Experiencing dizziness, confusion, and nausea? Discover the potential causes and how to manage these troubling symptoms.

Understanding Dizziness, Confusion, and Nausea

Dizziness, confusion, and nausea can be a concerning combination of symptoms, often signaling an underlying health issue. These symptoms can arise from various causes, ranging from inner ear problems to neurological disorders or even medications. It’s important to understand the potential triggers and seek medical attention to identify the root cause and receive appropriate treatment.

Causes of Dizziness, Confusion, and Nausea

The co-occurrence of dizziness, confusion, and nausea can be attributed to several factors. Some common causes include:

• Inner Ear Disorders: Conditions affecting the inner ear, such as vertigo, labyrinthitis, or Meniere’s disease, can disrupt the body’s balance and lead to dizziness, confusion, and nausea.
• Neurological Conditions: Neurological disorders, including migraines, stroke, or traumatic brain injury, can impact the brain’s ability to process sensory information, resulting in dizziness, confusion, and nausea.
• Medication Side Effects: Certain medications, such as some antidepressants, blood pressure drugs, or sedatives, can cause dizziness, confusion, and nausea as side effects.
• Dehydration and Electrolyte Imbalances: Insufficient fluid intake or imbalances in electrolytes like sodium, potassium, or calcium can lead to dizziness, confusion, and nausea.
• Infections: Viral or bacterial infections, such as the flu, can trigger dizziness, confusion, and nausea as the body tries to fight off the illness.
• Anxiety and Stress: Psychological factors, including anxiety and stress, can contribute to the experience of dizziness, confusion, and nausea.

Diagnosing the Underlying Cause

To determine the underlying cause of dizziness, confusion, and nausea, healthcare providers will typically conduct a comprehensive medical evaluation. This may include:

1. Medical History: The healthcare provider will ask about the onset, duration, and severity of the symptoms, as well as any underlying health conditions or recent illnesses.
2. Physical Examination: The healthcare provider will perform a physical examination, including checking the patient’s balance, coordination, and neurological function.
3. Diagnostic Tests: Depending on the suspected cause, the healthcare provider may order various tests, such as blood tests, imaging scans (e.g., CT scan, MRI), or specialized tests (e.g., vestibular function tests, electroencephalogram).

By identifying the underlying cause, the healthcare provider can develop an appropriate treatment plan to address the symptoms and manage the underlying condition.

Managing Dizziness, Confusion, and Nausea

The treatment for dizziness, confusion, and nausea will depend on the underlying cause. Common approaches include:

• Medication: Prescription or over-the-counter medications may be used to alleviate symptoms, depending on the cause. This can include anti-nausea medications, vestibular suppressants, or medications to address the underlying condition.
• Lifestyle Changes: Adjustments to diet, exercise, and stress management may help manage symptoms, especially in cases of dehydration, electrolyte imbalances, or stress-related triggers.
• Physical Therapy: For conditions affecting the inner ear or balance, physical therapy exercises can help improve stability and reduce dizziness.
• Cognitive-Behavioral Therapy: In cases where psychological factors, such as anxiety, contribute to the symptoms, cognitive-behavioral therapy can be beneficial.

When to Seek Medical Attention

If you experience a sudden onset of dizziness, confusion, and nausea, or if the symptoms persist or worsen, it’s important to seek medical attention promptly. These symptoms can be indicative of a more serious underlying condition, and early diagnosis and treatment are crucial for effective management.

Preventing Dizziness, Confusion, and Nausea

While some causes of dizziness, confusion, and nausea may be unavoidable, there are steps you can take to reduce the risk and manage these symptoms:

• Stay Hydrated: Ensure adequate fluid intake to maintain proper hydration and electrolyte balance.
• Manage Stress: Practice stress-reducing techniques, such as meditation, yoga, or deep breathing, to help alleviate anxiety and its associated physical symptoms.
• Maintain a Healthy Lifestyle: Engage in regular physical activity, eat a balanced diet, and get enough sleep to support overall well-being.
• Communicate with Your Healthcare Provider: Inform your healthcare provider about any new or persistent symptoms, as well as any changes in your medication regimen, to ensure timely diagnosis and appropriate treatment.

Conclusion

Dizziness, confusion, and nausea can be a concerning combination of symptoms, but understanding the potential causes and seeking prompt medical attention can help you manage these issues effectively. By working closely with your healthcare provider and implementing lifestyle modifications, you can take steps to address the underlying cause and alleviate these troubling symptoms.

Dizziness in adults – Mayo Clinic

About this Symptom Checker

Dizziness in adults

Find possible causes of dizziness based on specific factors. Check one or more factors on this page that apply to your symptom.

