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Dizziness or Lightheadedness -Types, Causes and Alarming factors

Dizziness may signify a false sense of spinning or movement, lightheadedness, loss of balance and instability, feeling like the person is floating, or feeling woozy. Dizziness may be triggered or worsened by the change of position or movement. 


What are the possible causes of dizziness?


Dizziness may be caused by simple factors such as motion sickness or as a side effect of medication. Dizziness may also result from problems with the inner ear, which is responsible for maintaining balance. However, the most significant is when it occurs due to an underlying health condition such as poor circulation or infection.


Leading causes of dizziness:


  • Vertebrobasilar insufficiency - This dizziness occurs due to atherosclerosis of plaque buildup in blood vessels and the consequent reduction in flow. The dizziness usually starts suddenly and may recur if the person suffers from TIA or a transient stroke. This may be accompanied by the presence of headaches, different style of walking, double vision, or other signs of neurological defects.


  • Cerebellar stroke - A stroke in the cerebellum due to atherosclerosis of the supplying blood vessels can lead to sudden severe episodes of dizziness. This may be accompanied by difficulty in swallowing or walking correctly. 


  • Brain stem stroke - A blockage of blood due to atherosclerosis for the section in the blood vessels can lead to sudden and severe episodes of dizziness that may be accompanied by other sensory disturbances and difficulty swallowing and making sounds.


  • Neurological conditions - Some neurological disorders, such as Parkinson's disease and multiple sclerosis, can also cause progressive loss of balance.


  • Low blood pressure - Drop in blood pressure may result in a feeling of faintness, especially if you are sitting up or standing up too quickly. This is otherwise known as postural or orthostatic hypertension.


  • Poor blood circulation - Cardiac conditions such as cardiomyopathy, heart rhythm problems, or heart attacks may cause inadequate blood flow to your brain or inner ear, leading to a feeling of dizziness.


  • Side effects of medications - Medications such as antiseizure drugs,  antidepressants, sedatives and tranquillisers, and blood pressure lowering medications may cause fainting and dizziness. If you are experiencing fainting or dizziness from blood pressure medication, you should consult the doctor and adjust the dosage because the medicines may lower your blood pressure.


  • Anxiety disorders - Anxiety disorders and panic attacks may lead to feelings of dizziness and may be triggered by factors such as being in large open spaces or being in crowds.


  • Low blood iron levels or anaemia - Dizziness due to anaemia may be accompanied by general fatigue or weakness and pale skin.


  • Low blood sugar - Low blood sugar may be triggered in people who use insulin for diabetes, which may accompany sweating and anxiety.


  • Heat stroke and dehydration - Being active in hot weather can lead to dehydration if you don't drink enough fluids. This can become far more significant if you are on heart medications.


  • Carbon monoxide poisoning - Symptoms of carbon monoxide poisoning also include headache, upset stomach, confusion, and chest pain, usually due to under-ventilation or exposure to smoke and fumes.

Peripheral causes of dizziness:


  • Benign paroxysmal positional Vertigo or BPPV - This form is usually accompanied by a false sense of spinning or moving which is usually triggered by sudden movement. It may be accompanied by a feeling of vomiting and is considered the most common cause of vertigo. Episodes of vertigo usually happen briefly and are related to the position.


  • Viral or post-viral inflammation of the vestibules - Dizziness is usually sudden to start and severe and usually goes down over days. This is caused by a viral infection of the vestibular nerve. 


  • Meniere's disease - When excess fluid builds up in your inner ear,  it can lead to dizziness that keeps recurring and lasts several hours. It may be accompanied by a ringing sensation in the ear called tinnitus. You may also experience hearing loss that keeps coming and going or feel like your ear is plugged up.


  • Migraine - People who experience migraines may have severe headache episodes accompanied by dizziness that may last between several minutes and several hours. It may also be accompanied by light and noise sensitivity.

What are the situations in which you should take dizziness seriously?


If you have recurrent, sudden, or severe dizziness or vertigo,  it is generally advisable to visit the doctor and understand what is causing it. 


Suppose you have any other symptoms such as a sudden severe headache, pain in the chest, difficulty breathing, numbness or paralysis of arms, seeing double, feeling irregular heartbeat, confusion or difficulty in speaking, difficulty in walking, continuous vomiting, severe, or a sudden change in hearing or weakness in a part of the body or the face. In that case, this could mean the dizziness is a more serious root cause and needs immediate medical care.

DR. Alkesh Jain
Cardiac Care
Meet The Doctor
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