By Vien Phommachanh, MD
February 23, 2014
Category: Dizziness
Tags: Vertigo   Imbalance   BPPV  

Doc, I'm dizzy. Can you help me?


Why am I dizzy? 

Unfortunately, that's complicated. There are many kinds of dizziness and many different causes. The good news is, we can help. Your brain interprets information from all the different parts of your body to coordinate your movements. It gets feedback from your arms, legs, eyes, and inner ear. Underneath it all, your brain is fueled by your heart and lungs. If any part of these is not working properly, it can result in dizziness or imbalance. 

What do I do first?

The most important thing is to make sure it's not a life-threatening condition. The other associated symptoms are very important. If you're dizzy and have accompanying symptoms such as chest pain, shortness of breath, severe headache, loss of memory, weakness in your arms or legs, or difficulty thinking, you may be having a heart attack or stroke and should seek immediate care. Otherwise, you should see an Otolaryngologist, or ENT (Ear, Nose, and Throat) doctor for evaluation. 

What is vertigo?

Vertigo is the false perception of movement, most commonly the sensation that the room is spinning. Often, this is the result of loose crystals in the inner ear. This condition is called Benign Paroxismal Positional Vertigo or BPPV. This typically will go away with time, but occasionally needs to be treated with a maneuver to reposition the crystals. Another cause can be viral infections of the inner ear. If this is the case, it can also result in hearing loss that can be permanent if not treated. It is important to seek care as soon as possible to have your hearing checked and prevent permanent hearing loss. Other causes include degenerative changes of the eye, spine, cardiovascular system, diabetes, and other musculoskeletal problems.

What should I expect?

Typically a CT or MRI of the brain is ordered to make sure there is no stroke or brain tumor. This is extremely unlikely in most circumstances. A study called a VNG is also occasionally ordered. This is a test of the function of the inner ear and coordination of movement of the eyes. This will show if anything has damaged the inner ear. If so, physical therapy can be used to rehabilitate your balance and prevent falls. 

Am I getting old?

Yes. Just kidding. Sort of. Dizziness can affect all ages, but is much more common as we age. Age-related decline in our vision, brain, muscles and bones, and general health can affect our balance. Unfortunately, in the elderly this often leads to falls that result in serious injury. Fractures of the hip or other bones can lead to significant disability, pain, and social isolation. Seeking care for dizziness or imbalance prior to significant injury is very helpful in preventing long term health consequences.