Causes of Dizziness
Dizziness can be grouped into types by the region of the vestibular system that is not working properly. The different regions include the inner ear, the brain, the eyes, and the limbs (neck, back and leg muscles, and joints which react to keep us upright).
Causes of dizziness include:
- inner ear dizziness
- autoimmune inner ear disease
- age-related imbalance (presbystases)
- motion sickness
- mal de débarquement (MdD) syndrome
- central dizziness
- muscle-join dizziness, including cervicogenic dizziness (CGD)
- visual dizziness
Half of the inner ear is used for hearing (the cochlea) and the other half is used for balance (vestibular system). Vestibular symptoms and imbalance can result if the vestibular system or the nerve that connects it to the brain is malfunctioning. Many types of maladies can occur in the inner ear, including:
- Ménière’s disease - read more
- vestibular neuritis - read more
- benign paroxysmal positional vertigo (BPPV) - read more
- tumours of the inner ear nerves - read more
Initial symptoms vary, but may include imbalance, vertigo (spinning), and nausea. Tinnitus and hearing loss may occur, especially if the cochlea is also affected.
Diseases of the immune system may cause hearing impairment, dizziness, or both. The diagnosis is based on the symptoms and blood test results. Treatment with cortisone or autoimmune drugs may prevent further hearing loss and usually relieves dizziness. Long-term drug therapy may be necessary.
In general, dizziness is not considered to be a normal part of aging. However, as with many other organs there is evidence that some inner ear degeneration occurs with age. Some individuals develop imbalance or vestibular dysfunction with age for which the exact reasons are not well understood. In some cases the very small blood vessels supplying the inner ear or balance centres in the brain may change. Although dizziness may be minimal, some people have a high risk of falling. Rehabilitation, education and prevention strategies can address the dizziness and reduce the risk of falling.
A portion of the population experiences sensations of dizziness or nausea with motion of either of the person or the surroundings. This may not necessarily be a medical disorder but more likely represents a sensitive or hyperactive balance system. However, some people develop these sensations for the first time after a new vestibular disorder. Medications, rehabilitation (exercises or desensitization) and coping strategies can be helpful.
MdD is a rare disorder in which the person has persistent feelings of dizziness or body sway after being exposed to an unstable surface for an extended period (usually more than 72 hours). Most commonly this results after a cruise, but it can occur after other activities such as a long car trip.
Central dizziness refers to problems in the balance centres of the brain. Anytime these areas are not working properly, dizziness and imbalance can occur. Symptoms may include dizziness, vertigo, light-headedness, disorientation, imbalance, and sometimes even blacking out. Causes of central dizziness include low blood sugar, low blood pressure to the brain, strokes, multiple sclerosis, migraine headaches, head injury, and tumours, among others. Treating these types of dizziness usually involves treating the underlying brain problem which varies from person to person, but may include medications, changes in lifestyle, or vestibular rehabilitation.
This type of dizziness is uncommon. In this type of dizziness, the limb sensors in the muscles or joints (usually in the feet or neck) are not working properly or give different information than the other balance centres. These can cause imbalance, unsteadiness, or a sense of disorientation. Causes of muscle-joint dizziness may include muscular dystrophy, severe diabetes, arthritis, joint replacements, and injuries such as whiplash. When these symptoms are the result of neck-related injury or disorders, it is often referred to as cervicogenic dizziness (CGD). Treatment often includes hands-on physiotherapy and vestibular rehabilitation exercises.
Eye muscle imbalance and poor vision can make balance worse. The brain relies on information from the eyes for balance. Carsickness or seasickness are types of visual dizziness as the eyes and the vestibular system receive different information about where you are in space, which confuses the balance part of the brain. This can lead to dizziness, nausea, or vomiting. On occasion, new disorders of the eyes, vestibular system or proprioceptive system can cause a similar motion sensitivity or visual dizziness. Treatment may include addressing poor vision, poor balance, or involve rehabilitation exercises to address these symptoms.
Read more: Balance and Dizziness: The Visual Connection