NH cares

Giddiness and Dizziness:
Diagnosis and treatment of frequent fainting

1.

Arrow

1.What is giddiness?

What is Giddiness

Giddiness or dizziness is the feeling of being unbalanced and lightheaded. One might feel woozy or have the disorienting feeling of the surroundings spinning, reeling or moving. One might also feel faint or like one is about to faint. Giddiness is sometimes accompanied by nausea or vomiting. While giddiness can affect a person severely, it is not an independent medical condition but often a symptom of some other underlying condition. This underlying condition could be something as simple as overexertion or as serious as a stroke. Most often it is caused by neurological or inner ear issues.

2.

Arrow

2.Causes of frequent giddiness

Some of the most common causes of frequent giddiness are:

Hypotension:

Hypotension is a term for low blood pressure. Hypotension is generally a blood pressure reading that is lower than 90 mm Hg/ 60mm Hg. Most people experience changes in blood pressure throughout the day within a normal range. A blood pressure of around 120 mm Hg/ 80 mm Hg is desirable. Some people have constantly low blood pressure with absolutely no symptoms. However, a sudden fall in blood pressure can sometimes trigger episodes of giddiness.

Hypoglycemia:

Low blood sugar is called hypoglycemia. A blood sugar reading of less than 70 mg/dL is considered low and can cause dizziness or lightheadedness. The causes for hypoglycemia are varied but it can be a potentially very serious event and should be treated by a qualified medical professional immediately.

BPPV or Benign Paroxysmal Positional Vertigo:

This condition is one of the most frequently seen causes for the feeling of giddiness. It is the condition when the patient experiences a spinning sensation with mild to severe giddiness. The spinning sensation is called vertigo. Any change in the position of the patient’s head can trigger the sensation. It can also be caused by lying down, sitting up or turning over in bed. BPPV is caused by problems with the inner ear.

BPPV Inner Ear Problems

The inner ear has tubes or canals that are filled with fluid that moves in accordance with the person’s head rotation movements. The canals also have hair-like sensors that detect movement in the fluid thus telling the brain about the person’s position. The ear also has Otolith Organs that have crystals that are sensitive to gravity and can detect the up and down, back and forth as well as the right and left movements of the person. When these crystals get dislodged they tend to move to the fluid containing canals. This confuses the body’s mechanism for sensing movement and sends confusing signals to the brain causing the spinning sensation of vertigo.

Inner Ear Problems:

Irritation or inflammation of the inner ear can cause balance problems and giddiness. Rarely, a viral or bacterial infection of the inner ear could occur that could also be a cause of giddiness. Meniere’s disease could also be a cause of vertigo. This disease affects the inner ear and causes hearing problems as well as vertigo.

Circulatory Problems:

Circulatory problems can be a cause of giddiness. When there is a problem with the circulation of blood within the body, the blood supply and consequently the oxygen supply to all the parts of the body are reduced. Heart muscle disease or problems such as Tachy Brady syndrome can cause dizziness or giddines. Such underlying problems should be immediately treated by a qualified medical professional.

Anaemia:

Anemia is the term used to describe low levels of red blood cells (RBC) in a person’s body. It is measured by checking the haemoglobin count of a person. When the RBC count is too low it reduces the oxygen-carrying capacity of the blood thus decreasing the amount of oxygen that is being supplied to the rest of the body causing dizziness.

Motion Sickness:

This is a common yet bothersome reason behind episodes of giddiness. Motion sickness occurs in some people when they travel either by boat, car, air or train. It makes a person feel woozy, nauseous and giddy.

Dehydration:

Dehydration is the condition when a person’s fluid loss is more than the intake. When there is too much water loss the body finds itself unable to function normally and giddiness is one of the symptoms.

Over Exertion Or Excessive Exercise:

While getting adequate exercise is always a good thing, too much of it can cause problems. One of the signs of excessive exercise is episodes of giddiness.

