Dizziness




For the film, see Dizziness (film).













Dizziness
暈-seal.svg
Depicting the character 暈 (dizziness) in the seal script of Ancient Chinese
Specialty ENT surgery

Dizziness is an impairment in spatial perception and stability.[1] The term dizziness is imprecise:[2] it can refer to vertigo, presyncope, disequilibrium,[3] or a non-specific feeling such as giddiness or foolishness.[4]


One can induce dizziness by engaging in disorientating activities such as spinning.




  • Vertigo is the sensation of spinning or having one's surroundings spin about them. Many people find vertigo very disturbing and often report associated nausea and vomiting. It represents about 25% of cases of occurrences of dizziness.[5]


  • Disequilibrium is the sensation of being off balance and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.


  • Presyncope is lightheadedness, muscular weakness, and feeling faint as opposed to a syncope, which is actually fainting.

  • Non-specific dizziness is often psychiatric in origin. It is a diagnosis of exclusion and can sometimes be brought about by hyperventilation.[4]


A stroke is the cause of isolated dizziness in 0.7% of people who present to the emergency department.[5]




Contents






  • 1 Classification


  • 2 Mechanism


  • 3 Diagnosis


    • 3.1 Differential diagnosis




  • 4 Epidemiology


  • 5 See also


  • 6 References


  • 7 External links





Classification


Dizziness is broken down into 4 main subtypes: vertigo (~50%), disequilibrium (less than ~15%), presyncope (less than ~15%) and lightheadedness (~10%).[6]



Mechanism


Many conditions cause dizziness because multiple parts of the body are required for maintaining balance including the inner ear, eyes, muscles, skeleton, and the nervous system.[7]


Common physiological causes of dizziness include:



  • inadequate blood supply to the brain due to:

    • a sudden fall in blood pressure[7]

    • heart problems or artery blockages[7]



  • loss or distortion of vision or visual cues[7]

  • disorders of the inner ear[7]

  • distortion of brain/nervous function by medications such as anticonvulsants and sedatives[7]

  • result of side effect from prescription drugs, including proton-pump inhibitor drugs (PPIs)[8] and Coumadin (warfarin) causing dizziness/fainting [9]



Diagnosis



Differential diagnosis


Many conditions are associated with dizziness. Dizziness can accompany certain serious events, such as a concussion or brain bleed, epilepsy and seizures (convulsions), strokes, and cases of meningitis and encephalitis. However, the most common subcategories can be broken down as follows: 40% peripheral vestibular dysfunction, 10% central nervous system lesion, 15% psychiatric disorder, 25% presyncope/disequilibrium, and 10% nonspecific dizziness.[10] Some vestibular pathologies have symptoms that are comorbid with mental disorders.[11] The medical conditions that often have dizziness as a symptom include:[10][12][7][13]



  • Benign paroxysmal positional vertigo

  • Meniere's disease

  • Labyrinthitis

  • Otitis media

  • Brain tumor

  • Acoustic neuroma

  • Motion sickness

  • Ramsay Hunt syndrome

  • Migraine

  • Multiple sclerosis

  • Pregnancy

  • Low blood pressure (hypotension)

  • Low blood oxygen content (hypoxemia)


  • Heart attack[14]

  • Iron deficiency (anemia)

  • Low blood sugar (hypoglycemia)

  • Hormonal changes (e.g. thyroid disease, menstruation, pregnancy)

  • Panic disorder

  • Hyperventilation

  • Anxiety

  • Depression

  • Age-diminished visual, balance, and perception of spatial orientation abilities



Epidemiology


About 20–30% of the population report to have experienced dizziness at some point in the previous year.[5]



See also




  • Balance disorder

  • Broken escalator phenomenon

  • Chronic subjective dizziness

  • Coriolis effect (perception)

  • Equilibrioception

  • Ideomotor phenomenon

  • Illusions of self-motion

  • Motion sickness

  • Postural orthostatic tachycardia syndrome

  • Proprioception

  • Seasickness

  • Spatial disorientation


  • The spins, a state of dizziness and disorientation due to intoxication

  • Vertigo




References





  1. ^ "dizziness" at Dorland's Medical Dictionary



  2. ^ Dizziness at the US National Library of Medicine Medical Subject Headings (MeSH)


  3. ^ Reeves, Alexander G.; Swenson, Rand S. (2008). "Chapter 14: Evaluation of the Dizzy Patient". Disorders of the Nervous System: A Primer. Dartmouth Medical School..mw-parser-output cite.citation{font-style:inherit}.mw-parser-output .citation q{quotes:"""""""'""'"}.mw-parser-output .citation .cs1-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/6/65/Lock-green.svg/9px-Lock-green.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .citation .cs1-lock-limited a,.mw-parser-output .citation .cs1-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Lock-gray-alt-2.svg/9px-Lock-gray-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .citation .cs1-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/a/aa/Lock-red-alt-2.svg/9px-Lock-red-alt-2.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/Wikisource-logo.svg/12px-Wikisource-logo.svg.png")no-repeat;background-position:right .1em center}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{font-size:100%}.mw-parser-output .cs1-maint{display:none;color:#33aa33;margin-left:0.3em}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}


  4. ^ ab Branch Jr., William T.; Barton, Jason J. S. (February 10, 2011). "Approach to the patient with dizziness". UpToDate.


  5. ^ abc Neuhauser HK, Lempert T (November 2009). "Vertigo: epidemiologic aspects" (PDF). Semin Neurol. 29 (5): 473–81. doi:10.1055/s-0029-1241043. PMID 19834858.


  6. ^ Post RE, Dickerson LM (August 2010). "Dizziness: a diagnostic approach". Am Fam Physician. 82 (4): 361–8, 369. PMID 20704166.


  7. ^ abcdefg "Dizziness and Vertigo". Merck Manual. 2009.


  8. ^ Research, Center for Drug Evaluation and. "Drug Safety and Availability – FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)". www.fda.gov. Retrieved 17 April 2018.


  9. ^ "Common Side Effects of Coumadin (Warfarin Sodium) Drug Center – RxList". rxlist.com. Retrieved 17 April 2018.


  10. ^ ab Chan Y (June 2009). "Differential diagnosis of dizziness". Curr Opin Otolaryngol Head Neck Surg. 17 (3): 200–3. doi:10.1097/MOO.0b013e32832b2594. PMID 19365263.


  11. ^ Lawson, B. D., Rupert, A. H., & Kelley, A. M. (2013). Mental Disorders Comorbid with Vestibular Pathology. Psychiatric Annals, 43(7), 324.


  12. ^ Tusa RJ (March 2009). "Dizziness". Med. Clin. North Am. 93 (2): 263–71, vii. doi:10.1016/j.mcna.2008.09.005. PMID 19272508.


  13. ^ Bronstein AM, Lempert T (2010). "Management of the patient with chronic dizziness". Restor. Neurol. Neurosci. 28 (1): 83–90. doi:10.3233/RNN-2010-0530. PMID 20086285.


  14. ^ O'Connor RE, Brady W, Brooks SC, et al. (November 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S787–817. doi:10.1161/CIRCULATIONAHA.110.971028. PMID 20956226.




External links











Classification
D



  • ICD-10: R42


  • ICD-9-CM: 780.4


  • MeSH: D004244


  • DiseasesDB: 17771
External resources


  • MedlinePlus: 003093


  • eMedicine: neuro/693



  • Dizzytimes.com Online Community for Sufferers of Vertigo and Dizziness

  • Dysautonomia Youth Network of America, Inc.









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