Be Dizzy No More
What You Can Do to Reduce Dizziness
- Avoid rapid changes in position, especially from lying down to standing up or turning from one side to another.
- Avoid extremes of head motion, especially looking up, turning or twisting.
- Eliminate or decrease use of products that impair circulation, such as nicotine, caffeine and salt.
- Minimize your exposure to circumstances that cause your dizziness, such as stress and anxiety, or substances to which you are allergic.
- Avoid hazardous activities when you are dizzy, such as driving, operating dangerous equipment, climbing a ladder, etc.
September 2001 — Every year more than 2 million people see a doctor for dizziness. In men and women over age 65, dizziness is a major cause of serious falls that break bones and start a downward spiral of declining health. At any age, dizziness can be distressing, frightening and isolating.
There are many causes for dizziness. Fortunately, most can be easily treated.
"Dizziness is widely associated with the inner ear, where our balance mechanism is centered. However, a good number of patients who say they are dizzy do not have an inner ear problem. It's our job to sort out the underlying cause with a thorough history and physical examination. Once the correct diagnosis has been made, treatment is almost always easy," says otolaryngologist (ear, nose and throat doctor) Myles K. Krieger, M.D.
Yet several inner ear problems are famous for causing dizziness. Perhaps the most common is benign paroxysmal positional vertigo (BPPV), also called cupulolithiasis. This condition is caused by small particles of calcium that touch exquisitely sensitive hair cells in the inner ear. A simple procedure called the liberatory maneuver can float these particles out of the inner ear to a place where they do not stimulate hair cells. The procedure takes about 4 minutes, and patients can learn how to do it at home.
Viral labyrinthitis, an infection that irritates the inner ear, can also cause dizziness. "Treatment with meclizine or another labyrinthine sedative usually treats the symptoms while the virus gradually resolves. A sedative may also be useful when BPPV recurs during sleep so that you don't awaken with a sensation of spinning (vertigo)," says Dr. Krieger.
Vertigo may also occur with nystagmus, a rapid, jittery movement of the eyes. Many patients with nystagmus find relief by focusing on a point in the distance and staring at it for 10 seconds.
Treating Meniere's disease is more complicated. Patients with this condition not only feel dizzy, but also hear roaring noises and suffer some hearing loss. The affected ear often feels full.
"This is not their imagination. The inner ear actually swells," Dr. Krieger explains.
Meniere's can be caused by an autoimmune disease, metabolic disorder or infection, or can arise from an unknown source. Once the underlying cause has been identified, treating it can resolve the symptoms. When no specific problem can be found, the diagnosis of idiopathic Meniere's disease is made, and diuretics are given to reduce swelling. Rarely, surgery is needed to drain the inner ear.
Other causes of dizziness vary widely. People with circulation problems such as atherosclerosis or high blood pressure can feel lightheaded regularly or periodically when the brain or inner ear fails to receive an adequate blood supply.
Certain medications, stimulants such as caffeine and nicotine, too much salt in the diet, and emotional stress can lead to poor circulation and resulting dizziness. Allergies, head trauma, and certain neurological diseases can also cause dizziness.
It is important to know that almost everyone experiences dizziness at some point in their life.
"The key is that when dizziness becomes worse, occurs more frequently, or affects the person's ability to live a normal life, it may be wise to make an appointment with a physician to get a proper diagnosis and begin treatment," says Dr. Krieger. "There's no need to suffer."