You feel

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  A spinning sensation




• 
  Lightheaded or faint

• 
  Unsteady

Symptoms are

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  New or sudden




• 
  Recurrent or ongoing

Triggered or worsened by

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  Change in head or body position

Accompanied by

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  Anxiety




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  Blurred or double vision




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  Buzzing or ringing in ear




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  Buzzing or ringing (tinnitus) in only one ear




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  Chest pain or tightness




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  Confusion




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  Ear pain or pressure




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  Fever




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  Hearing loss

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  Nausea or vomiting




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  Numbness or weakness on one side of body




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  Pain in neck, jaw, arms, shoulders or back




• 
  Rapid or irregular heartbeat




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  Severe headache




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  Shortness of breath




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  Slurred speech




• 
  Sweating

1. Walls RM, et al. , eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Oct. 30, 2017.
2. Palmer J, et al. Abdominal pain mimics. Emergency Medicine Clinics of North America. 2016;34:409.
3. UpToDate. https://www.uptodate.com/contents/search. Accessed Oct. 30, 2017.
4. Zeiter D. Abdominal pain in children. Pediatric Clinics of North America. 2017;64:525.
5. Palmer J, et al. Abdominal pain mimics. Emergency Medicine Clinics of North America. 2016;34:409.
6. Feldman M, et al. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Oct. 30, 2017.
7. Merck Manual Professional Version. https://www.merckmanuals.com/professional. Accessed Oct. 30, 2017.
8. AskMayoExpert. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
9. Kliegman RM, et al. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 2, 2017.
10. Zitelli BJ, et al., eds. Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Nov. 11, 2017.
11. Ferri FF. Ferri’s Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Nov. 11, 2017.
12. Muncie HL, et al. Dizziness: Approach to evaluation and management. American Family Physician. 2017;95:154.
13. American College of Emergency Physicians. https://www.acep.org. Accessed Nov. 11, 2017.
14. U.S. Food and Drug Administration. http://www.fda.gov. Accessed Nov. 11, 2017.
15. Schmitt BD. Fever. In: Pediatric Telephone Protocols: Office Version 15th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2015.
16. Mannenbach MS (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.
17. Goyal DG (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.
18. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 28, 2017.
19. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org. Accessed Nov. 20, 2017.
20. Petty RE, et al., eds. Textbook of Pediatric Rheumatology. 7th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 20, 2017.
21. Elsevier Point of Care. https://www.clinicalkey.com.  Accessed Nov. 20, 2017.
22. Kasper DL, et al., eds. Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Accessed Nov. 20, 2017.
23. Wein AJ, et al., eds. Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com.. Accessed Dec. 2, 2017.
24. National Eye Institute. https://nei.nih.gov. Accessed Dec. 5, 2017.
25. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 8, 2017.

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Sudden Dizziness: Causes, Symptoms, and More

Inner ear problems are the most common causes of sudden dizziness and nausea. These include BPPV, Meniere’s disease, and vestibular neuritis. But there are several other possible causes.

A sudden spell of dizziness can be disconcerting. You may feel sensations of lightheadedness, unsteadiness, or spinning (vertigo). In addition, you may sometimes experience nausea or vomiting.

But what conditions can cause sudden, intense dizzy spells, particularly when they’re accompanied by nausea or vomiting? Read on to discover more about potential causes, possible remedies, and when to see a doctor.

There are many reasons why you may suddenly feel dizzy. Most often, though, sudden dizziness occurs due to problems in your inner ear, which is responsible for maintaining balance.

Sudden intense dizziness accompanied by nausea or vomiting is the hallmark symptom of certain conditions and may be caused by:

• low blood sugar
• heat exhaustion
• anxiety or panic disorders
• medication side effects

Below, we’ll explore in more detail a few of the other conditions that can cause sudden dizziness and nausea.

Benign paroxysmal positional vertigo (BPPV)

BPPV is a condition that causes sudden, intense feelings of dizziness. The sensation often feels like everything around you is spinning or swaying, or that your head is spinning on the inside.

When dizziness is severe, it’s often accompanied by nausea and vomiting.

With BPPV, symptoms almost always occur when you change the position of your head. An episode of BPPV usually lasts less than a minute. Even though the dizziness is short lived, the condition can become disruptive to daily activities.

BPPV happens when crystals in a specific part of your inner ear move out of place. Often, the exact cause of BPPV is unknown. When a cause can be established, it’s often the result of:

• injury to the head
• inner ear disorders
• damage during ear surgery
• unnatural positioning on your back for extended periods, like lying in a dentist‘s chair

When these crystals are dislodged, they move into another part of your inner ear where they don’t belong. Because the crystals are sensitive to gravity, changes in the position of your head can cause intense dizziness that seems to come out of nowhere.

Treatment typically involves your doctor maneuvering your head in specific directions to reposition the dislodged crystals. This is called canalith repositioning, or the Epley maneuver.

It’s possible for BPPV to go away on its own, though the condition has a recurrence rate of about 22 percent over 5 years. In rare cases, surgery may be necessary.

