Dizziness is one of the most common health problems for adults. Dizziness can be a range of sensations including feeling light-headed, faint, woozy, giddy, unsteady, off-balance or weak.

Vertigo is a type of dizziness that feels as though you or your surroundings are spinning.

Dizziness is often caused by illnesses that affect the inner ear, such as benign paroxysmal positional vertigo (BPPV), migraine and inflammation of the inner ear balance apparatus (called vestibular neuritis).

Dizziness rarely indicates a serious or life-threatening condition, even though it can be very disturbing and disabling. Symptoms can often disappear with no treatment.

 

Symptoms of dizziness may include:

• a sensation of movement (including spinning), either of yourself or the external environment
• unsteadiness, including finding it difficult to walk in a straight line
• light-headedness
• feeling faint

Other symptoms that may accompany dizziness include:

• headache
• nausea and vomiting
• fatigue
• ringing or other sounds in the ears (tinnitus)
• difficulty hearing
• staggering gait and loss of coordination (ataxia)
• unusual eye movements, such as flitting of the eyes (nystagmus)
• blurred vision
• finding it difficult to see clearly when moving, for example, when reading a sign while walking or driving
• difficulty concentrating

Symptoms may be constant or come and go. Episodes can last from minutes to days.

 

While some people understandably find it difficult to describe their dizziness, a description of your dizziness and the circumstances in which it occurs may be very helpful in reaching a diagnosis.

In trying to work out the cause of a person’s dizziness, investigations may include:

• medical history, including careful questioning about the nature of the dizziness
• physical examination, which may include observing eye movements, positional testing and a blood pressure check
• specialised hearing or balance testing
• CT or MRI scans of the inner ear or brain
• other tests relating to specific conditions

Inner ear disorders cause about half of all dizziness cases including:

• Benign paroxysmal positional vertigo (BPPV) – involves intense, brief episodes of dizziness related to moving your head, often when turning over in bed or sitting up. It occurs when particles (otoconia) break loose and fall into the wrong part of the semicircular canals in the inner ear. This gives a sensation of spinning (vertigo). The cause of BPPV is not always known, but it may be a result of ageing or head trauma.
• Acute vestibular neuronitis or labyrinthitis – an inflammation of the inner ear causing sudden, intense vertigo that may persist for several days, with nausea and vomiting. This can be very disabling and may require bed rest initially. Fortunately, vestibular neuronitis generally subsides and clears up on its own. The cause of this condition is unknown but it may be a viral infection.
• Ménière's disease – involves the build-up of fluid pressure in the inner ear. This leads to repeated sudden episodes of vertigo lasting 20 minutes or longer, with changing hearing loss, the feeling of fullness in the ear and buzzing or ringing in the ear (tinnitus). The cause of Ménière's disease is unknown.
• Vestibular migraine – can cause vertigo lasting from minutes to days with or without headache. Attacks may be triggered by quick head turns, being in a crowded or confusing place, driving or riding in a vehicle, or watching movement on TV. Vestibular migraine may also cause unsteadiness, hearing loss, and ringing in the ears (tinnitus).
• Anxiety and stress – can intensify inner ear dizziness symptoms. Anxiety and stress are also the most common causes of dizziness that are not caused by the inner ear.
• Other causes – including brain related disorders and medical conditions such as low blood pressure.