Dizziness is a feeling of being unsteady, but can refer to different sensations including vertigo, feeling faint and problems with balance. This leaflet gives a brief overview of the causes of dizziness. There are separate, more detailed leaflets for some of the conditions listed.
What is dizziness?
Ah, that is the million dollar question. "Feeling dizzy" means different things to different people. Or even to the same person in different situations. Most commonly it is used to describe one of the following sensations:
- Vertigo, which is a feeling of spinning around.
- Feeling faint or light-headed, as if about to pass out or collapse.
- Loss of normal balance, ie being unsteady but without feeling faint or whirly.
When you go to a doctor saying you feel "dizzy", you are giving them a real challenge. Because the word "dizzy" describes several symptoms, and a vast number of conditions can cause dizziness. Your doctor should, however, be able to narrow it down, by finding out exactly what you personally mean by dizziness, and asking about other symptoms.
Why am I dizzy?
Dizziness is usually a problem of the inner ear or brain. It may be due to infection or nerve problems. Balance issues without dizziness may be due to low blood pressure, anxiety, nerve problems and heart issues. It is important to see your doctor to investigate the problem.
Well, again, it is going to depend on what you personally mean by dizziness. If you have vertigo, ie you feel as if you or the world around you is spinning, then the most common causes are inner ear problems. Other than confusing your inner ear balance system by riding on a playground roundabout or the teacups ride at the fair, or by turning a load of pirouettes, then causes include:
- An infection in the region of the inner ear, such as labyrinthitis or vestibular neuritis.
- Benign paroxysmal positional vertigo (BPPV), a condition where certain movements of your head set off a spinning sensation.
- Ménière's disease.
Read more about these conditions and other causes of vertigo.
If, by dizziness, you mean feeling faint or light-headed, then conditions originating anywhere in your body may be the cause. For example:
- Having a high temperature (fever).
- Very hot weather.
- Side-effects of certain medicines.
- Panic attacks.
- Problems with your heart rate - for example, your heart going too fast, too slow or not regularly.
- Low iron levels (and other causes of anaemia).
- A drop in your blood pressure when you stand up (orthostatic hypotension).
Learn more about conditions which cause the type of dizziness where you feel faint or light-headed.
And if you mean the type of dizziness where you don't feel you or the room are spinning and you don't feel faint, but you just feel unbalanced, then there are yet more possible causes. These also can start from problems of various body organs and systems, such as your ear, your brain, your nervous system and your general state of health. Alcohol, street drugs and various medicines can also make you feel off-balance, and affect different people differently.
Find out more about how normal balance is achieved, and conditions which can cause loss of balance.
Is a cause always found?
With this number of possibilities, it isn't all that surprising that a cause is not always found. Indeed, it is estimated that in one out of every five people who go to the doctor complaining of dizziness, a cause is never found. Fortunately even if the cause hasn't been found, the symptom of dizziness often settles in time.
Should I worry about dizziness?
- Tinnitus (ringing or pulsing in ears)
- Hearing or visual loss
- Loss of consciousness or memory
- Headache, worsening or worse when laying down
- Headache, worse when coughing
- Numbness, movement or speech problems
- Irregular, slow or fast pulse
If you are getting recurring dizzy spells, or a constant dizziness for which there is no obvious cause, then see your doctor. If you have dizziness with other alarming symptoms (such as sudden weakness in your arms, legs or face muscles, or chest pain or feeling very breathless), then call an ambulance or see a doctor urgently.
Learn more about seeing a doctor if you have dizziness.
Will I need tests?
It depends. Your doctor will in many cases be able to work out the cause from listening to you explain your symptoms, and from examining you. There may be some special examination techniques used which examine your balance system. In other cases, more tests might be needed, which could include blood tests or a scan such as an MRI scan.
Read more about investigation of dizziness.
Is there any treatment?
The treatment you will have will depend on the cause. If the cause is found and treated, then the dizziness will settle. There are medicines which help with the vertigo type of dizziness, such as prochlorperazine or cinnarizine. Sometimes these are used to help the dizziness while waiting for a condition to settle (such as labyrinthitis, which usually gets better on its own over time). In other cases it is used to help you feel better while you await tests, or if a cause hasn't been found.
Read more about the treatment of dizziness.
Further reading and references
Vertigo; NICE CKS, April 2010 (UK access only)
Huh YE, Kim JS; Bedside evaluation of dizzy patients. J Clin Neurol. 2013 Oct9(4):203-13. doi: 10.3988/jcn.2013.9.4.203. Epub 2013 Oct 31.
Kaski D, Bronstein AM; Making a diagnosis in patients who present with vertigo. BMJ. 2012 Sep 3345:e5809. doi: 10.1136/bmj.e5809.
Post RE, Dickerson LM; Dizziness: a diagnostic approach. Am Fam Physician. 2010 Aug 1582(4):361-8, 369.
Kerber KA, Baloh RW; The evaluation of a patient with dizziness. Neurol Clin Pract. 2011 Dec1(1):24-33.
Hello, I’m a 32 yo male with type 1 diabetes and for the last 2 months I’ve experienced daily episodes of lightheadedness. I’ve seen an ENT, a neurologist and a cardiologist and all of them have...BrooklynMatt
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