Deciphering Dizziness and When To Call a Doctor

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You roll over in bed – and the room starts to spin. Or you stand up from the couch – and you suddenly feel woozy and disoriented. What’s going on?

“Dizziness” is one of the most frequently cited complaints when people seek medical help. According to estimates from the National Institutes of Health, dizziness, vertigo and balance problems affect between 15 - 20 percent of U.S. adults each year, with higher rates seen in people 65 and older. It affects females up to three times more than males.* 

Diagnosing dizziness can be frustrating because dizziness isn’t a disease or a condition– it’s a symptom. Many factors can disrupt your balance. Being hungry or dehydrated can make you feel lightheaded. Some medications can make you feel dizzy. Health problems such as infection, stroke or tumor can affect your inner ear or brain, throwing off your balance.

To pinpoint the underlying cause, healthcare providers must first identify the type of dizziness a person is experiencing, said Nofrat Schwartz, MD, an otolaryngologist (ear, nose and throat surgeon) at Yale New Haven Health and assistant professor of Otolaryngology at Yale School of Medicine.

“When a patient complains of dizziness, it can refer to many different sensations,” she said. “It’s important for a provider to figure out what dizziness means to you.”

“Many types of dizziness are caused by inner ear diseases, so it is important for a patient to accurately describe symptoms,” added Frank Dellacono, MD, section chief of Otorhinolaryngology at Lawrence + Memorial Hospital.  

Types of dizzy sensations:  

• Are you lightheaded? Lightheadedness is a feeling of faintness or wooziness, as if you are suddenly about to pass out. You may feel sweaty and nauseous or have trouble hearing or seeing well. This can be related to conditions that affect the heart or blood circulation. You may also feel lightheaded and woozy if you are dehydrated or have low blood sugar. It may also be a side effect of medications.
• Is it vertigo? Does it feel like the room is spinning and swirling around you, even though you are sitting still? This is called vertigo, and it may be accompanied by nausea, vomiting, sweating or difficulty walking. Vertigo can be associated with many conditions, including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniere's disease, migraines, concussions from head injuries and motion sickness.
• Are you feeling unsteady or off-balance? Balance problems can make you feel dizzy. Losing your balance while walking or standing can result from problems with your inner ear; muscle weakness or nerve damage to your legs (peripheral neuropathy); certain neurological conditions; joint, muscle or vision problems; or as a side effect of medications.

When to call your healthcare provider

Everybody experiences dizziness at some point in their lives, and many cases are mild and go away on their own. But when you should see your healthcare provider?

“See your doctor if you’ve never had dizziness before or if you are experiencing different symptoms than you normally do,” Dr. Schwartz. said. “Also, if you are experiencing significant dizziness or unsteadiness that that is hampering your daily activity, that also warrants further medical evaluation.

“You might occasionally experience vertigo when you have a mild illness, but if it lasts for more than a day, it’s recommended that you see a doctor about what might be causing it,” Dr. Dellacono said.

Tell your health care provider when the symptoms occurred, how long they lasted and what triggered them. This will help your provider narrow down the possible cause and determine what’s causing your symptoms.

According to Dr. Dellacono, a new balance problem can sometimes signal a medical emergency, like a stroke. “If the dizziness is not fleeting or eased by lying down or if your balance is compromised, you should immediately visit the closest emergency department,” he said. 

It’s important to get symptoms checked out as soon as possible. Seek medical attention immediately if you have any of the following symptoms:

• Dizziness after a head injury
• High fever
• Stiff neck 
• Sudden or severe headache
• Sudden change and complete loss of hearing
• Convulsions or ongoing vomiting
• Chest pain, heart palpitations, shortness of breath, inability to move an arm or leg
• Change in vision or speech
• Fainting and/or loss of consciousness 
• Weakness or numbness in your face, leg or arm

Chronic dizziness can be concerning and may indicate a more serious issue. To learn more about dizziness and related symptoms and conditions, visit Yale New Haven health and click here to learn more.