Dizziness

Dizziness is a non-specific term used to express a variety of sensations like lightheadedness, imbalance, or like the room is spinning.

Its causes range from standing up too quickly to more serious conditions—like vertigo—that merit medical treatment. Most of the time, dizziness is an acute symptom that resolves quickly and on its own, but sometimes it may signal a more serious problem.

This article discusses the symptoms and potential causes of dizziness and covers the risk factors and when to seek tests or treatment for your symptoms.

Symptoms of Dizziness

Dizzy is a subjective feeling that differs from person to person. Dizziness is most commonly described as one of the following sensations: 

• Lightheadedness
• Woozy
• Feeling like your spinning or disoriented
• Unsteady (like you are going to lose your balance)
• A swimming feeling like you need to hold onto something or concentrate while walking

Sometimes dizziness is also accompanied by:

• Clamminess
• Nausea
• Vomiting
• Paleness
• Loss of consciousness 

Types of Dizziness

The various types of dizziness are outlined below.

Vertigo

Vertigo is a subtype of dizziness characterized by a sensation of motion either of the body or the surrounding environment due to dysfunction of the vestibular system, which helps maintain balance.

Vertigo is most commonly described as the feeling of the room spinning while you’re still. There are many different subtypes of vertigo, such as:

• Vestibular neuritis
• Benign paroxysmal positional vertigo (BPPV)
• Vestibular migraine (the most common type)

The cause of your dizziness may differ depending on the subtype, but they all show some level of discord in how the brain interprets visual information about one’s position in space.

Of note, vertigo can be a medical condition in and of itself—oftentimes of unknown origin—or a symptom of an underlying medical condition such as a metabolic disorder like kidney failure, multiple sclerosis, or stroke.

Presyncope

Presyncope is that faint feeling you feel when you get up too quickly. More commonly known as lightheadedness, presyncope occurs when blood is restricted to the brain.

Disequilibrium

Disequilibrium is the feeling of unsteadiness or imbalance often associated with inner ear dysfunction, ear infections, and neuro-degenerative conditions, such as Parkinson’s disease.

Causes of Dizziness

The foremost common causes of dizziness are:

• Ear infections
• Inner ear disorders (such as benign paroxysmal positional vertigo [BPPV] and Meniere's syndrome)
• Motion sickness
• Side effects from medication 

It’s also important to note that sometimes the cause of your dizziness simply cannot be explained.

What Medications Can Cause Dizziness

Any medication that is toxic to the inner ear (ototoxic) or can precipitate an electrolyte imbalance in the body has the potential to cause dizziness.

The following medications (and their drug classes) most commonly trigger medication-induced vertigo-like symptoms:

• Analgesics (codeine)
• Antibiotics (aminoglycosides, macrolides, minocycline, nitrofurantoin, sulfamethoxazole)
• Anticonvulsants (levetiracetam, phenytoin, pregabalin)
• Anti-inflammatories (celecoxib, parecoxib, naproxen, prednisone)
• Antimalarials (mefloquine, quinine, hydroxychloroquine)
• Antivirals (oseltamivir, raltegravir)
• Anti-Parkinson’s drugs (lisuride)
• Cardiovascular drugs (nifedipine, furosemide, indapamide, prazosin, terazosin, glyceryl trinitrate, isosorbide mononitrate, sotalol, timolol)
• Gastroenterology drugs (omeprazole, lansoprazole, sucralfate)
• Rheumatology drugs (zolendronic acid, alendronate)
• Phosphodiesterase type-5 inhibitors (sildenafil, vardenafil)
• Other medicines (lithium, haloperidol, benzodiazepines, desmopressin, melatonin)
  

How to Treat Dizziness

Finding the root cause of your dizziness will determine the best course of action for you. 

• Inner-ear issues: If the cause of your dizziness is due to inner-ear issues, it can usually be well managed with medications, at-home positional exercises, or canalith positioning procedures—a special set of exercises performed by your physical therapist designed to remove inner ear crystals.
• BPPV: This can be resolved with canalith positioning procedures, a special set of exercises performed by your physical therapist designed to remove inner ear crystals. Surgery is not usually indicated. 
• Migraines: These can be treated with triptan medication, an anti-inflammatory diet, avoiding common migraine triggers, and anti-nausea medication such as Zofran ODT (ondansetron).
• Meniere’s disease: This is an inner ear disorder characterized by severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. The exact cause of Meniere's is a mystery, and there is no cure, but your symptoms may be mitigated with a low-salt diet and balancing exercises to ‘retrain’ the nervous system. Prescription drugs such as meclizine, diazepam, glycopyrrolate, and lorazepam can also help relieve dizziness and shorten the duration of your dizzy spells. In more severe cases, injections with the antibiotic gentamicin or ear surgery may be indicated.
• Panic disorder: If this is the cause of your dizziness, cognitive behavioral therapy may be helpful. Taking anti-anxiolytics and using breathing exercises may also provide added benefits if anxiety is at the root of your dizziness. 
• Electrolyte or hormonal imbalance: To help this, drinking an energy drink such as zero-sugar Gatorade or Powerade, as well as plenty of water, can reverse your chemical imbalance and dehydration, resolving your dizziness along the way. Be sure to avoid strenuous exercise and excessively hot places for additional relief.
  

Are There Tests to Diagnose the Cause of Dizziness?

Finding the root cause of your dizziness always starts with a healthcare provider taking a detailed medical history, including careful questioning about the nature of the dizziness, and a focused physical examination, which may include observing eye movements, balance and walking, positional testing, and a blood pressure check. 

To determine what might be causing your dizziness, your healthcare provider may recommend/perform one of these tests:

• CT scan or MRI of the head and neck: These imaging techniques can look for physical abnormalities or blockages that might explain the lack of blood flow to the brain, which can cause dizziness.
• Blood work: A blood test can identify electrolyte or vitamin deficiencies.
• Electronystagmography (ENG or electrooculography): This test uses electrodes to measure electrical impulses in the eye associated with nystagmus (rapid involuntary eye movement). If nystagmus does not occur upon electrical stimulation, it may indicate inner ear dysfunction.

Consult your healthcare provider if your test results are unclear or if you have any questions. After taking these exams, you should meet with your healthcare provider, who will explain the results and discuss your treatment options.

When to See a Healthcare Provider

If your symptoms of dizziness are recurrent, sudden, worsening, not going away with your typical treatments, or worrying you, seek immediate medical attention. 

If you or a loved one experiences any of the following associated symptoms, call 911, as it may be a sign of a stroke or some other life-threatening problem:

• Confusion
• Difficulty speaking or understanding others who are speaking
• Slurred speech or a hoarse voice
• Numbness or weakness in the face or extremities, especially if it’s on one side
• Tremors or clumsiness
• Vision problems, like difficulty seeing or double vision
• Unequal pupil size
• A drooping eyelid on one side
• Loss of balance or inability to stand even if holding onto a stationary object
• Inability to move one or more extremities
• Sudden or severe vomiting without known cause
• Sudden, severe headache or neck pain without known cause

Summary

Dizziness is a non-specific term used to express a variety of sensations like lightheadedness, imbalance, or like the room is spinning triggered by a range of conditions and activities, from unknown causes and standing up too fast to heart failure or inner ear disorders. 

A Word From Verywell

If you're feeling dizzy, make sure you prevent yourself from falling and injuring yourself. If your dizziness goes away, it may not be cause for concern. If your dizziness repeats, consider seeing a healthcare provider to better understand what's causing your dizziness.