“Dizziness” is a symptom that almost everyone has experienced at some point. The overall characteristic of this symptom is feeling lightheaded, confused, a floating sensation, unsteady or unstable, commonly referred to as “vertigo”. It may also be accompanied by faintness. Dizziness can occur in all ages and genders but is more common in the elderly. Some people may consider these symptoms normal and something anyone can experience, but sometimes dizziness can be an early warning sign of other diseases as well.
Why do we feel dizzy?
Dr. Dolchit Taweechotphat, an otolaryngology specialist at Phyathai 2 Hospital, explained that dizziness is a common symptom. Generally, it means feeling mentally foggy or unclear, as if covered by a thin cloud, similar to being sleep-deprived, resulting in reduced ability to work or perform activities fully. This is combined with decreased sensory perception in vision, hearing, and balance, mainly caused by the following:
- The visual nervous system (or the oculomotor system) does not correspond with rapid movement conditions such as when a car is moving fast or following fast-moving objects.
- The sensory nervous system from various systems is abnormal such as standing near a very large cliff or experiencing acrophobia (fear of heights).
- The central nervous system’s nerve signal reception such as central nerves being suppressed by sleeping pills, alcohol consumption, sleep deprivation, stress, anxiety, fear, or physical diseases affecting the brain including nutritional deficiencies, abnormal blood sugar levels (high or low), hyperthyroidism, heart disease, chronic lung disease, etc.
Symptoms depend on the underlying disease!
Dr. Dolchit Taweechotphat provided information that generally, human balance is maintained by the coordinated function of three important organs: the eyes, the sensory nervous system, and the inner ear, with the brain as the control center managing and coordinating these functions to maintain balance. For example, when walking on the street, the eyes observe the surroundings to provide information to the brain on how to move. The sensory nervous system senses the movement of the legs, and the inner ear adjusts balance according to the earth’s gravity to prevent staggering. Everything works in harmony, but if this balance is disrupted, it will cause “dizziness”, which can be divided into two groups:
- The group with lightheadedness, meaning “feeling dizzy only” without vertigo or spinning sensations of the surroundings. They feel slightly confused, light, and may faint easily. This type of dizziness is caused by insufficient blood pressure and blood volume supplying the brain. It is common in the elderly or those with underlying diseases affecting the circulatory system such as heart disease, hypertension, or diabetes. These symptoms worsen if left untreated.
- The group with illusions of movement where the person feels that everything around them is spinning while they remain still, similar to being drunk. This causes loss of balance, difficulty walking, and nausea or vomiting. This type of dizziness is caused by abnormalities in the inner ear, which controls balance and equilibrium in the body, such as inner ear stones, unequal inner ear fluid pressure, or deep inner ear infections. Doctors call this condition Vertigo.
5 Important Diseases… Causes of ‘Dizziness’
- Benign Paroxysmal Positional Vertigo (BPPV) caused by degeneration of the inner ear, commonly found in the elderly. The specific symptom is vertigo that occurs immediately when changing head position (such as lying down or bending to pick something up). The symptoms usually last a short time, only seconds when moving the head, then gradually disappear. However, patients often experience recurrent symptoms almost daily but without hearing loss, tinnitus, or neurological symptoms such as limb numbness or weakness.
- Migraine-associated dizziness Migraine is a condition where patients experience one-sided throbbing headache synchronized with the heartbeat. Sometimes, instead of the headache being the main symptom, dizziness occurs instead. It tends to come and go. During episodes, hearing ability decreases, tinnitus occurs, sensitivity to bright light, or seeing flashing lights may accompany. Sometimes it is mistaken for Meniere’s disease due to hearing loss.
- Meniere’s disease (unequal inner ear fluid) caused by abnormalities in the inner ear with unknown exact causes. Patients experience severe vertigo, nausea, vomiting, and loss of balance, often staggering or falling easily. This condition lasts a long time, causing patients to remain still to avoid worsening dizziness.
- Diseases related to the circulatory system such as hypoglycemia, anemia, or hypertension requiring multiple blood pressure medications, which can cause low blood pressure and insufficient blood supply to the brain, resulting in faintness or syncope.
- Diseases caused by stress or psychiatric disorders cause severe dizziness in confined spaces, open areas, heights, or crowded places, but symptoms disappear when out of these situations. Increased stress causes hyperventilation syndrome, rapid breathing, shallow breaths, numbness and coldness in hands and feet, hand cramps, dizziness, and chest tightness.
Questions to Identify… The Cause of Dizziness
Many people experience frequent dizziness and begin to wonder if it is more than just the symptoms they show. Dr. Dolchit advises that you should see a doctor for consultation and proper diagnosis to receive the most accurate and appropriate treatment. The questions to ask to investigate the root cause include:
- Characteristics of dizziness and lightheadedness
- Does dizziness occur suddenly with position changes such as turning the head, sitting to lying down, or lying down to sitting?
- Severity and frequency of dizziness and lightheadedness
- Do you feel that everything around you is spinning or that you are spinning around objects?
- Duration of the symptoms
- How long does each episode last?
- How often do you experience dizziness and lightheadedness?
- Factors that trigger dizziness and lightheadedness
- Factors that relieve dizziness and lightheadedness
- Are there other symptoms accompanying dizziness?
- Nausea and vomiting
- Stress
- Faintness or loss of consciousness
- Ringing in the ears
When Experiencing “Vertigo,” This Technique Helps
- Head exercises
- Bend your head forward then tilt it backward. Do this with eyes open slowly, then gradually increase speed. Do 20 times in total.
- Turn your head from one side to the other slowly, then gradually increase speed. Do 20 times in total. It is recommended to do this with eyes closed.
- Eye exercises
- Look up then look down slowly, then gradually increase speed. Do 20 times in total.
- Roll your eyes from left to right. Start slowly because doing it fast may increase dizziness. Do 20 times in total.
- Stretch your arm fully forward and focus your eyes on your index finger, then slowly bring it back to the starting position. Do this 20 times.
- Seated exercises
- Shrug your shoulders up and down 20 times while sitting.
- Turn your shoulders to the right then to the left 20 times.
- Bend forward slowly to pick up something from the floor, then slowly return to sitting upright. Repeat 20 times. You will feel stretched.
- Movement
- Walk up and down stairs with eyes open 10 times, then with eyes closed 10 times.
- Throw a small rubber ball from one hand to the other and catch it. The ball must be thrown above eye level. Do at least 10 times.
“Dizziness should be treated at the root cause by investigating through history taking, physical examination, and thorough diagnosis to improve or cure dizziness and vertigo.”
Health check-ups are another option that helps detect diseases early and plan effective treatment.
