Dizziness: Description, Causes, and Risk Factors:
Dizziness is a sensation of imbalance or faintness, sometimes associated with weakness, confusion, and blurred or double vision. It is a common symptom. Episodes of this symptom are usually brief. They may be mild or severe with an abrupt or gradual onset. It may be aggravated by standing up quickly and alleviated by lying down or by rest.
Dizziness typically results from inadequate blood flow and oxygen supply to the cerebrum and spinal cord. It is commonly confused with vertigo - a sensation of revolving in space or of surroundings revolving about oneself. However, unlike dizziness, vertigo is commonly accompanied by nausea, vomiting, nystagmus, a staggering gait, and tinnitus or hearing loss. Dizziness and vertigo may occur together such as in post-concussion syndrome.
Causes and Risk Factors:
Typically anemia causes dizziness that is aggravated by postural changes or exertion. Other signs and symptoms include pallor, dyspnea, fatigue, tachycardia, and a bounding pulse. Capillary refill time is increased.
- Cardiac arrhythmias. With arrhythmias, dizziness lasts for several seconds or longer and may precede fainting. The patient may experience palpitations, weakness, blurred vision, paresthesia, or an irregular pulse.
- Drugs. Anxiolytics, central nervous system depressants, opioids, decongestants, antihistamines, antihypertensive and vasodilators commonly cause dizziness.
- Generalized anxiety disorder. Generalized anxiety disorder produces continuous dizziness that may intensify as the disorder worsens. Associated signs and symptoms are persistent anxiety, insomnia, difficulty concentrating, irritability, twitching or fidgeting, muscle aches, a furrowed brow, and a tendency to be startled.
- Hypertension. With hypertension, this symptom may precede fainting, but it may also be relieved by rest. Other common signs and symptoms include a headache or blurred vision.
- Hyperventilation syndrome. Episodes of hyperventilation cause dizziness that usually last a few minutes; however, if episodes of hyperventilation occur frequently, it may persist between them.
- Hypovolemia. With hypovolemia, dizziness is caused by a lack of circulating volume and may be accompanied by dry mucous membranes, decreased blood pressure, or increased heart rate.
- Orthostatic hypotension. Orthostatic hypotension produces dizziness that may end with fainting or disappear with rest. Other findings include dim vision, spots before the eyes, pallor, diaphoresis, hypotension, and tachycardia.
- Transient ischemic attack (TIA). Dizziness may vary severity is typically present during a TIA. Lasting from a few seconds to 24 hours, a TIA commonly signals an impending stroke.
The false sense of motion or spinning (vertigo).
- Lightheadedness or the feeling of near fainting.
- Loss of balance or unsteadiness (disequilibrium).
- Other sensations such as floating, swimming or heavy-headedness.
Ask the patient if the patient has a history of diabetes or cardiovascular disease, is taking antihypertensive medications, any drug history, ask about palpitations, chest pain, diaphoresis, shortness of breath, and chronic cough.
Next, perform a physical examination. Begin with a quick neurologic assessment, checking the patient's level of consciousness, motor and sensory functions, and reflexes. Inspect for poor skin turgor and dry mucous membranes. Auscultate heart rate and rhythm. Inspect for barrel chest, clubbing, cyanosis, and accessory muscle use. Also, auscultate breath sounds. Take the patient's blood pressure while the patient is lying down, sitting, and standing to check for orthostatic hypotension. Test capillary refills time in the extremities and palpates for edema.
Dizziness is a symptom, not a disease, and treatment will be directed to the underlying cause. For example, dizziness or lightheadedness due to dehydration from gastroenteritis may require intravenous fluids and medications to stop the vomiting and diarrhea, while dizziness or lightheadedness from a heart rhythm condition may require admission to the hospital and specialized testing and treatment.
NOTE: The above information is an educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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