Can dizziness cause various concerns?

Dr. Anu Thampy, ENT Consultant, SUT Hospital, Pattom, Trivandrum

Dizziness is a condition that causes physical and mental distress. Most people would have felt dizzy on various occasions in one’s life. Usually we ignore it without taking it seriously. Dizziness can occur for a number of serious and non-serious reasons. To eliminate the likelihood of serious consequences dizziness needs to be taken seriously and attended to on occurrence.

Feeling an imbalance during getting out of bed or moving your head or else feeling as if you are on a spin normally could be ‘True Vertigo’. Not all patients who claim to experience dizziness may have true vertigo. It is often confused with presyncope, syncope, and ‘true vertigo’. These types of symptoms can be caused by anaemia, high blood pressure, hypothyroidism, spondylitis, migraine, multiple sclerosis, epilepsy, heart disease, diabetes, tumors, and stress.

What is the relationship between ear and balance? The ear can be divided into external ear, middle ear and inner ear. The balance of the ear is controlled by the vestibular apparatus in the inner ear. It passes messages regarding the movements of head, to brain via the ‘vestibular’ nerve. True Vertigo is a disorder caused by the infection of ear or by disrupting the vestibular nerve that balances the nerve, and the area where it connects to the brain. About 80% of true vertigo is caused by a lack of balance in the ear. A small percentage can also be a disease within the brain.

Major symptoms of True Vertigo could be Dizziness, Feeling like you are moving or spinning, losing balance, Slowness, Ringing in the ear, Deafness, Vomiting. People with vertigo should get up slowly from the bed or chair and avoid turning the head too quickly. It is helpful to sleep with one’s head slightly raised. One should also avoid head-turning tasks and functions to minimise the impact of True Vertigo. Affected people must be careful not to drive, use machinery, climb stairs, or get too close to water or fire.

Benign Paroxysmal Positional Vertigo (BPPV) is the most common form of dizziness. It is more common in women. Excessive movement of the head can cause dizziness that lasts for a few seconds. Dizziness is caused by the movement of calcium carbonate granules called Otolith inside the inner ear which flows into a fluid called endolymph which causes motion. Diagnosis can be made through the Dix Hallpike test. In addition, hearing tests such as audiometry, OAE, ECOG, MRI scan, and blood tests may also be required. Re-positioning exercises and simple exercises called vestibular habituation therapy can cure the disease. Care should also be taken not to get dizzy in intervals.

Another important disease is Meniere’s Disease, which is caused by increased pressure of endolymph fluid in the inner ear. Symptoms include dizziness that lasts for hours, as well as loss of hearing, wheezing, and vomiting. In case of dizziness, Vestibular sedatives can be given in pill or injection form. Other treatments depend on the frequency with which it occurs. If not, surgery may be needed. Caffeine free, low salt (caffeine and salt content in coffee) and diet can help control the disease.

Infections could also lead to dizziness. Infections could be both bacterial and viral. It needs to be ascertained that infection is not a result of above organisms to arrive at the reason for persistent dizziness. Labyrinthitis and inflammation of the vestibular nerve (vestibular neuronitis) can also cause dizziness. It can be caused by various other ailments. Peri-labyrinthine fistula, semicircular canal dehiscence, labyrinthine concussion, posterior circular stroke (paralysis of the balance area of ​​the brain), and brain tumors that can be caused by birth or trauma to the head can also cause dizziness.