnosing the cause of dizziness starts with a history and physical examination. This may be all that is needed to figure out the cause. In other cases, further tests may be needed.
For example, a fasting blood glucose test may be done to look for low blood sugar. Measuring the blood pressure can detect low blood pressure. A special x-ray test, called a cranial CT scan, may be done if a stroke or brain tumour is suspected. A test to measure brain waves, called an electroencephalogram or EEG, may be done if seizures are suspected. Many other tests are possible depending on the suspected cause.
What are the long-term effects of the condition?
Those who feel dizzy may injure themselves or others if they are not careful. Most long-term effects are related to the cause. For example, dizziness from low blood pressure is usually easy to correct and causes no long-term effects in many people. Dizziness due to a brain tumour may cause death.
What are the risks to others?
Dizziness is not contagious and usually poses no risk to others. However, those who are dizzy may injure others. For example, a person who becomes dizzy while driving a car may have an accident.
What are the treatments for the condition?
Treatment is directed at the cause of the dizziness.
What are the side effects of the treatments?
- Medications can reduce dizziness in some cases. Examples include antihistamines such as diphenhydramine and sedatives such as diazepam.
- Those persons with low blood pressure may need to stop taking blood pressure medication or get intravenous fluids.
- Those who have anaemia may need a blood transfusion to build up their red blood cell counts.
- Those with an infection may need antibiotics.
- If a brain tumour is the cause, a person may need surgery, chemotherapy or radiation therapy.
Side effects depend on the treatments used. All medications have possible side effects. For example, antibiotics may cause allergic reactions or stomach upset. Surgery carries a risk of bleeding and infection. Blood transfusions may cause infections or allergic reactions.
What happens after treatment for the condition?
If the cause is treated and the dizziness goes away, no further treatment may be needed. This is what usually happens, for example, when the cause is a medication and the person stops taking the medication. In others, dizziness may persist and require further treatment and monitoring.
How is the condition monitored?
Those with dizziness need to be careful, as they may injure themselves or others. People who are dizzy should not drive or engage in other possibly dangerous activity. Further monitoring depends on the cause of the dizziness. For example, those with anaemia may need a FBC blood test in the future to make sure their blood counts have returned to normal.
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request