Meniere’s disease

Meniere’s disease also affects the inner ear. It typically only affects one ear. People with this condition can experience severe vertigo, which may lead to feelings of nausea. Other symptoms of Meniere’s disease include:

• muffled hearing
• a feeling of fullness in the ear
• ringing in the ears (tinnitus)
• hearing loss
• loss of balance

The symptoms of Meniere’s disease can come on suddenly or after a short episode of other symptoms like muffled hearing or ringing in your ears. Sometimes, episodes may be spaced apart, but other times they can happen closer together.

Meniere’s disease happens when fluid gathers in your inner ear. What causes this fluid buildup is unknown, although infections, genetics, and autoimmune reactions are suspected.

The treatment options for Meniere’s disease include:

• medications to treat the symptoms of dizziness and nausea
• salt restriction or diuretics to help reduce the amount of fluid your body retains
• injections with steroids or the antibiotic gentamicin to alleviate dizziness and vertigo
• pressure treatment, during which a small device delivers pulses of pressure to prevent dizziness
• surgery, when other treatments are not effective

Labyrinthitis and vestibular neuritis

These two conditions are closely related. Both have to do with inflammation in your inner ear.

• Labyrinthitis happens when a structure called the labyrinth in your inner ear becomes inflamed.
• Vestibular neuritis involves inflammation of the vestibulocochlear nerve in your inner ear.

With both conditions, dizziness and vertigo can come on suddenly. This can lead to nausea, vomiting, and problems with balance. People with labyrinthitis may also experience ringing in the ears and hearing loss.

It’s unknown what causes labyrinthitis and vestibular neuritis. However, it’s believed that a viral infection may be involved.

Treatment often involves resting in bed, avoiding bright light, and avoiding activities like watching TV or reading while symptoms are present. A person may need to take medications that can relieve symptoms like dizziness and nausea.

If balance problems persist, treatment may involve a type of therapy called vestibular rehabilitation. This therapy uses various exercises to help you adjust to changes in balance.

Vestibular migraine

People with vestibular migraine experience dizziness or vertigo in association with migraine attacks. Other symptoms can include nausea and sensitivity to light or sound. In some cases, a headache may not even be present.

The length of these symptoms can range from 5 minutes to 72 hours. Like other types of migraine, symptoms may be caused by certain triggers like stress, lack of rest, or certain foods.

It’s unknown what causes vestibular migraine, although genetics may play a role. Additionally, conditions like BPPV and Meniere’s disease have been associated with vestibular migraine.

Treatment involves using over-the-counter (OTC) or prescription medications to ease migraine pain and symptoms of dizziness or nausea. Vestibular rehabilitation may also be used.

Orthostatic hypotension

Orthostatic hypotension is a condition in which your blood pressure suddenly drops when you change positions quickly. It can happen when you go from lying down to sitting up, or from sitting up to standing.

Some people with this condition have no noticeable symptoms. However, others may experience nausea, along with other symptoms like:

• dizziness
• lightheadedness
• headache
• fainting episodes

The drop in blood pressure means less blood flows to your brain, muscles, and organs, which can lead to symptoms. Orthostatic hypotension has been linked to neurological conditions, heart disease, and certain medications.

Orthostatic hypotension can be managed through lifestyle changes. These include:

• changing positions slowly
• sitting down while performing daily tasks
• changing medications, if possible

Dizziness is typically caused by issues with the inner ear, which regulates balance. When your brain receives signals from your inner ear that don’t line up with the information your senses are reporting, it can result in dizziness and vertigo.

Several factors can cause sudden dizzy spells, including:

• anemia
• dehydration
• medication side effects
• circulation issues, such as sudden drops in blood pressure or insufficient blood flow to your brain, such as a transient ischemic attack (TIA) or stroke

TIA or stroke

Often called a “ministroke,“ a transient ischemic attack (TIA) is like a stroke, but the symptoms typically only last a few minutes. It happens when there’s a temporary lack of blood flow to part of the brain.

Unlike a stroke, a TIA usually doesn‘t cause lasting damage. But it can be a warning sign of a more serious stroke.

Although rare, a TIA can be the cause of sudden dizziness. According to a 2019 review, sudden dizziness is reported in about 8 percent of patients with a TIA or stroke.

Sometimes, a sudden onset of dizziness is the only symptom of a TIA. Other times, there may be other symptoms. These can include:

• weakness, numbness, or tingling in your arm, leg, or face, usually on one side of your body
• slurred speech or difficulty talking
• problems with balance
• vision changes
• sudden, severe headache
• disorientation, confusion

Although less common, sudden dizziness can also be caused by a stroke, specifically a brain stem stroke. With a brain stem stroke:

• Dizziness lasts longer than 24 hours.
• Dizziness, vertigo, and imbalance usually occur together.
• Weakness on one side of the body isn’t typically a symptom.
• In more severe cases, symptoms can include slurred speech, double vision, and a decreased level of consciousness.

If you have any symptoms of a TIA or stroke, it‘s important to get immediate medical attention. Your doctor will determine if you‘ve had a TIA or a stroke, or if your symptoms have a different cause.

