Dizziness: Causes, diagnosis and treatment

What is dizziness?

Dizziness is also called lightheadedness and describes sensations such as feeling unsteady, balance problems or the room spinning.

Feeling dizzy at times is common. Different people may experience slightly different feelings of dizziness. Severe dizziness is called vertigo. A feeling of being unsteady is also called disequilibrium.

If dizziness happens often, causes falls, or if you have concerns - seek medical advice.

Doctors will be more concerned about a person being dizzy if they also lose consciousness or  faint.

What causes dizziness?

Dizziness can have many causes, including:

• Ear infections and conditions, including labyrinthitis and Ménière's disease, affecting balance
• Migraines
• Stress
• Anxiety
• Low blood sugar levels ( hypoglycaemia) that can affect people with diabetes, also called 'hypos'
• Blood pressure falling when standing up, called postural hypotension, that can affect older people
• Dehydration
• Heat exhaustion
• Lack of blood flow to the brain, called vertebrobasilar insufficiency
• Neurological (brain) conditions, including stroke and multiple sclerosis (MS)
• Anaemia
• Alcohol abuse
• Drug abuse
• Side-effects of some medication
• Irregular heartbeat
• Carbon monoxide poisoning
• Head injury
• Vision problems, adjusting to new glasses
• Sea, air or rail travel - along with travel sickness or motion sickness.

Diagnosing dizziness

Dizziness is a symptom of something else rather than a condition in its own right.

A diagnosis is not an easy task because of many causes and possibly vague symptoms.

A doctor will ask about the symptoms felt during spells of dizziness, how often it happens and whether it happened when standing up or at any time, including when lying down.

They may perform a physical examination, and will look at the person's medical history for any conditions or medication that could be causing the problem.

It may help to keep a log of times dizziness came on, and what may have been happening at the time, to see if there's a pattern.

A GP may make a referral to a specialist for further tests, investigations, diagnosis and possible treatments. This may be to a hospital 'neuro-otology' department - meaning it deals with neurological conditions affecting the ears and balance system.

An assessment may include balance tests which check balance alongside information from the eyes:

• ENG (electro-nystagmography) checking eye movements while sitting down
• Caloric Test - checking balance in each ear alongside eye movements
• SVV/SVH short for subjective visual vertical or horizontal carried out in a dark room using lasers
• Posturography to check balance test while standing on a platform
• Dix Hallpike Manoeuvre to check for a build-up of crystals in the inner ear
• VEMP Test (vestibular evoked myogenic potential) to check balance while moving the head.

A person who experiences regular dizzy spells will need to tell the DVLA about it as it can affect safe driving.

Treating dizziness

Treating an underlying health condition may help prevent dizziness symptoms - such as better control of diabetes and avoiding 'hypos'.

If a bacterial ear infection is suspected, antibiotics may be recommended.

Preventing dizziness

Dizzy spells can't always be avoided, but looking after general health with a healthy balanced diet and taking exercise may help reduce the risk of dizziness.

Avoiding stress can also help some people. Consider relaxation techniques and leaving plenty of time for appointments so you don't feel under pressure.