Migraines:

The symptoms of migraines vary from person to person. Some people suffer from migraines that are accompanied by dizziness and lightheadedness.

Head Injury:

Head injuries can cause a host of symptoms and problems. However, giddiness is a very common symptom in head injury patients. It should not be taken lightly and one must immediately seek the attention of a qualified medical professional.

Stroke:

A Stroke is caused when the blood supply to the brain is disrupted in some way. Sometimes, the onset of a Stroke is gradual and one amongst the symptoms is giddiness. It is a potentially dangerous condition that should be immediately treated by a qualified medical professional.

Neurological Problems:

Neurological issues such as Multiple Sclerosis or Parkinson’s exhibit giddiness as one of the symptoms.

Vestibular Neuritis And Labyrinthitis:

Vestibular Neuritis is the condition of inflammation of the vestibular nerve whereas Labyrinthitis is the inflammation of both the vestibular nerve and cochlear nerve. Since the vestibular nerve transmits information about balance to the brain it causes only vertigo symptoms. The cochlear nerve transmits hearing information and therefore Labyrinthitis causes both Vertigo as well as hearing problems and ringing in the ears. Both the conditions can be accompanied by nausea, vomiting and concentration problems. Most Vestibular Neuritis cases are caused by viral infections while some can be the result of bacterial infections too.

Anxiety Disorders:

When a person has anxiety disorders one of the common symptoms is a feeling of giddiness. The types of disorders and the triggers are varied from individual to individual.

Heat Stroke:

Exposure to excessive heat or physical exertion in high temperatures causes the body to overheat. This can cause a serious condition of heatstroke when the body temperature goes above 104 F (40 C) or higher. This is most likely to occur in summer and starts with symptoms of giddiness. It is an emergency situation that requires immediate medical attention.

Medication:

Certain medications can have a side effect of causing giddiness. For example, incorrect doses of medication to treat blood pressure may lower the blood pressure too much thus causing dizziness. The medication dosage would have to be adjusted by a medical professional. Anti-seizure medication, sedatives, antidepressants and tranquilizers are some of the medications that may have the unpleasant side effect of causing dizziness.

3.

img

3.Giddiness and its link to Tachy Brady syndrome

Tachy Brady Syndrome is the name that is used to refer to Tachycardia Bradycardia Syndrome which is a heart condition that is a type of Sick Sinus Syndrome (SSS). The SSS type of disorders are caused by the malfunctioning of the Sinus Node in the heart which controls the pace of one’s heartbeat. When the Sinus Node malfunctions the heart does not beat properly and exhibits different types of issues with the heart rate called Arrhythmias.

When the heart beats too fast it is called Tachycardia and when it beats too slowly it is called Bradycardia. When both the issues alternate it is called a Tachy Brady Syndrome. When one suffers from this syndrome, the heartbeats alternate between abnormally fast and abnormally slow.

This causes improper flow of blood to the rest of the body which causes fatigue, giddiness and even fainting in some cases. It is usually seen to occur in people who have experienced Atrial Fibrillation. The most common symptoms for this condition are dizziness and palpitations.

4.

img

4.Symptoms of Giddiness

Giddiness presents with some or all of the following symptoms:

  • Feeling faint
  • Feeling lightheaded
  • Feeling like the surroundings are moving or spinning
  • Being unsteady on one’s feet
  • Losing one’s balance
  • A disoriented feeling of floating or swimming

5.

Arrow

5.Should you consult a doctor?

Giddiness is not an issue by itself but is often a symptom of an underlying health issue. When it occurs very frequently or over longer periods of time, it could indicate an underlying health issue for which one should consult a qualified medical professional. When giddiness is accompanied by the following symptoms one should see a qualified medical professional immediately.