If you have a sudden onset of dizziness, nausea, or vertigo, consider taking the following steps:

• Sit down as soon as the dizziness comes on.
• Try to avoid walking or standing until the dizziness passes.
• If you must walk, move slowly and use a supportive device like a cane, or hold onto furniture for support.
• Once your dizziness has passed, be sure to get up very slowly.
• Consider taking an OTC medication like dimenhydrinate (Dramamine) to ease your nausea.
• Avoid caffeine, tobacco, or alcohol, which can worsen your symptoms.

Make an appointment to see your doctor or healthcare professional if you have sudden dizziness and nausea that:

• happens frequently
• is severe
• lasts a long time
• can’t be explained by another health condition or a medication

To help diagnose the cause of your dizziness and nausea, your doctor will ask about your medical history and perform a physical examination. They’ll also perform a variety of tests. These may include:

• balance and movement testing, which can help determine if specific movements lead to symptoms
• eye movement testing to detect abnormal eye movements associated with inner ear conditions
• hearing tests to check if you have any hearing loss
• imaging tests like MRIs or CT scans to generate a detailed image of your brain
• complete blood count and blood chemistry tests

Seek emergency medical care if you experience sudden dizziness or nausea that occurs with any of the following symptoms:

• feelings of numbness, weakness, or tingling
• severe headache
• slurred speech or trouble talking
• chest pain
• rapid heartbeat
• trouble breathing
• frequent vomiting
• changes in your hearing, such as ringing in your ears or hearing loss
• blurry or double vision
• confusion
• fainting

If you don’t already have a healthcare professional, our Healthline FindCare tool can help you connect with physicians in your area.

Many people experience dizziness for one reason or another. However, in some cases, dizziness may seem to come out of nowhere and feel intense. In these cases, you may also experience symptoms like nausea or vomiting.

Many of the causes of this type of dizziness are associated with inner ear problems. Examples include BPPV, Meniere’s disease, and vestibular neuritis.

See your doctor if you have dizziness or vertigo that’s frequent, severe, or unexplained. Other symptoms like severe headache, numbness, or confusion could indicate another condition, such as a stroke, and require emergency medical attention.

First aid for acute cerebrovascular accident (ACC)

Main signs (symptoms) of acute cerebrovascular accident:

• Numbness of a limb, weakness, “naughtiness” or paralysis (immobilization) of an arm, leg, half of the body, twisting of the face and / or drooling on one side of the face.
• Sudden dizziness, sharp and severe headache.
• Speech disorders (difficulty in choosing the right words, understanding speech and reading, slurred and fuzzy speech – up to complete loss of speech). A person is unable to smile, cannot show his tongue, or he is slanted to one side.
• Violation and loss of vision, “double vision” in the eyes, difficulty focusing vision.
• Impaired balance and coordination of movements (feelings of “swaying”, “falling through”, rotation of the body, unsteady gait up to a fall).
• Nausea, vomiting.
• Confusion or loss of consciousness, uncontrolled urination or defecation.

If any of these signs appear suddenly, call ambulance team, even if these manifestations of the disease were observed for only a few minutes.

Emergency Algorithm:

1. Urgently call an ambulance team, even if these manifestations of the disease were observed for only a few minutes:

103 or 03 – from a landline phone;

112 – call from a mobile phone.

2. Before the arrival of the ambulance:

• If the patient is unconscious, lay him on his side, remove removable dentures, food debris, vomit from the oral cavity, make sure that the patient is breathing.
• If the victim is conscious, help him to take a comfortable sitting or half-sitting position in a chair or on a bed, placing pillows under his back. Provide fresh air. Unbutton the shirt collar, belt, belt, remove tight clothing.
• Measure blood pressure, if its upper level exceeds 220 mm Hg, give the patient a drug that lowers blood pressure, which he took before.
• Measure body temperature. If t-38 ^about or more, give the patient 1 g of paracetamol (2 tablets of 0.5 g to chew, swallow). In the absence of paracetamol, do not give other antipyretic drugs!
• Put ice on your forehead and head. You can take food from the freezer, packed in bags and wrapped in a towel.
• If the patient has previously taken statin cholesterol-lowering drugs (ismvastatin, lovastatin, fluvastatin, pravastatin, atorvastatin, rosuvastatin), give the patient the usual daily dose.
• If the casualty has difficulty swallowing and is dripping saliva from his mouth, tilt his head to the weaker side of his body, blot the dripping saliva with clean tissues.
• If the casualty is unable to speak or is slurred, reassure and reassure them that the condition is temporary. Keep his hand on the non-paralyzed side, stop trying to talk, and don’t ask questions that require an answer. Remember that although the victim cannot speak, he is aware of what is happening and hears everything that is said around him.

