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What is Dizziness?
Dizziness Types – Causes of Dizziness – Vertigo vs. Lightheadedness vs. Lack of Balance
What is dizziness? This word means nothing because every single person puts a different meaning into it. Check Webster! Even definition of the word does not mean much.
So, what does it mean? For now, I will try to list some of the meanings that I’ve heard so far: lightheaded, spinning sensation, tired, confused, near-fainting, heavy sensation in the head, “mind is in the fog”, lack of coordination or balance, blurred vision, and so on. Every single office day I see at least someone who complains about feeling dizzy… What do I do with this package?
It is very simple! After exclusion of all “brain fog”-like and vision related thingies we are left with only three categories. They are vertigo, lightheadedness or near fainting, and issues with balance and stability while walking. All the articles about “dizziness” on this site are broken down into categories based on this classification.
Vertigo is a rocking or spinning sensation. This sensation is very straightforward and very few people experience difficulty describing it. Those who have poor insight sometimes may describe it as a lack of balance and a tendency to fall.
Besides being the most distinctive sensation, vertigo always has a particular detectable cause. Sometimes it is hard to pinpoint the exact disease but the source of this sensation is almost always clear.
The vast majority of spinning sensation is caused by a disease of the labyrinth. This is a paired organ situated within the temporal bones, responsible for the detection of the speed, the direction, and the plane of the head movements.
This vertigo is called peripheral. It might have different pattern and triggers. Benign paroxysmal positional vertigo is triggered by the head movements as the name implies. Vertigo may be episodic or recurrent and be totally independent of the head motion like in Meniere disease.
Occasionally, vertigo may be caused by strokes, multiple sclerosis, tumors, temporal lobe epilepsy, or migraine. Unlike peripheral vertigo, central vertigo in above mentioned conditions is usually accompanied by additional symptoms, which help to make the right diagnosis.
Lightheadedness is a sensation of near-fainting. This is what people normally feel shortly before they faint. Lightheadedness is only rarely related to any brain disease. Parkinson disease spectrum disorders, for example, are often associated with the autonomic system failure to regulate the blood vessel tone. Lightheadedness and fainting in upright position is one of the symptoms of multiple system atrophy. Another example is polyneuropathy, which might lead to poor cardiovascular regulation when the body position is changed.
Most of the time lightheadedness is caused by a general circulation failure. Possible reasons are cardiac arrhythmias, pauses in heart contractions, blood pressure drop, dehydration, altitude sickness, pulmonary embolism, and similar.
Tendency to fall due to inability to keep balance while walking or standing is most of the time related to the brain or nerve disorders.
Lack of coordination occurs in Parkinson’s disease. Acute lack of balance occurs in stroke. Slightly less acute onset is typical for multiple sclerosis either due to brain or spinal cord involvement. Actually any brain or spinal cord disease may affect ambulation and ability to balance while walking.
Ambulation is very complex process requiring multiple feedback loops. Polyneuropathy, if severe enough, may produce a gait instability and falls.
Non-neurological causes of unsteadiness are mostly related to arthritis and joint replacement in the lower body or any type of musculoskeletal pain in the legs and the lower back.
Chronic subjective dizziness syndrome is a bizarre phenomenon of subjective instability, which cannot be confirmed by an outside observer.
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Disclosure: This Web Site is intended for education purpose only. The information provided on this site must not be perceived as a guide for self-diagnosis or self-treatment. Every effort is made to keep the information current, but there are absolutely no guarantees of timely updates. By Andre Strizhak