Although not life threatening, frequent spells of dizziness is a condition that can significantly affect your life. A range of symptoms such as feeling weak and unsteady, lightheadedness or blackouts when rising from a sitting or lying position, feeling off balance or that you are about to faint are identified as dizziness. A common dizziness related disease is vertigo where the affected person is assailed by a sense that everything around them is spinning.
It was earlier thought that the most important causes of dizziness were low blood sugar (hypoglycemia), anemia related to kidney failure, and cancer. New research shows that many possible causes other than these conditions can lead to dizziness.
Reports suggest that 15-30 % people experience dizziness at some point in life. Around 50 % of elders above 65 years are likely to have medical conditions that cause dizziness and imbalance.
Benign paroxysmal positional vertigo (BPPV) is a spinning dizziness often triggered by a mechanical problem in the inner ear. It occurs when the calcium carbonate crystals (otoconia) embedded in the otolith organs become dislodged and move into one or more of the three fluid-filled semicircular canals.
This causes the semicircular canal to become sensitive to changes in head position. Although it may go away on its own, BPPV can be treated using a series of movements known as canalith repositioning procedure. The crystals are moved from the fluid-filled semicircular canals back into the otolith organs using several slow and simple maneuvers.
Vestibular migraine is the second most common form of vertigo and is commonly seen in women. Drugs used to prevent frequent migraine attacks and other vestibular suppressants may be used in treating the condition.
Persistent postural-perceptual dizziness (PPPD) is a chronic functional disorder of the nervous system that usually affects people in the 30-50 age group. Characterised by non-spinning vertigo, the affected person experiences a constant feeling of motion or swaying unsteadiness.
Meniere’s disease is characterized by sudden episodes of vertigo lasting several hours. It is caused by excessive build up of fluid in the inner ear. Medicines can relieve the symptoms in most patients.
Orthostatic hypotension or postural hypotension is a low blood pressure condition that happens when you stand up from sitting or lying position. The person may feel dizzy or lightheaded and might faint in some cases. Sudden blackouts and fainting can often lead to injuries.
Vestibulopathy is a condition that occurs when the balance portions of the inner ear – the peripheral vestibular system - is damaged. Depending on whether the system is damaged only in one ear or both ears, the disease is classified into unilateral and bilateral.
Viral infections of the vestibular nerve, poor blood circulation, side effects of medicines and anxiety disorders can be the reasons for dizziness. It can also be an early warning to an impending stroke or other serious medical conditions. It is best to consult your doctor if you experience recurrent, severe and unexplained dizziness or vertigo and also if the condition is accompanied by symptoms like confusion and slurred speech, severe headache, weakness, double vision etc.
Neurologists play an important role in evaluating patients complaining dizziness. The history of the patient and physical examination are crucial in defining the symptom and managing it. Most of the common forms of dizziness can be treated with medication, physical therapy and canalith repositioning procedure although a very small percentage of patients might require surgery.
(Dr P Sreeram is a senior ENT Specialist, Aster Medcity, Kochi)