REMEMBER THAT:

1. Only emergency medical assistance called in the first 10 minutes after the onset of a heart attack or stroke allows you to fully use modern highly effective methods of inpatient treatment and reduce mortality from these diseases many times over.
2. The state of alcoholic intoxication is not a reasonable ground for delaying the call of an ambulance team in the event of a heart attack and acute cerebrovascular accident. About 30% of people who suddenly died at home were intoxicated.
3. Closed heart massage, carried out in the first 60-120 seconds after sudden cardiac arrest, can bring up to 50% of patients back to life.

The material was prepared by

– 2019

Vertigo | Clinic Rhinos

Dizziness is the second most common symptom with which adults turn to a neurologist (back pain and headaches come first). The causes of dizziness can be osteochondrosis of the cervical spine, diseases of the inner ear, vestibular apparatus, lowering blood pressure, cerebrovascular accident, psychogenic disorders, etc. Usually, attacks of dizziness are accompanied by nausea, vomiting, severe weakness.

A neurologist can help clarify the cause of dizziness. Based on the diagnosis, treatment is prescribed, which includes: the use of drugs for dizziness, performing special exercises designed to train the vestibular apparatus, following a special diet, and in some cases, surgery.

What is dizziness?

True dizziness is a condition in which the patient has a false sensation that the surrounding objects revolve around him or a sensation of his own movement, rotation.

For an example of true vertigo that is not associated with an illness, consider the vertigo that occurs after riding a carousel. If the carousel is abruptly stopped, it seems to the person that the surrounding objects continue to rotate around him, as if the carousel was still in motion.

Most often, the occurrence of true dizziness is a symptom of human diseases associated with the control system of balance and position of the body in space, which includes the eyes, the vestibular apparatus of the inner ear, sensitive receptors of muscles, joints and bones of a person.

If dizziness is caused by imbalance in the balance system, it is often accompanied by nausea and vomiting.

It is possible to define dizziness as a sensation of disturbed orientation of the body in space, this implies a sensation of rotation of the patient or objects surrounding him. Often, dizziness means various sensations: slight unsteadiness, a feeling of dizziness, intoxication, or the impression of rotation of one’s body or surrounding objects.

Dizziness occurs when one of the three anatomical systems in the body is stimulated, which are responsible for controlling the balance of the body in space: vestibular, visual, muscular. This can happen if, for example, you quickly rotate on a carousel. But if the occurrence of dizziness is not associated with an apparent cause, it may be a symptom of some disease. It can also appear in connection with the defeat of the peripheral parts of the vestibular apparatus of the inner ear or the vestibular nerve. In this case, dizziness is called peripheral. In addition, the cause of dizziness can be diseases of the brain, then it is called central vertigo.

Causes of dizziness

There are many causes of dizziness. It can occur due to damage to the vestibular nerve or inner ear, in which case it will be called peripheral. Also, the causes of dizziness may include diseases of the brain, in this case we are talking about central dizziness. Symptoms accompanying dizziness, the nature of dizziness, the duration and frequency of attacks make it possible to establish the true cause of the disease:

• Discharge from the ear and hearing loss may indicate inflammation of the inner ear, in which case conservative treatment may be required.
• Dizziness, accompanied by tinnitus, hearing loss, nausea, vomiting, probably indicates the presence of Meniere’s syndrome. In the absence of auditory dysfunction, dizziness may be a manifestation of vestibular neuritis. Neuritis is characterized by a sudden onset. When trying to stand up and moving the head, the feeling of rotation increases, severe dizziness and constant vomiting. Most often, within 2-3 days, these symptoms gradually disappear. After the end of the acute period, in some cases, the illusion of movement remains with linear accelerations, for example, in a lift or a car.
• In the event of sudden unilateral deafness, tinnitus, vomiting, in half of the cases, patients are diagnosed with a perilymphatic fistula. Also, the fistula can manifest itself with varying degrees of dizziness and hearing impairment (hearing loss, noise, ringing in the ears).
• Unilateral hearing loss and vertigo rule out brain tumor. Such dizziness begins gradually, often accompanied by gradually increasing headaches. In certain positions of the body, increased dizziness is characteristic.
• Transient cerebrovascular accident and stroke are characterized by an acute onset, a combination of dizziness with impaired coordination of movements, double vision, weakness in the arms and legs, and sensitivity disorders. As a rule, dizziness is persistent and lasts for several days.
• Vertigo accompanied by unsteadiness, a sense of disorientation in space, increased with movements in the cervical spine, especially sudden (such as flexion, extension and turning of the head to the side), pain and limitation of mobility in the cervical spine, most likely due to diseases of the cervical spine section.
• An injury to the head or spine that precedes vertigo is indicative of a traumatic brain or whiplash injury.
• Vertigo associated with a change in body position in space most likely indicates benign positional vertigo, the presence of which is determined by a simple positional test.
• Dizziness preceding a headache is indicative of basilar migraine. Dizziness can last from a few minutes to an hour, accompanied by nausea, vomiting, tinnitus, and other neurological symptoms.
• Dizziness that occurs during flight, car, train or water travel is most likely due to motion sickness.
• Taking antibiotics can also cause dizziness. In this case, it is necessary to stop taking them or reduce the dose of the drug.

