Dizziness

The sensation of ‘dizziness’ is among the most disturbing of medical symptoms and the hardest to diagnose.

Patients’ experience of dizziness varies widely from a general feeling of ‘light headedness’ faintness or weakness to a more specific sensation of vertigo.

Vertigo, most commonly experienced after disembarking from a boat or fair-ground ride, is the sensation that the world or floor continues to move. It is also known as the ‘hallucination of movement’.

Dizziness has multiple possible causes since the mechanism of balance is complex, involving parts of the body from the ear to the heart. Most commonly, it results from a problem with a part of the inner ear called the labyrinth, such as labyrinthitis or Benign Paroxysmal Positional Vertigo. But it may also be due to abnormalities in specific areas of the brain that deal with balance or integration of vision. One of these abnormalities is migraine. Accurate diagnosis relies on a thorough understanding of a patients’ medical history.

Medication may be an appropriate treatment for some patients, however many forms of dizziness can be treated with simple head manoeuvres, such as the Epley’s. Patients should avoid commonly prescribed but ineffectual treatment known as vestibular suppressants.

In some sufferers, the dizziness can become chronic. This is now recognised as Persistent Postural Perceptual Dizziness (PPPD) and may require a combination of medication and vestibular rehabilitation.