Dizziness
Lightheadedness - dizzy; Loss of balance; VertigoDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo.
Lightheadedness is a feeling that you might faint.
Vertigo is a feeling that you are spinning or moving, or that the world is spinning around you. Vertigo-associated disorders is a related topic.
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Considerations
Most causes of dizziness are not serious, and they either quickly get better on their own or are easy to treat.
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Causes
Lightheadedness occurs when your brain does not get enough blood. This may occur if:
- You have a sudden drop in blood pressure.
- Your body does not have enough water (is dehydrated) because of vomiting, diarrhea, fever, or other conditions.
- You get up too quickly after sitting or lying down (this is more common in older people).
Lightheadedness may also occur if you have the flu, low blood sugar, a cold, allergies, or take medicines that may lower your blood pressure.
More serious conditions that can lead to lightheadedness include:
- Heart problems, such as a heart attack or abnormal heart beat
- Stroke
- Bleeding inside the body
- Shock (extreme drop in blood pressure)
If any of these serious disorders are present, you will usually also have symptoms like chest pain, a feeling of a racing heart, loss of speech, change in vision, or other symptoms.
Vertigo may be due to:
- Benign positional vertigo, a spinning feeling that occurs when you move your head
- Labyrinthitis, a viral infection of the inner ear that usually follows a cold or flu
- Meniere disease, a common inner ear problem
Other causes of lightheadedness or vertigo may include:
- Use of certain medicines
- Stroke
- Multiple sclerosis
- Seizures
- Brain tumor
- Bleeding in the brain
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Home Care
If you tend to get lightheaded when you stand up:
- Avoid sudden changes in posture.
- Get up from a lying position slowly, and stay seated for a few moments before standing.
- When standing, make sure you have something to hold on to.
If you have vertigo, the following tips can help prevent your symptoms from becoming worse:
- Keep still and rest when symptoms occur.
- Avoid sudden movements or position changes.
- Slowly increase activity.
- You may need a cane or other help walking when you have a loss of balance during a vertigo attack.
- Avoid bright lights, TV, and reading during vertigo attacks because they may make symptoms worse.
Avoid activities such as driving, operating heavy machinery, and climbing until 1 week after your symptoms disappear. A sudden dizzy spell during these activities can be dangerous.
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When to Contact a Medical Professional
Call your local emergency number (such as 911) or go to an emergency room if you are dizzy and have:
- A head injury
- Fever over 101°F (38.3°C), headache, or very stiff neck
- Seizures
- Trouble keeping fluids down
- Chest pain
- Irregular heart rate (heart is skipping beats)
- Shortness of breath
- Weakness
- Inability to move an arm or leg
- Change in vision or speech
- Fainting and loss of alertness for more than a few minutes
Contact your health care provider for an appointment if you have:
- Dizziness for the first time
- New or worsening symptoms
- Dizziness after taking medicine
- Hearing loss
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What to Expect at Your Office Visit
Your provider will perform a physical exam and ask questions about your medical history and symptoms, including:
- When did your dizziness begin?
- Does your dizziness occur or get worse when you move?
- What other symptoms occur when you feel dizzy?
- Are you always dizzy or does the dizziness come and go?
- How long does the dizziness last?
- Were you sick with a cold, flu, or other illness before the dizziness began?
- Do you have a lot of stress or anxiety?
Tests that may be done include:
- Blood pressure reading
- Electrocardiogram (ECG)
- Hearing tests
- Balance testing (ENG)
- Magnetic Resonance Imaging (MRI)
Your provider may prescribe medicines to help you feel better, including:
- Antihistamines
- Sedatives
- Anti-nausea medicine
Surgery may be needed if you have Meniere disease.
References
Baloh RW, Jen JC. Hearing and equilibrium. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 428.
Chang AK. Dizziness and vertigo. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 15.
Muncie HL, Sirmans SM, James E. Dizziness: approach to evaluation and management. Am Fam Physician. 2017;95(3):154-162. PMID: 28145669 pubmed.ncbi.nlm.nih.gov/28145669/.