The most common forms and causes of dizziness

According to modern research, dizziness is most often a symptom of the following diseases:

• Benign paroxysmal positional vertigo (BPPV).
• Osteochondrosis of the cervical spine and vertebrobasilar insufficiency.
• Inflammation of the vestibular nerves (vestibular neuritis).
• Tumors of the brain.
• Psychogenic dizziness.
• Meniere’s disease.
• Basilar migraine.

It should be noted that more than 80% of cases of true vertigo are due to BPPV.

Below we will discuss the main diseases that accompany dizziness, as well as the characteristics of dizziness in each case.

Benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo is one of the most common forms of true vertigo. The name of this disease is deciphered as follows: “benign” means a favorable, not dangerous course of the disease, “paroxysmal” means the appearance of dizziness suddenly, “positional” means the appearance of dizziness at the moment the head is turned in a certain direction.
The reason for the development of benign positional vertigo is irritation of otolith pebbles, which are located in the semicircular canals of the inner ear, receptors of the vestibular apparatus. This disease usually occurs in people over 50-60 years of age, after an injury or infection, but can occur spontaneously in a person of any age.

The main symptoms of benign positional vertigo are:

• The appearance of severe dizziness when tilting the head, when turning the head to the side, when bending over, when turning in bed.
• Duration of severe dizziness – from a few seconds to several minutes, it may be accompanied by weakness, severe nausea, vomiting.
• A series of attacks of dizziness may occur, after which they may disappear for a while.

Treatment of benign positional vertigo is performed under the supervision of a neurologist using a special exercise, which is partially described below (Complex No. 1). The effectiveness of this exercise reaches 90%, and the duration is only 1-2 minutes.

Psychogenic dizziness

Psychogenic dizziness is the second most common after BPPV.

Unlike BPPV, psychogenic vertigo is not associated with disorders of the vestibular apparatus, that is, it is not true vertigo.

The main characteristics of psychogenic vertigo:

• Dizziness can be described as a feeling of fog in the head, confusion, fear of losing consciousness, falling, but not as a whirling of objects or the object itself.
• There are attacks of dizziness spontaneously, often in stressful situations, in a closed limited space (transport, elevator), in crowded places.
• In addition to the occurrence of dizziness, patients note various other symptoms that resemble some diseases of the internal organs. For example: pain and tension in the muscles, in the chest, in the region of the heart, in the abdomen, feeling short of breath, sore or lump in the throat, irritability, anxiety, disturbed sleep, feeling of inner fear, tension, strong unreasonable concern about the state of one’s own health and health loved ones, etc.

Psychogenic dizziness can be considered as one of the most common manifestations of vegetovascular dystonia (VVD). Attacks of false dizziness are especially common in patients with anxiety disorders and panic attacks. Determining the psychogenic nature of dizziness is important for proper treatment. Much more effective for psychogenic dizziness will be treatment that is intended for the treatment of VVD (sedatives, psychotherapy) than treatment with specific drugs prescribed in all cases of true dizziness.

Migraine dizziness

Migraine is one of the most common types of headaches. During a migraine attack, in some cases, there is a violation of blood circulation in those areas of the brain that control the functioning of the vestibular apparatus. The result is severe dizziness. Immediately after it, a severe headache in the occipital region, imbalance, vomiting, intolerance to noise and light can develop. Some migraine patients may experience only severe dizziness and nausea, and may not have headache attacks. One of the harbingers of migraine in the future is attacks of severe dizziness, imbalance, nausea and vomiting in children, which eventually turn into typical migraine attacks.

Vertigo associated with Ménière’s disease

Ménière’s disease is characterized by bouts of severe dizziness, deafness (usually only in one ear), occurring intermittently and gradually leading to hearing loss.
The cause of Meniere’s disease is currently unknown. Presumably, in certain cases, the onset of the disease may be due to trauma, viral infection, or allergies.

The typical manifestation of Meniere’s disease is an acute attack of severe dizziness lasting from several hours to several days. It is accompanied by tinnitus, a feeling of pressure inside the ear, hearing loss (in one ear), nausea, and vomiting.

Typically, attacks of Meniere’s disease occur within a few hours one after another, after which they disappear for a while, but sooner or later they reappear.
Dizziness in osteochondrosis, neck and head injuries, vertebrobasilar insufficiency

As mentioned above, for the balance control system to work, sensitive receptors of bones, ligaments, muscles, joints of the whole organism and, first of all, bones, muscles, ligaments of the neck are necessary.

Degenerative diseases of the cervical spine (including osteochondrosis) are one of the common causes of dizziness, described by patients as unsteady gait, in very rare cases as a feeling of whirling.

