Dizziness and Vertigo

Vertigo, the feeling of spinning or whirling, and dizziness are among the most common complaints prompting a patient to visit the doctor. These symptoms affect 20 to 30% of the general population and translate into millions of hospital and doctor visits a year.

Due to the vague nature of these symptoms the possible causes are endless, ranging from benign to more serious conditions; however, making the distinction between true vertigo and other forms of dizziness or light headedness is critical. Vertigo typically points to a problem with your inner ear, especially if the sensation is triggered by sudden movement.

The sensation of vertigo is caused by a disruption in the signals between your brain and your body’s position and balance systems. Your inner ear contains specialized cells that help detect motion and changes in positions. Typically this information reinforces visual cues regarding your body’s position and movements. When there is injury or disease to the inner ear, it can send false signals that conflict with visual and positional information. As your brain tries to process these confusing signals, vertigo can occur.

Sudden attacks of vertigo are more commonly due to benign disorders of the inner ear and while bothersome, they can be less worrisome.  Viral infections of the inner ear can interfere with normal signaling, causing a sudden attack of vertigo that can last for over 24 hours. Usually, patients will have a history of recent runny nose, cough, or fever. On the other hand, short episodic attacks associated with changes in head position are suggestive of a condition called, benign paroxysmal positional vertigo. While symptoms can be debilitating, the conditional can be easily treated by a physician through series of specific physical maneuvers to reposition the components of the inner ear.

Dizziness or lightheadedness, on the other hand, could signal a heart or vascular problem. For instance, a drop in blood pressure could cause lightheadedness or a feeling of weakness. Similarly, decreased blood flow from the heart caused by various heart conditions could also cause these same symptoms.

This time of year, as the temperature begins to climb, dehydration and heat stroke are two other important causes of dizziness to remain cognizant of. In the United Sates, heat waves claim more lives, than hurricanes, floods, tornadoes, and earthquakes combined. Heat stroke occurs when the body’s temperature regulation fails or becomes overwhelmed.

The key is prevention. If possible intense physical activity should be avoided during excessively hot or humid times of day. However, if it is unavoidable it is best to slowly acclimate to the environment and drink plenty of fluids. The elderly are at higher risk for heat exhaustion due to underlying medical conditions and increased dependence on other. When temperatures are very high, spending time in an air conditioned environment can be very beneficial in preventing negative effects of heat. In fact, during heat waves, large cities will often open cooling centers to help reduce the risk of heat-related illnesses.

Overall, while dizziness is often transient and related to begin conditions, it is an important symptom to discuss with your physician. When associated with chest pain, breathing difficulty, changes in vision or speech and/or muscle weakness, dizziness could signal a more threatening condition and one should call 911 or visit an emergency room immediately.

David Samadi, MD - Medical Contributor

View posts by David Samadi, MD - Medical Contributor
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel's Medical A-Team. Learn more at roboticoncology.com. Visit Dr. Samadi's blog at SamadiMD.com. Follow Dr. Samadi on Twitter, Instagram, Pinterest, and Facebook.
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