Don’t Ignore dizziness and vertigo; The Deccan Hospital

Dizziness and balance problems are common complaints that can affect people of all age groups. While occasional light-headedness may be due to dehydration, fatigue or low blood pressure, recurrent or severe dizziness may indicate an underlying neurological, inner-ear, cardiovascular or metabolic condition.

According to Dr Srinivas Deshmukh, MD, DM (Neurology), Neuro Physician, The Deccan Hospital, Somajiguda, Hyderabad, patients often use the word “dizziness” to describe different sensations. These may include a spinning sensation, light-headedness, unsteadiness while walking, or a feeling of being about to faint. Identifying the exact nature of the symptom is important for determining the cause.

What is Vertigo?

Vertigo is a specific type of dizziness in which a person feels that they or their surroundings are spinning or moving. It is commonly related to disorders of the inner ear, but neurological conditions can also cause vertigo.

One of the common causes is Benign Paroxysmal Positional Vertigo (BPPV), where brief episodes of spinning are triggered by movements such as turning in bed, getting up, or looking upward. Other causes include vestibular disorders, migraine-associated vertigo, certain medications and, less commonly, problems involving the brain or blood circulation.

Common symptoms

• Patients with dizziness or vertigo may experience:
• Spinning or a sensation that the surroundings are moving
• Unsteadiness while standing or walking
• Nausea or vomiting
• Difficulty maintaining balance
• Blurred or unusual visual sensations
• Ringing in the ears or hearing changes
• Headache
• Weakness, numbness or difficulty speaking in some neurological conditions

When should you be concerned?

Sudden-onset dizziness accompanied by facial weakness, weakness or numbness of an arm or leg, difficulty speaking, double vision, severe headache, difficulty walking, loss of coordination or loss of consciousness should not be ignored.

These symptoms may sometimes indicate a stroke or another serious neurological condition and require immediate medical evaluation.

Diagnosis depends on the cause

A detailed medical history and neurological examination are important. Depending on the symptoms, the physician may assess balance, eye movements, hearing and coordination. In selected patients, investigations such as blood tests, hearing or vestibular evaluation, ECG, or brain imaging may be recommended.

Treatment is cause-specific. For example, BPPV can often be treated with appropriate repositioning manoeuvres. Other conditions may require medication, vestibular rehabilitation, treatment of migraine or management of underlying medical problems.

Preventing falls

People experiencing recurrent balance problems should take precautions to prevent falls:

• Rise slowly from a sitting or lying position.
• Keep floors and pathways free from obstacles.
• Use adequate lighting, especially at night.
• Wear appropriate, non-slip footwear.
• Avoid walking without support during severe episodes.
• Review medications with a doctor if dizziness started after a new medicine.
• Stay adequately hydrated unless fluid restriction has been advised.

Don't self-medicate

Repeated use of medicines for dizziness without identifying the underlying cause may not provide a long-term solution. Persistent, recurrent or unexplained dizziness should be evaluated by a qualified physician or neurologist.

“Dizziness is a symptom, not a diagnosis. Understanding whether the patient is experiencing spinning, light-headedness or imbalance is the first step towards identifying the underlying cause and providing appropriate treatment.”

Dr Srinivas Deshmukh, MD, DM (Neurology) Neuro Physician, The Deccan Hospital, Somajiguda, Hyderabad

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The Hans India