  • Headache
  • High Fever
  • Chest Pain
  • Head Injury
  • Drooping of Eye or Mouth
  • Hearing Loss or Blurred Vision
  • Speech Difficulties
  • Numbness or Tingling
  • Ongoing Vomiting
  • Loss of Consciousness

6.

img

6.Diagnosis of frequent dizziness

Frequent dizziness or giddiness is not a condition by itself but is often a symptom of an underlying condition. Therefore, when you consult a doctor you will be questioned about your episodes of dizziness as well as your medical history. Your doctor will want to know

  • A list of medication that is being taken.
  • When giddiness happens.
  • Is there any pattern or particular situation that it occurs in?
  • How frequent are the episodes of feeling giddiness?
  • How severe are the episodes of feeling giddiness?
  • Are the episodes accompanied by other symptoms?

The doctor will have to investigate and diagnose any underlying giddiness reasons. This may include a physical exam, eye and ear examinations, balance tests and neurological tests. If it is warranted, CT or MRI scans may be recommended to rule out neurological issues.

7.

Arrow

7.Treatment of giddiness

When giddiness is caused by hypotension, treatment to normalise blood pressure will cure the episodes of giddiness. When dizziness is caused by hypoglycemia, treating the condition will resolve the dizziness.

Benign Paroxysmal Positional Vertigo (BPPV) can be treated by Epley’s Maneuver which is a series of movements that cause the crystals in the ear to be dislodged from the ear canals thus resolving vertigo. This can be performed at home without the need for any equipment. Two other exercises that are not as well known are Semont-Toupet Maneuver and the Brandt-Daroff exercise which can also be done at home. The Brandt-Daroff exercise sometimes makes a person feel dizzier for a short while after the exercise and adequate precautions must be taken. Sometimes BPPV requires medication to be resolved. This would include anticholinergics, antihistamines or sleep aids. It can also recur even after being successfully treated. If BPPV is accompanied by vision or speech problems it could indicate another underlying problem that would need further investigation and treatment. Some studies have shown that BPPV symptoms get worse in some patients if they also have a Vitamin D deficiency. Treating this deficiency with supplements and dietary means has helped reduce the severity of BPPV.

The giddiness that is caused by Meniere’s disease can be resolved by maintaining a healthy low sodium diet with medications or ear surgery if required. Taking adequate quantities of Vitamin C can help patients suffering from Meniere’s disease.

When heart problems are the cause for dizziness, the treatment of the heart and circulatory problem as required will resolve the issue. Tachy Brady Syndrome treatment to regularise the heart rate with medication, ablation or pacemaker implantation will resolve the giddiness.

Simple measures to maintain a healthy intake of food and water is the best giddiness treatment for symptoms caused by dehydration, exertion, anemia and heat. Migraines, neurological and anxiety related giddiness problems can be treated through appropriate medication and lifestyle changes. Stress relief and balance improvement practices such as yoga and Tai Chi also help. Some people have found great relief through acupuncture. Bacterial and viral infections of the inner ear will be treated suitably by the consulting doctor.

Dizziness caused by medication would require an adjustment in the dosage or in severe cases, a change of medication altogether. This would have to be done in consultation with the treating doctor.

It is also advised to avoid salt, caffeine, tobacco and alcohol as these could make the dizziness worse. One should be aware of and avoid triggers for giddiness episodes.

8.

img

8.What to do while feeling giddy?

  • Lying Down Before Calling For Help
  • Lie Down and Rest
  • Drink Enough Water
  • Avoid Caffeine
  • Use Stair Rails
  • Tai Chi for Stress Relief and Balance

The very first thing that one should do when feeling dizzy is to sit or lie down immediately and then call for help. One should rest until one is feeling stable. This will be an important measure to prevent serious injuries caused by falling as a result of losing one’s balance.

If the giddiness is caused by heat or overexertion, one should rest in a cool place and drink water. Any severe episode of giddiness and nausea warrants a period of lying down and rest.

