Dizziness: Fainting vs. Inner ear disease

Dizziness, lightheadedness, or giddiness can result from many different diseases and is not limited to problems in the inner ears.    In general, these symptoms can be broken into two broad  categories: presyncopal lightheadedness, and vestibular dizziness

Syncope is the medical term for a faint.  When you feel as if you are passing out or about to faint, you are experiencing presyncopal lightheadedness.  During fainting loss of consciousness occurs, and you will usually slump or fall to the floor. Just prior to fainting there is a sensation that vision is dimming, the world is fading far away, and thoughts are hard to keep focused.  There may be a rushing or ringing sound in the ears and a feeling of weakness or nausea.  A faint typically occurs when the blood flow to the head is abruptly reduced, either because the blood pressure or volume is too low, or the heart rhythm is disturbed.  There are many different disorders that can cause faints or lightheadedness. For example, dehydration, medications, and palpitations can all result in a faint.

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Making the diagnosis: The first spell

Vertigo and dizziness come from many different causes, and it is important to figure out exactly which one is the source.  When people come to me with a dizziness problem, one of the key things to narrow down the diagnosis is to have them describe their first spell.  Here are a couple of examples:

Beth recalled having three bouts of vertigo over the last several years.  The first one was very similar to the other two.  She was in bed, and in the early morning she woke up with vertigo immediately after rolling over to her right side.  The room was spinning violently but only for about 15 seconds.  When she tried to get out of bed, it happened again.  All the spells were short.  That morning after she was up and about, she felt better, but when shampooing her hair in the shower, she had another brief bout.   She had to be careful when lying down on her right side for a couple of weeks, but it all gradually went away. 

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Take the first steps to solve vertigo

Dizziness is one of the most common symptoms people report to their doctors. Sadly, many people never find out why they are dizzy. Their doctors often have very limited knowledge about the many different problems that generate vertigo, so they dread seeing dizzy patients and have little to provide in the way of treatment. Most vertigo can be greatly improved or completely eliminated, so choosing to educate yourself about your dizziness can help you narrow down the cause of the problem and find a solution. That’s the purpose of this blog.

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