The most frequent causes of vertigo and dizziness among adult patients in outpatient medical practice have been varied and include many common conditions. The most common causes of vertigo and dizziness, in both acute and chronic patient settings, are cited below. BPPV (benign paroxysmal positional vertigo) is the only cause of vertical movement that can be associated with a fall, although other causes of dizziness can occur when someone is climbing or moving at a fast rate. (Dizziness is also a symptom of several disorders, including vertigo.) The majority of patients with BPPV present with some degree of neck or head pain, and a majority of those patients with BPPV also report feeling nausea, vomiting, or both.
A more common cause of dizziness and vertigo is peripheral vestibular disorders (PVD), which can be either inherited or acquired. Typically, when PVD becomes severe, it is accompanied by a variety of symptoms, including loss of balance, unsteadiness, nausea, and vomiting. It has been shown that, in addition to the above-mentioned symptoms, there are many others that occur with PVD: difficulty staying on balance (including balance difficulty maintaining walking or standing), head spinning, dizziness or lightheadedness. Because some of these symptoms are caused by high blood pressure, and because many individuals with PVD have normal or low blood pressure, the underlying cause of dizziness and vertigo often cannot be determined. When this is the case, an alternative diagnostic approach, such as echocardiography or magnetic resonance imaging, may be used to further ascertain the diagnosis.
One of the rarest causes of vertigo and dizziness is the development of ischemic heart disease. Although ischemic heart disease accounts for only about a third of all cases of dizziness and vertigo, it is especially associated with loss of consciousness combined with tachycardia. Thus, patients without previous history of ischemic heart disease are particularly at risk. This condition can be isolated through the results of an echocardiogram or magnetic resonance imaging study if there is no previous history of ischemic heart disease.
The symptoms of vertigo commonly occur together with feelings of nausea, vomiting, or an increased urge to urinate. In rare instances, patients may also experience chest pain in the throat. When vertigo is present along with other symptoms, further testing is needed to establish the exact nature of the symptoms. Therefore, patients should be aware of the symptoms that may be associated with dizziness so they can recognize them when they occur.
Motion sickness is one of the primary causes of vertigo and dizziness. When a person experiences this symptom, he or she may experience a feeling of being “spinning around.” The sensation of spinning around is associated with nausea, and the spinning feeling may be more intense if a person is vomiting.
Motion-sensitive vestibular rehabilitation therapy has been effective in correcting many self-motion sickness (sensory), vestibular (balletic) dysfunction, balance related, and balance-related neurological disorders. Motion sickness occurs when the head or neck becomes sensitive to changes in acceleration, rotation, or motion. Common symptoms include dizziness, loss of balance, nausea, lightheadedness, and headache. Several factors are believed to trigger this symptom. The vestibular system projects internal movement patterns, which include eye movements, facial expression, and body positions. Thus, when objects move rapidly, the sensations experienced are typically dizzy.
The many different mechanisms through which dizziness can be caused are considered to be the result of imbalance between accommodative and excretory systems. In some instances, the inner ear is not functioning properly, causing the brain to compensate by spinning and bouncing in an effort to maintain balance. There are also many people who have inner ear involvement, but do not experience dizziness because their dizzy spells are short term occurrences. Many people experience dizziness on a daily basis, but many experience dizziness only occasionally, such as while flying or when crossing the street.
Dizziness and vertigo should be evaluated and treated immediately. Untreated vertigo and dizziness can have severe consequences, especially if the imbalance is not corrected promptly. For example, if you were driving and suddenly experienced a feeling of dizziness, the chances are good that the accident might have been prevented if you had been examined by an emergency medical team prior to the accident. Therefore, it is important that you visit an emergency department or neurologist if you ever experience dizziness and/or vertigo.