Maintaining adequate water intake is vital to prevent the body from becoming dehydrated. Maintaining a balanced diet will also prevent vitamin deficiencies that may make existing conditions causing dizziness even worse.

One should absolutely avoid operating any machinery or driving if one is prone to spells of dizziness.

If one is prone to frequent giddiness , it makes sense to use a walking stick or cane. Using handrails when they are available, especially when using stairs is a sensible thing to do to avoid falls.

Ask your doctor for over the counter medication to be taken when one experiences nausea with dizziness. These medications sometimes have the tendency to cause drowsiness and may not be suitable for people who need to be active after taking the medication.

9.

Arrow

9.Giddiness FAQs: All your concerns addressed

Q.  What causes giddiness?

  1. Giddiness by itself is not a medical issue as it is always a symptom of an underlying issue. The reasons could be as varied as simple dehydration or a stroke. The symptoms would have to be diagnosed by a qualified medical professional to find the exact reason.

Q.  Are vertigo, giddiness and dizziness the same?

  1. Dizziness and giddiness are often used interchangeably to describe the sensation of lightheadedness, unsteadiness and the feeling of faltering or fainting. However, vertigo specifically refers to the spinning feeling that could also be a part of giddiness symptoms.

Q.  Do I have to see a doctor?

  1. Giddiness can be a sign of underlying problems some of which are potentially life threatening. Therefore prolonged, frequent or severe episodes of giddiness must certainly be seen by a doctor. If giddiness is accompanied by any of the following symptoms it requires urgent medical attention. Symptoms: headache, high fever, chest pain, head injury, drooping of eye or mouth, hearing loss or blurred vision, speech difficulties, numbness or tingling, ongoing vomiting or loss of consciousness.

Q.  Can I live a normal life with giddiness?

  1. Isolated episodes of giddiness cannot be predicted but if one has frequent episodes of giddiness one must avoid operating machinery or vehicles. If you know what your dizziness triggers are,you will have to try and avoid them in your daily life.

Q.  Why do I feel giddy when I suddenly stand up or get out of bed?

  1. A type of hypotension (low blood pressure) called Orthostatic Hypotension or Postural Hypotension can make you dizzy or faint when you abruptly change position.

Q.  What is the treatment for Giddiness?

  1. Giddinessis a symptom of other problems. So, after diagnosing the problem causing the giddiness, taking the treatment for that problem will resolve the symptom of dizziness.

Q.  Can allergies cause dizziness?

  1. Yes, allergies can cause dizziness. Usually, dizziness caused by allergens can be airborne allergy-induced or food allergy-induced. Allergies can block your Eustachian tube with mucus. As a result, it won’t be able to equalize pressure in the ear and maintain the body’s balance, thus causing the symptoms of dizziness. On the other hand, food allergy-induced dizziness may come from an intolerance to gluten, wheat, or other food products. The symptoms might surface immediately after eating the food or hours later.

Q.  What medicine is good for dizziness?

  1. Dizziness usually gets better without receiving any form of treatment. The body starts adapting to whatever is causing the condition within a few weeks. However, if the symptoms affect your day to day activities, and you seek treatment, your doctor will try to identify the cause of your condition and symptoms. The treatment may include medication and balance exercises.
  2. In case your dizziness persists without any causes, prescription drugs, and other treatments can help alleviate the symptoms. Your doctor may prescribe the following medications.
  • Water pills: A water pill or a diuretic is prescribed when your dizziness is caused due to Meniere’s disease. The medication, coupled with a low-salt diet, can effectively reduce the episodes of dizziness.
  • Antihistamines and anticholinergics: Such medications are known to provide immediate relief from dizziness, vertigo, and nausea. Many of them may cause drowsiness.
  • Anti-anxiety medications: Examples include benzodiazepine drugs like Diazepam and Alprazolam. Like antihistamines and anticholinergics, these medications can cause drowsiness as well.
  • Anti-anxiety medications: Examples include benzodiazepine drugs like Diazepam and Alprazolam. Like antihistamines and anticholinergics, these medications can cause drowsiness as well.
  • Preventive medicine for migraine attacks

