Understanding Dizziness

Our body's balance system depends on integrated sensory inputs from nerve fibres throughout the limbs, trunk, cervical spine, and brain, as well as from vision and the inner ear. 

Disruptions in this system can lead to dizziness. 

Many factors can cause dizziness, ranging from minor issues to underlying medical conditions that may involve the vascular circulatory and neurological systems throughout the body, neck, spine, and brain, as follows:

• Brain Problems

  • Narrowed arteries in the neck and brain due to atherosclerosis, when severe enough to reduce blood flow to the brain, can produce signs of an impending stroke. 

  • Stroke: An ischemic stroke affecting the brainstem may sometimes present only with symptoms of dizziness.

  • Head injuries: dizziness is a very common symptom in post-concussion syndrome.

  • Brain tumour: acoustic neuroma, a noncancerous tumour in the skull base and inner ear can affect balance and cause dizziness.

  • Anxiety Disorders: Panic attacks, generalised anxiety, or agoraphobia can induce lightheadedness or wooziness. Hyperventilation due to anxiety or stress can also cause dizziness.

  • Parkinson's disease, multiple sclerosis, migraines or other diseases affecting the brain or nervous system can impair balance and cause dizziness

• Inner Ear Conditions (Vestibular Disorders)

  • The inner ear plays a vital role in maintaining balance. 

  • When the inner ear sends signals to the brain that conflict with information from the eyes and sensory nerves, vertigo can result

  • Common inner ear causes include:

    1. Benign Paroxysmal Positional Vertigo (BPPV): The most common cause of vertigo, characterised by intense, brief spinning sensations triggered by rapid head movements (e.g., turning in bed, sitting up).

    2. Ménière's Disease: A rare condition involving fluid buildup in the inner ear, causing sudden, prolonged vertigo episodes, fluctuating hearing loss, ringing in the ear (tinnitus), and a feeling of ear fullness.

    3. Persistent Postural Perceptual Dizziness (PPPD): Chronic dizziness triggered by visual stimuli or upright posture, often fluctuating.

    4. Vestibular Neuritis/Labyrinthitis: Inflammation of the vestibular nerve (vestibular neuritis) or the inner ear (labyrinthitis), often caused by a viral infection, leading to intense, constant vertigo and sometimes sudden hearing loss.

• Neck Problems

  • Neck problems or cervical spine issues are a common yet often overlooked cause of dizziness. 

  • Cervical spondylosis with disc protrusions impinges spinal cord or nerves to interfere with nerve signal transmission at the cervical spine, thus leading to feelings of unsteadiness, wooziness, or loss of balance.

• Blood Circulatory Problems

  • Insufficient blood flow to the brain can cause dizziness, faintness, or imbalance. These issues include:

    1. Orthostatic Hypotension: A sudden drop in blood pressure upon standing or sitting up quickly, leading to brief faintness or dizziness.

    2. Narrowed arteries (atherosclerosis) along neck and brain: can reduce blood flow to the brain or inner ear, causing dizziness. 

    3. Heart disease conditions like cardiomyopathy, heart attack, irregular heartbeat (e.g., atrial fibrillation)

  • Anaemia: A lack of healthy red blood cells circulates to oxygenate the brain, resulting in dizziness, fatigue, weakness, and pale skin.
     

• Drugs effects

  • Certain drugs, such as anti-seizure medications, antidepressants, sedatives, tranquillisers, and blood pressure medications, can cause dizziness as a side effect 
     

• Generalised and metabolic Problems

  • Mild systemic diseases like flu can lead to dizziness in addition to headaches, weakness, and an upset stomach 

  • Low blood sugar (Hypoglycemia): Especially in individuals with diabetes, low blood sugar can cause sudden dizziness, sweating, and anxiety. 

  • Dehydration or Overheating: Insufficient fluid intake or activity in hot weather can lead to dizziness