Dizziness

Dizziness can be classified into 4 types –

1. False sense of motion or spinning motion or illusion or hallucination of movement  – Vertigo
2. Off- balance or Impaired walking due to difficulties with balance – Disequilibrium
3. Losing consciousness or blacking out – Presyncope
4. Vague symptoms possibly disconnected with environment or Dizziness which is not vertigo or presyncope or disequilibrium – Light headedness

Vertigo Causes –

• Motion sickness -Traveling by car, air or boat can all cause motion sickness. Motion sickness usually goes away when the motion stops.
• Height Vertigo – When the sensation of vertigo is triggered by heights.
• Migraine – Typically last from 4 to 72 hours and vary in frequency from daily to less than once a year. Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of your head. You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound.
• Meniere’s Disease – is an inner-ear condition with recurrent episodes of vertigo, tinnitus, hearing loss and feeling of fullness in usually one ear. It is caused by excess fluid build up in inner ear. Vertigo in this can last up-to 24 hours.
• Labyrinthitis – Swelling in inner ear and hearing nerves that usually occurs due to viral or bacterial infection which causes hearing loss, vertigo and sometimes vision problems too. Usually, it causes no serious damage. However, if left untreated can cause permanent hearing loss.
• BPPV – is a condition resulting from loose debris (otoconia) that collect within a part of the inner ear. BPPV is the most common cause of vertigo. In addition to head injury, BPPV can occur due to the degeneration of inner ear hair cells during the natural process of aging. Diagnostic examination of BPPV is Dix Hallpike manoeuvre. BPPV typically results in short episodes of vertigo that come on suddenly and last a few seconds to a few minutes. 
• Vestibular Neuritis – This is also thought to occur as a result of inflammation of the vestibular nerve, usually due to a viral infection. The hearing loss will be of sudden onset and severely incapacitating.  
• Otitis Media – Inflammation of the middle ear is called otitis media.
• Acoustic Neuroma – It is a non-cancerous tumour that may develop on vestibulocochlear nerve (8^th cranial nerve). It is also called vestibular schwannoma. Mri scan can be used for its diagnosis. Symptoms are hearing loss, vertigo, tinnitus, fullness of one ear usually.

Disequilibrium Causes –

• Peripheral Neuropathy – It occurs, as a result of damage of the nerves that carry messages to and from the brain and spinal cord to the rest of the body. The most common cause of this is diabetes. Other causes are hepatitis B, Hepatitis C, leprosy, , diptheria, HIV, shingles, lyme disease, GB syndrome, Sjogren’s syndrome, lupus, rheumatic arthritis, chronic inflammatory demylinating polyneuropathy, vasculitis, benign or malignant tumours on nerves, lymphoma, myeloma, Vitamin B group deficiency, Vitamin E deficiency, hypothyroidism, alcoholism, chronic kidney disease, lead poisoning, mercury poisoning, injuries due to motor vehicle accidents, sports injuries etc. Treatment would include treating the underlying cause of disease.
• Parkinson’s Disease – It is a neuro-degenerative disease that affects movement. It starts gradually with slight tremor in hands and stiffness of body. Most of the symptoms result from fall in dopamine levels in brain. Consult the doctor immediately when you notice tremors, loss of co-ordination and balance, changes in gait, voice, handwriting, facial expression, smelling sense, dementia.  
• Multiple sclerosis – It is a auto-immune disorder which affects brain, spinal cord and optic nerves. Its signs and symptoms vary from person to person. Symptoms commonly affect movement which results in numbness or weakness in limbs, lack of balance, numbness and tingling sensation, muscle spasms, fatigue, bowel problems, sexual dysfunction, vision problems.
• Medications– Certain medications such as, anti-seizure drugs, antidepressants, sedatives, B.P. medicines, tranquilizers can cause vertigo/disequilibrium in body.

Presyncope Causes –

• Arrythmias – It means that the heart rate or rhythm is disturbed. Alcohol abuse, smoking abuse, drug abuse, excessive coffee intake, stress, CHF, hypertension, hyperthyroidism, diabetes, etc can cause arrythmias.
• Myocardial Infarction – It means death of heart muscle due to prolonged lack of oxygen supply. Slow blood flow in a coronary artery can happen when the heart is beating very fast or the person has low blood pressure. If the demand for oxygen is greater than the supply, a heart attack can happen without formation of a blood clot. People with atherosclerosis are also more likely to have this reason for a heart attack.
• Orthostatic BP – Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position.

Light headedness causes –

• Anxiety – Occasional anxiety is an expected part of life. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The anxiety can interfere with job performance, school work, and relationships.
• Depression – Depression and anxiety can occur at the same time. It is a mood disorder characterized by prolonged feelings of sadness and loss of interest in daily activities. If these symptoms persist for a period of at least two weeks, it is considered a depressive episode.
• Low sugar levels – Hypoglycemia occurs when the level of  glucose. in your blood drops below normal. For many people with diabetes, that means a level of 70 milligrams per deciliter (mg/dL) or less. It can occur due to fasting, excessive physical activity, consuming high amount of alcohol or even, with diabetes. 
• Low iron levels – Decreased level of hemoglobin in blood can also lead to dizziness. Eating diet rich in Iron will help to combat it. In cases of severe anemia, please consult the doctor.
• Dehydration – It is a condition that can occur when the loss of body fluids, mostly water, exceeds the amount that is taken in. It can occur during high fevers, excessive sweating, diarrhea, vomiting. Severe dehydration is a medical emergency and needs immediate medical attention.