In osteochondrosis of the spine, not only the normal functioning of the sensitive receptors of the neck is disturbed, but also the blood circulation through the vertebral arteries located in the brain stem, which supply blood to the parts of the brain responsible for the functions of balance and maintaining body position in space, can be disturbed.

Chronic circulatory disorders that occur in the lower parts of the brain (vertebrobasilar basin) is called vertebrobasilar insufficiency. A certain role in the development of vertebrobasilar insufficiency is played by a prolonged increase in blood pressure (hypertension) and atherosclerosis of the vessels of the neck. Most often, vertebrobasilar insufficiency occurs in the elderly. In addition to dizziness, this disease is accompanied by the following symptoms: headache (mainly in the back of the head), tinnitus, memory loss.

Acute circulatory disorders in the vertebrobasilar basin are manifested by severe dizziness, loss of consciousness, vomiting, double vision, weakness.

Injuries to the head and cervical spine (especially from car accidents) can also cause dizziness. Usually, trauma-induced dizziness is most pronounced in the first days after the injury, it gradually decreases as the patient recovers.

Vertigo due to brain tumors

In some cases, brain tumors that are located near the inner ear can cause severe, progressive dizziness. In addition to dizziness, tumor symptoms may include:

• headache
• tinnitus
• hearing impairment (most often in one ear)
• nausea
• Strabismus or paralysis of facial muscles

As a symptom of a brain tumor, dizziness is most common in children and young people.

Vertigo due to vestibular neuritis

Vestibular neuritis is an inflammation of the vestibular nerve that conducts impulses to the brain from receptors in the inner ear. With inflammation, the vestibular nerve temporarily loses its ability to conduct impulses. This is manifested by severe dizziness, unsteady gait, nausea and vomiting.

The main cause of vestibular neuritis is viral infections. Therefore, attacks of dizziness that are associated with it may be accompanied by fever, runny nose, cough, weakness. Often, true dizziness is combined with psychovegetative disorders, such as: nausea, vomiting, sweating, pallor, anxiety. This is due to the close relationship between the vestibular and autonomic systems. Any damage to the vestibular system will immediately lead to autonomic disorders. Despite the feeling of fear that accompanies almost any attack of dizziness, it in itself is not a life-threatening condition. It is important to timely and correctly diagnose the disease that caused dizziness.

Dizziness during pregnancy

Quite often during pregnancy there is a false dizziness, which is manifested by a feeling of instability, weakness, near fainting. In pregnant women, vertigo attacks are usually associated with a decrease in blood glucose concentration and hypotension.

For the treatment of dizziness in pregnant women, the following prescription is effective: 1-2 tbsp. Dissolve spoons of sugar in a glass of warm boiled water, drink in the morning after waking up or before leaving the house.

Pregnant women (especially in the first half of pregnancy) should always carry water with them. When the first signs of dizziness appear, you should try to drink as much as possible.

Which symptoms are not diagnosed as dizziness?

As it becomes clear from the above, the term dizziness has a rather narrow medical interpretation: a false sense of one’s own rotation or the rotation of the surrounding world. A number of other symptoms that are not actually dizziness are often mistaken for dizziness:

• Weakness, unsteadiness, confusion in the legs, nausea
• Feeling of unsteady gait, imbalance
• Darkening of the eyes as a result of getting up abruptly from a lying or sitting position
• Feeling close to fainting, loss of consciousness
• Veil before the eyes.

A dizzy patient at a doctor’s appointment should tell the doctor as accurately as possible about his state of health, try to describe his condition, the symptoms observed, and not just tell the doctor that he suffers from “dizziness”. The plan for further examination and treatment depends on the accuracy of the patient’s description of his symptoms.

Unlike true dizziness, as it was said, which is a consequence of a violation of the balance system, false dizziness, described by patients as a feeling of instability, darkening in the eyes, weakness and a veil before the eyes, may be a sign of vegetovascular dystonia, anemia, chronic fatigue, hypotension (low blood pressure), hypovitaminosis. Also, dizziness can be confused with episodes of lipothymia (a sharp decrease in muscle tone with strong physical exertion), fainting, short-term attacks of epilepsy.

Special attention should be paid to acute attacks of weakness and dizziness in patients with diabetes mellitus. For this category of patients, weakness and dizziness may be a sign of a dangerous decrease in blood glucose levels.

How does the human balance system work?

True (central, systemic) dizziness is most often a manifestation of various diseases of the system that provides balance and control over the position of the human body in space.

The components of this system are:

• The vestibular apparatus, which is located in the thickness of the skull, where there are sensitive receptors that respond to linear or angular acceleration of the human body in space.
• Eyes that provide visual information about the location of the human body, as well as its individual parts in space relative to other objects.
• Proprioreceptors (sensitive receptors), which are located in the bones, joints, muscles, ligaments of a person, providing accurate information about the position of individual parts of the human body in space, as well as relative to each other.

