Dizziness
Dizziness | |
---|---|
Classification and external resources | |
Specialty | otolaryngology |
ICD-10 | R42 |
ICD-9-CM | 780.4 |
DiseasesDB | 17771 |
MedlinePlus | 003093 |
eMedicine | neuro/693 |
MeSH | D004244 |
Dizziness is an impairment in spatial perception and stability.[1] Because the term dizziness is imprecise,[2] it can refer to vertigo, presyncope, disequilibrium,[3] or a non-specific feeling such as giddiness or foolishness.[4]
One can induce dizziness by engaging in disorientating activities such as spinning.
- Vertigo is the sensation of spinning or having one's surroundings spin about them. Many people find vertigo very disturbing and often report associated nausea and vomiting. It represents about 25% of cases of occurrences of dizziness.[5]
- Disequilibrium is the sensation of being off balance, and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.
- Presyncope is lightheadedness, muscular weakness and feeling faint as opposed to a syncope, which is actually fainting.
- Non-specific dizziness is often psychiatric in origin. It is a diagnosis of exclusion and can sometimes be brought about by hyperventilation.[4]
A stroke is the cause of isolated dizziness in 0.7% of people who present to the emergency room.[5]
Contents
Classification[edit]
Dizziness is broken down into 4 main subtypes: vertigo (~50%), disequilibrium (less than ~15%), presyncope (less than ~15%) and lightheadedness (~10%).[6]
Differential diagnosis[edit]
Many conditions are associated with dizziness. Dizziness can accompany certain serious events, such as a concussion or brain bleed, epilepsy and seizures (convulsions), strokes, and cases of meningitis and encephalitis. However, the most common subcategories can be broken down as follows: 40% peripheral vestibular dysfunction, 10% central nervous system lesion, 15% psychiatric disorder, 25% presyncope/dysequilibrium, and 10% nonspecific dizziness.[7] Some vestibular pathologies have symptoms that are comorbid with mental disorders.[8] The medical conditions that often have dizziness as a symptom include:[7][9][10][11]
- Benign paroxysmal positional vertigo
- Meniere's disease
- Vestibular neuronitis
- Labyrinthitis
- Otitis media
- Brain tumor
- Acoustic neuroma
- Motion sickness
- Ramsay Hunt syndrome
- Migraine
- Multiple sclerosis
- Pregnancy
- low blood pressure (hypotension)
- low blood oxygen content (hypoxemia)
- heart attack[12]
- iron deficiency (anemia)
- low blood sugar (hypoglycemia)
- hormonal changes (e.g. thyroid disease, menstruation, pregnancy)
- panic disorder
- hyperventilation
- anxiety
- depression
- age-diminished visual, balance, and perception of spatial orientation abilities
Mechanism[edit]
Many conditions cause dizziness because multiple parts of the body are required for maintaining balance including the inner ear, eyes, muscles, skeleton, and the nervous system.[10]
Common physiological causes of dizziness include:
- inadequate blood supply to the brain due to:
- loss or distortion of vision or visual cues[10]
- disorders of the inner ear[10]
- distortion of brain/nervous function by medications such as anticonvulsants and sedatives[10]
- result of side effect from prescription drugs, including proton-pump inhibitor drugs (PPIs)[13] and Coumadin (warfarin) causing dizziness/fainting [14]
Epidemiology[edit]
About 20–30% of the population report to have experienced dizziness at some point in the previous year.[5]
See also[edit]
- Balance disorder
- Broken escalator phenomenon
- Coriolis effect (perception)
- Equilibrioception
- Ideomotor phenomenon
- Illusions of self-motion
- Motion sickness
- Postural orthostatic tachycardia syndrome
- Proprioception
- Seasickness
- Spatial disorientation
- The spins, a state of dizziness and disorientation due to intoxication
- Vertigo
References[edit]
- ^ "dizziness" at Dorland's Medical Dictionary
- ^ Dizziness at the US National Library of Medicine Medical Subject Headings (MeSH)
- ^ Reeves, Alexander G.; Swenson, Rand S. (2008). "Chapter 14: Evaluation of the Dizzy Patient". Disorders of the Nervous System: A Primer. Dartmouth Medical School.
- ^ a b Branch Jr., William T.; Barton, Jason J. S. (February 10, 2011). "Approach to the patient with dizziness". UpToDate.
- ^ a b c Neuhauser HK, Lempert T (November 2009). "Vertigo: epidemiologic aspects". Semin Neurol. 29 (5): 473–81. doi:10.1055/s-0029-1241043. PMID 19834858.
- ^ Post RE, Dickerson LM (August 2010). "Dizziness: a diagnostic approach". Am Fam Physician. 82 (4): 361–8, 369. PMID 20704166.
- ^ a b Chan Y (June 2009). "Differential diagnosis of dizziness". Curr Opin Otolaryngol Head Neck Surg. 17 (3): 200–3. doi:10.1097/MOO.0b013e32832b2594. PMID 19365263.
- ^ Lawson, B. D., Rupert, A. H., & Kelley, A. M. (2013). Mental Disorders Comorbid with Vestibular Pathology. Psychiatric Annals, 43(7), 324.
- ^ Tusa RJ (March 2009). "Dizziness". Med. Clin. North Am. 93 (2): 263–71, vii. doi:10.1016/j.mcna.2008.09.005. PMID 19272508.
- ^ a b c d e f g "Dizziness and Vertigo". Merck Manual. 2009.
- ^ Bronstein AM, Lempert T (2010). "Management of the patient with chronic dizziness". Restor. Neurol. Neurosci. 28 (1): 83–90. doi:10.3233/RNN-2010-0530. PMID 20086285.
- ^ O'Connor RE, Brady W, Brooks SC, et al. (November 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S787–817. doi:10.1161/CIRCULATIONAHA.110.971028. PMID 20956226.
- ^ http://www.fda.gov/Drugs/DrugSafety/ucm245011.htm
- ^ http://www.rxlist.com/coumadin-side-effects-drug-center.htm
External links[edit]
- Dizzytimes.com Online Community for Sufferers of Vertigo and Dizziness
- Dysautonomia Youth Network of America, Inc.