Dizziness versus Vertigo

When someone says “I feel dizzy” what exactly do they mean? Dizziness can be described in two different ways; lightheadedness and vertigo. Lightheadedness can be described as feeling like you are going to faint or pass out. You may feel dizzy, but do not feel like you or your surroundings are moving around you. Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are off balance, spinning, whirling, falling, or tilting. You may have nausea and/or vomiting with lightheadedness and vertigo. Anyone can experience dizziness but it is most common in the elderly. 

Lightheadedness

Lightheadedness can occur when you move quickly from a seated or laying down position to a standing position. This positional change results in decreased blood flow and pressure to the brain; which can make you feel faint. Some common causes can be allergies, flu/cold, dehydration, rapid breathing, stress and anxiety, the use of tobacco or alcohol. Also many prescription and over-the-counter medications can cause lightheadedness or vertigo to happen.

Vertigo

There are many different causes of vertigo. It is important to determine if the cause is central or peripheral. Central causes of vertigo occur in the brain or spinal cord whereas peripheral vertigo arises from problems in the inner ear. The inner ear can become inflamed because of an illness or small crystals have become displaced within the semicircular canals causing irritation, which leads to a form of vertigo called Benign Paroxysmal Positional Vertigo (BPPV). Meniere’s disease can cause vertigo along with fluctuating hearing loss, roaring, and pressure in the ears. Head trauma, migraine headaches, strokes, multiple sclerosis, and tumors could all lead to an onset of vertigo.

How is vertigo diagnosed?

If you suspected you are having symptoms of vertigo the first step is to see an audiologist for an audiogram (hearing test) to rule out hearing loss as a factor to your dizziness symptoms. Then, you will see the otolaryngologist for a full history to evaluate your symptoms and medications. The next step is for an audiologist to perform a Videonystagmography (VNG) test. The VNG is important because it is a three step test to assess the inner ear system while looking for abnormal eye movements at each step. This test determines if your vertigo is central, peripheral, or both.

What are the treatments?

After determining the type of vertigo you have the type of treatment can be discussed. Particle repositioning maneuvers such as the Epley Maneuver; which are a series of head movements to reposition the crystals in the semicircular canals. These maneuvers and other vestibular exercises can be performed by physical therapists. Also at home exercises can also be given to help relieve symptoms