Simultaneously, all three components of the system (vestibular apparatus, eyes, proprioceptors) send data to the brain. In certain areas of the brain, this information is analyzed, and then processed into a person’s ideas about how his body is located in space and relative to surrounding objects.

If for any reason the data that comes from one of the sources is distorted (for example, irritation of the receptors of the vestibular apparatus at rest), an incorrect idea about the position of the body in space and its movement occurs in the brain. In this case, an illusory sensation arises that the body is moving and rotating at the moment when in fact it is motionless.

The reasons that lead to the disruption of the balance system are different. To date, there are more than 80 diseases, the symptoms of which are dizziness. This article will discuss only the most common of them.

In which case should I immediately consult a doctor in case of dizziness?

In all cases of dizziness accompanied by the following symptoms, seek medical attention as soon as possible:

• Severe headache and weakness in the muscles of the arms or legs.
• Severe dizziness that does not go away for more than an hour.
• Severe dizziness in a patient with hypertension or diabetes mellitus.
• The patient fell and injured himself as a result of dizziness.
• The patient lost consciousness as a result of dizziness.
• Fever.
• Persistent vomiting.

What to do if you feel dizzy?

If dizziness occurs, it is recommended to consult a neurologist. Establishing the exact cause of dizziness and prescribing the correct treatment requires a comprehensive examination of the therapist, neuropathologist, endocrinologist, otolaryngologist.

If dizziness develops acutely and there are speech disorders, weakness or awkwardness in the limbs, double vision, numbness or other sensory disturbances, a doctor should be called immediately. It would be best to lie down before the arrival of the doctor, measure blood pressure. If the pressure is elevated, no measures should be taken to reduce it sharply. Remember: in most cases, a decrease in blood pressure below normal is more dangerous than its increase. Do not take medication without consulting your doctor.

Examinations that help to establish the diagnosis

Diagnosis and treatment of dizziness diseases are carried out by neuropathologists, otolaryngologists, ophthalmologists. In order to clarify the cause of dizziness and prescribe the correct treatment, the patient undergoes a series of examinations:

• examination by an ophthalmologist,
• X-ray of the skull and cervical spine,
• ultrasound dopplerography of the main arteries of the head,
• computed tomography (CT) or nuclear magnetic resonance (NMR),
• audiographic study.

Diet in the treatment of dizziness

Due to the fact that in some diseases that are accompanied by dizziness, there is an excess of filling fluid in the inner ear (for example, hydrops of the inner ear, Meniere’s disease), it is recommended to observe a number of dietary restrictions for excretion of excess fluid from the body in these patients:

• Restriction in the consumption of salty foods and table salt (no more than 2 g per day).
• Restriction in fluid intake (no more than 1.5 liters per day).
• Elimination of tobacco and alcohol.
• Restriction of consumption of chocolate, tea, coffee.

Rules for organizing the life of a patient prone to dizziness

Excluding those cases where dizziness is a sign of a dangerous disease (for example, a brain tumor), it does not pose a particular danger to human life. But its consequences can be very dangerous, for example, injuries as a result of falls. Patients suffering from chronic forms of dizziness are recommended to secure their place of work and home according to the following principles:

• Cover the floors with soft carpets that are free of folds and kinks that could be tripped over.
• In the bathroom, install a shelf with accessories in an easily accessible place that you can reach without getting up, stick special non-slip rubber pads on the bottom of the bathroom.
• Install handrails in the shower cubicle and place a chair on which you can take a seated shower.
• Equip existing staircases in the house with double-sided railings. When climbing stairs, always hold on to them, even if at that moment your head is not spinning.
• Place a night light on your bedside table so that you can turn it on without getting out of bed.
• If possible, place the phone near the bed so that you can reach it without getting up.
• When getting out of bed, take your time, get up with care, sit on the bed for 1-2 minutes and only get up completely when you feel normal.
• Avoid activities that require balance and precise control of body position in space (active sports, cycling).

Exercises to treat vertigo

Some types of vertigo (eg benign positional vertigo) are successfully treated with specific exercises.

Complex №1.

• Sit on the floor with your legs extended and looking straight ahead.
• Quickly lie on your back, quickly turn to your left side, continuing to look ahead.
• Quickly roll over onto your right side, then just as quickly roll over onto your back, then return to the sitting position.

It is very important in this case to do the exercise quickly. This is necessary to maintain the therapeutic effect. Before performing the exercise at a fast pace, do it several times, slowly, slowly, remembering the order of movements.

Complex №2.

Standing position, look straight ahead. Turn left (around the left heel), turn right (around the right heel).

Complex №3.

• Sitting on a chair, quickly lean forward, look at the floor. You also quickly straighten up, turning your head to the left.
• Repeat the exercise one more time, while turning the head to the right.
• Quickly turn your head to the left, then to the right. Repeat three times.
• Bend over quickly, looking at the floor. Then quickly straighten up, keep your head straight.