Dizziness and Lightheadedness are increasingly common symptoms nowadays. The factors causing these symptoms are varied and can stem from many complex diseases. Dizziness symptoms are divided into 2 types:
- Dizziness refers to a broad range of symptoms from lightheadedness to vertigo and spinning sensations. It is a nonspecific symptom that can result from various diseases such as circulatory system disorders, neurological diseases, anemia, etc.
- Vertigo specifically refers to the sensation of spinning or swaying.
When a patient presents with dizziness, the hospital must clearly ask about the history to understand what the patient means, as some patients may refer to dizziness (Dizziness) or may mean lightheadedness as if about to faint, or even headache caused by stress, which can also be described as dizziness.
Patients with dizziness often experience mild to severe lightheadedness without a spinning sensation. This dizziness can be caused by various factors such as postural hypotension, near syncope, hyperventilation. Elderly patients with dizziness often have abnormalities in multiple sensory systems related to balance called Multiple Sensory Deficits, including decreased vision, impaired hearing, and proprioception abnormalities. These patients often experience dizziness especially when walking or balancing.
Vertigo or spinning sensation (Vertigo) occurs due to abnormal perception of body movement. It may be a feeling that oneself is moving abnormally or that the environment is abnormal. Generally, patients describe seeing the surroundings tilt or spin, or themselves spinning around. Sometimes there is a swaying sensation like being on a boat, with vertigo and seeing the floor or ceiling spin, commonly called “spinning dizziness.” It usually lasts briefly when moving the head (bending up-down, turning left-right). Nausea and vomiting may accompany. Symptoms improve when sitting upright or lying still. Some patients may have unsteady gait, nystagmus, or severe vertigo that makes sitting up and walking impossible.
Causes of Dizziness
This abnormality can arise from disorders of the peripheral balance system (inner ear and vestibular nerve) or the central nervous system balance system.
- Displaced otoliths in the inner ear or positional vertigo (Benign Paroxysmal Positional Vertigo: BPPV) is the most common cause of vertigo. This disease results from degeneration of the inner ear, mostly found in the elderly. The characteristic symptom is sudden vertigo occurring when changing head position, such as lying down, getting up, looking up, or bending down to pick something up. The symptoms usually last only a few seconds during head movement and then gradually subside. Patients with this condition do not have hearing loss, tinnitus, or neurological symptoms such as limb numbness or weakness (except in those with pre-existing ear diseases).
- Abnormal inner ear fluid or Meniere’s disease is caused by an unknown abnormality of the inner ear fluid, leading to severe spinning vertigo accompanied by nausea, vomiting, and loss of body balance, causing easy falls. Vertigo episodes can last from minutes to several hours. During attacks, patients should remain still and avoid head movements to prevent worsening vertigo. Patients may also experience hearing loss and tinnitus, and sometimes ear fullness.
- Other causes
- Labyrinthitis is inflammation of the inner ear caused by viral infection. Patients often have a history of cold or respiratory infection. If the virus spreads to the inner ear and nerves, it causes inflammation leading to severe vertigo lasting several days. Hearing is usually normal. Bacterial labyrinthitis, often seen in patients with middle ear infections or chronic ear disease, causes more severe symptoms and hearing loss.
- Acoustic Neuroma is a tumor of the vestibular or auditory nerve. Patients experience vertigo with hearing loss and sometimes tinnitus. Large untreated tumors may cause facial numbness, facial paralysis, unsteady gait, or other brain symptoms due to tumor pressure on the brain.
- Vestibular Neuronitis causes severe vertigo lasting days to weeks but does not affect hearing. Patients maintain normal hearing.
- Temporal Bone Fracture
- Vertebra-Basilar Insufficiency
Other Symptoms Associated with Dizziness
- Nausea, vomiting, runny nose, tearing
- Paleness
- Increased blood pressure
- Headache
Treatment of Vertigo and Spinning Sensation
- Try not to lie flat on the floor but elevate the head slightly to help relieve vertigo better.
- When vertigo or spinning sensation begins, move cautiously and slowly to prevent falls.
- Avoid positions that trigger dizziness during attacks, such as rapid head turning, sudden posture changes, or full neck bending and turning.
- Reduce or stop smoking and coffee consumption.
- Avoid triggers that cause dizziness such as stress, anxiety, allergens, and insufficient rest.
- Avoid situations with a high risk of accidents, such as driving while symptomatic or climbing at heights.
See a doctor for further examination if you have these symptoms
- Increasing severity of nausea or vomiting
- Moderate to severe dehydration
- Loss of consciousness
- No improvement within 1 week
- Frequent or severe symptoms
Doctors will consider treatment based on the cause of vertigo, with treatment approaches varying. The doctor will determine the appropriate treatment for each patient.
