What to Do About Dizziness: Symptoms, Causes, Treatment and Frequently Asked Questions

Article by Hearing Partners, contributed by Jennifer Lee, Senior Clinical Audiologist at Hearing Partners

Dizziness can refer to lightheadedness, vertigo, lethargy, or a feeling of being out of balance. Severe cases can result in unsteadiness, vomiting or loss of consciousness.

Dizziness is one of the common reasons adults see a doctor. Frequent or persistent dizziness can affect your life and actions significantly and can make you feel anxious and afraid.

In this article, we’ll start by looking at the common symptoms and causes of dizziness. We’ll also discuss how to diagnose dizziness and the treatment options available.

• Common Symptoms of Dizziness
• Causes of Dizziness
• Diagnosing Dizziness
• Treatment for Dizziness
• FAQs About Dizziness

Common Symptoms of Dizziness

The symptoms of dizziness may vary from person to person, but they can fall into 4 broad categories:

• Vertigo: A false sense of motion
• Disequilibrium: Feeling off balance, unsteady, or wobbly
• Presyncope: Feeling of imminent loss of consciousness
• Lightheadedness

Symptoms can be sudden or gradual, one-off or recurring. They can last for seconds or days and can be triggered or exacerbated by changes in movement, body posture, or head movement. These sensations and information are helpful to a doctor’s diagnosis.

Causes of Dizziness

• Health conditions such as diabetes, vitamin deficiencies, anaemia, and tumours
• Motion sickness
• Alcohol and drug reactions
• Infections
• Head injuries and concussions
• Degenerative diseases such as multiple sclerosis
• Problems with vision, proprioception, and vestibular organs

Maintaining balance depends on the information the brain receives from the eyes, muscles, joints, and vestibular organs. Symptoms of dizziness will surface if 2 of the 3 organs present questionable or opposing information.

Visual problems

The vision system is responsible for sensing the direction and speed of head movements, and keeping the image steady while you’re moving. Certain visual disorders, such as myopia, oscillopsia, and Binocular Vision Disorders, can affect spatial orientation. This, in turn, results in a tilted gaze and incorrect posture, increasing the risk of dizziness.

In fact, Binocular Vision Disorders are a common condition that affects many people around the world. It’s caused by a misalignment of vision between the eyes, causing 2 images of slightly different positions to be sent to the brain. To correct this discrepancy, the brain forces the eyes to realign.

However, this alignment is only temporary, and the misalignment recurs over time, eventually stressing the eye muscles and causing symptoms such as dizziness, nausea, and headaches.

Issues with the proprioceptive system

The proprioceptive system of skin, muscles, and joints is responsible for sensing the position of the head and body relative to the ground, allowing us to maintain an upright and balanced posture. Having muscle and joint pain or problems such as osteoporosis, arthritis and muscular atrophy can increase your chances of imbalance and dizziness.

Vestibular problems

The vestibular system is located deep in the inner ear and is composed of semicircular canals and otolithic organs. These structures are responsible for sensing head movements such as head tilt, rotation and speed changes. The information sent by the vestibular system has the ability to affect the visual and proprioceptive systems.

The 3 vestibular responses are the Vestibulo-Ocular Reflex (VOR), the Vestibulo Collic Reflex (VCR) and the Vestibulo Spinal Reflex (VSR).

The VOR is the action-opposed eye response responsible for aiming and stabilising sight while moving. If you turn your head to the left while reading this article, your eyes will automatically look to the right to continue reading – this indicates that your VOR is normal. An abnormal VOR sends false signals to the brain, which can lead to activity-related dizziness, blurred vision, unsteady movements, and nausea.

The VCR and VSR are responses used to adjust head and body balance. Abnormal reflexes can cause the body to sway or lean to one side when walking, and in severe cases, fall.

Inner ear problems

Inner ear problems include ear fluid imbalance, Benign Paroxysmal Positional Vertigo (BPPV), and Superior Canal Dehiscence Syndrome (SCDS).

Diagnosing Dizziness

To find out the cause of the dizziness, a healthcare professional will need to do a detailed evaluation of your medical history and some diagnostic tests.

Hearing tests

Because the vestibular organs are closely related to the hearing organs, certain health conditions can cause dizziness, hearing changes, or tinnitus.

Even if you don’t feel like your hearing has changed, you may wish to take a short 5-minute online hearing test at home so that you can better understand your hearing level and create a baseline for future hearing tests.

Eye movement tests

A common test for dizziness and balance is Videonystagmography (VNG). This test is usually evaluated by an otolaryngologist and referred to an audiologist.

During the VNG test, you’ll wear special goggles and sit in a dark examination room. The goggles have cameras that’ll record your eye movements and eye coordination when your posture changes or when the temperature changes.

This test is often used by healthcare professionals to diagnose vestibular disorders, including Ménière’s disease and vestibular neuritis.

Posturography

For this test, you’ll stand on a static or dynamic platform that’ll measure your movements. It can move with your movements, or perform a standard set of movements to test your balance response in different situations.

Detailed images and reports will be generated based on the test and they’ll be compared to the expected responses of people of similar age and size. As part of this test, 2 important measurements are your centre of gravity and centre of pressure. These measurements will determine the cause of your balance problems.

MRI scans

For people with vertigo, especially those who also have hearing loss and tinnitus, doctors may recommend an MRI scan to get a closer look at the inner ear and its surrounding structures.

An MRI scan uses a magnetic field and radio waves to create a 3-dimensional picture of the ear and the auditory nerves. The scan can also show fluid buildup or inflammation in the inner ear, or fibroids on the nerves.

Treatment for Dizziness

Dizziness is a symptom of another condition, so finding out what’s causing the condition and treating it – with medication, glasses, hearing aids or therapy – can improve the dizziness. However, as the cause of dizziness is often unknown, balance exercises are the most effective way to relieve this symptom.

Medication

Glasses

Dizziness caused by Binocular Vision Disorders can be resolved with the help of special lenses called prisms. They help the eyes align the images they see, creating a single, sharp image. This reduces pressure on the eye muscles and relieves dizziness and other related symptoms.

Hearing aids

Hearing aids can improve your balance and relieve feelings of dizziness by increasing your awareness of your surroundings. Hearing aids are especially helpful if hearing problems make it difficult for you to assess your surroundings.

Therapy

A type of physical therapy called vestibular rehabilitation may help alleviate feelings of dizziness for individuals with vestibular and proprioceptive problems in the inner ear. This balancing therapy uses specially designed exercises to strengthen the muscles and joints and allow the brain to get used to the effects of the vestibular disorder.

FAQs About Dizziness