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It has been suggested that Disequilibrium (medicine) be merged into this article. (Discuss) Proposed since July 2018.

Dizziness
Depicting the character 暈 (dizziness) in the seal script of Ancient Chinese
Classification and external resources
Specialty	otolaryngology
ICD-10	R42
ICD-9-CM	780.4
DiseasesDB	17771
MedlinePlus	003093
eMedicine	neuro/693
MeSH	D004244
[edit on Wikidata]

Dizziness is an impairment in spatial perception and stability.^[1] 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 department.^[5]

Classification

Dizziness is broken down into 4 main subtypes: vertigo (~50%), disequilibrium (less than ~15%), presyncope (less than ~15%) and lightheadedness (~10%).^[6]

Mechanism

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.^[7]

Common physiological causes of dizziness include:

• inadequate blood supply to the brain due to:
  
  • a sudden fall in blood pressure^[7]
  
  
  • heart problems or artery blockages^[7]
  
  


• loss or distortion of vision or visual cues^[7]


• disorders of the inner ear^[7]


• distortion of brain/nervous function by medications such as anticonvulsants and sedatives^[7]


• result of side effect from prescription drugs, including proton-pump inhibitor drugs (PPIs)^[8] and Coumadin (warfarin) causing dizziness/fainting ^[9]

Diagnosis

Differential diagnosis

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/disequilibrium, and 10% nonspecific dizziness.^[10] Some vestibular pathologies have symptoms that are comorbid with mental disorders.^[11] The medical conditions that often have dizziness as a symptom include:^{[10][12][7][13]}

• Benign paroxysmal positional vertigo


• Meniere's disease


• 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^[14]


• 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

Epidemiology

About 20–30% of the population report to have experienced dizziness at some point in the previous year.^[5]

See also

References

External links

• 
  Dizzytimes.com Online Community for Sufferers of Vertigo and Dizziness


• Dysautonomia Youth Network of America, Inc.