Are you feeling unsteady? Dizzy? Is it vertigo?
It can be difficult to tell someone exactly what you are feeling even though you may be experiencing it frequently. Dizziness is the term most used to describe these sensations, but it is too general of a description to be helpful in determining the cause of your dizziness symptoms.
Spinning around, as in familiar childhood games, can produce temporary vertigo by stimulating the motion sensing organs of your inner ear. It was fun to spin around as a child, but when it does not stop it quickly becomes a nightmare. Your vision may become blurred due to difficulty focusing both eyes on the same object. Hearing loss is common with some causes of vertigo.
Dizziness describes the feeling that you, or your environment, is moving when it should not be. There are four classifications of dizziness that help point to the cause of your symptoms. These classifications of dizziness are: vertigo; disequilibrium; pre-syncope; and non-specific dizziness.
Vertigo is when you experience a whirling or spinning sensation in the absence of your body moving in a way that would cause that sensation. Your balance is often noticeably affected making standing or walking difficult. You may feel nauseated and vomit if your vertigo is severe enough.
The causes of vertigo can be divided into three main areas: peripheral vertigo, the most frequent cause; central vertigo; and vertigo of undetermined cause (chronic subjective vertigo and phobic postural vertigo for example).
Peripheral vertigo is caused by problems in the motion sensing organs of the inner ear (vestibular organs) or the vestibular nerve carrying signals to the brainstem centers (vestibular nuclei). Common conditions of the peripheral vestibular system are BPPV (benign paroxysmal positional vertigo), vestibular neuritis, Meniere’s disease, labyrinthitis, superior canal dehiscence, antibiotic toxicity, and perilymphatic fistula.
Usually a rapid compensation process occurs in the vestibular system, causing symptoms of acute peripheral vertigo to improve in several days to a few weeks. If your vertigo symptoms are persistent, or keep coming back we recommend you have a professional evaluation.
Central vertigo is caused by problems within the brain or brainstem (tumor, infarction, epilepsy, cervical spine degeneration, Parkinson’s, MS, etc.) Usually there is less illusion of movement and nausea than with peripheral vertigo. Neurologic symptoms such as slurred speech, double vision, nystagmus (involuntary jerky eye movements), and disequilibrium (poor balance) are present.
Disequilibrium is often used to describe the unsteady (ataxic) movements and feelings of people when there is no definite cause. This is more often reported with advancing age, however it is not always due to the aging process. An underlying cause that can be corrected may be found with further examination and testing.
Pre-syncope consists of unsteadiness, weakness, or cognitive symptoms without loss of consciousness. It is often a symptom of orthostatic hypotension, cardiovascular abnormality, nervous system autonomic dysfunction or medication side effects.
Non-specific dizziness, or vertigo of undetermined cause means that there is no objective finding on examination or diagnostic test that shows a visible physical cause of the vertigo. This does not mean that there is not a cause, just that the available tests have not shown the cause. The cause may be due to a problem with the function of the nervous system and not with the structure. There may be psychological states such as panic, anxiety, depression, phobia, PTSD associated with the dizziness.
To find the cause of your dizziness or vertigo we look not only at the peripheral vestibular system, but also the central nervous and metabolic systems. <