Q.  When should you worry about dizziness?

  1. Generally, there’s nothing to be worried about if dizziness goes away after a few moments. But you should consult a doctor if you experience additional symptoms, such as vomiting, double vision, or having difficulty using your arms or legs. In women, dizziness along with back pain, shortness of breath, and fainting are common signs of a heart attack. Other signs that you need to watch out for are fever, difficulty walking, chest pain, stiff neck, and common signs of a stroke.
  2. Maintaining a healthy weight, limiting smoking, and leading a healthy life, in general, can alleviate the symptoms of dizziness and prevent serious problems from occurring. If you experience dizziness frequently, make sure to talk to your doctor about it in detail.

Q.  How long can vertigo last?

  1. Depending on the cause, episodes of vertigo can last a few seconds, minutes, hours, or even days. If you have mild vertigo, the symptoms don’t last longer than one to two weeks. In the case of Meniere’s disease, vertigo may come and go over time or become an ongoing issue.
  2. You may experience lightheadedness for a few seconds or minutes sometimes or every time you stand up. In a majority of the cases, the doctor determines the causes and treats your lightheadedness. But if you are taking medicines for several medical problems, finding the cause and treatment for lightheadedness can be a tough challenge. You need to work with your doctor and let them know what's working and what’s not.

Q.  Should I go to the hospital for dizziness?

  1. Dizziness doesn’t need medical attention unless you are experiencing sudden, severe, recurrent and unexplained dizziness. You have to look out for the following signs and get emergency medical care if you experience any of the following with dizziness.
  • Chest pain
  • Sudden headache
  • Numbness or paralysis of arms or legs
  • Trouble breathing or shortness of breath
  • Fainting
  • Double vision
  • Rapid or irregular heartbeat
  • Vomiting
  • Sudden change in hearing
  • Seizures
  • Confusion
  • Facial numbness
  1. Meanwhile, follow the below-mentioned self-care tips to avoid any serious problems.
  • Move slowly: If you stand up from lying down, move slowly. It is common for many people to feel dizzy if they stand up quickly.
  • Stay well-hydrated: Drink plenty of fluids throughout the day. Staying well-hydrated can help to prevent many types of dizziness.
  • Stay away from tobacco and caffeine: These substances are known to make symptoms worse by restricting blood flow.

Q.  What are the home remedies for vertigo?

  1. Vertigo can restrict a person’s activities and make them feel uneasy. While there are medications available to treat vertigo, natural home remedies to work well without any side effects. Some of the home remedies for vertigo are:
  • Epley manoeuver
  • Ginkgo biloba, an herb that relieves dizziness by managing blood flow to the brain.
  • Drinking ginger tea may help with dizziness and nausea.
  • Dehydration can worsen the symptoms of vertigo. So, staying hydrated is important.
  • Essential oils, including peppermint, lavender, ginger, and lemon, can be topically applied or inhaled through an infuser to treat the symptoms of vertigo.
  • Acupressure can help manage vertigo by stimulating the pressure points in the body.

Q.  Can high blood pressure cause dizziness?

  1. No, there is no such evidence that suggests high blood pressure could be the reason for dizziness. However, certain blood pressure medications may cause dizziness as a side effect. Sudden dizziness, trouble walking or loss of balance or coordination may indicate a serious underlying problem or a stroke. Hence, it is advisable not to ignore such symptoms and seek medical help quickly.

Q.  What are the therapies used for the treatment of dizziness?

  1. Usually, dizziness goes away on its own without any treatment. But, in serious cases, your doctor may prescribe the following therapies along with medications depending on the symptoms and causes of your condition.
  • Epley manoeuvre: It is also known as canalith repositioning. It is an effective technique in which the doctor or therapist manoeuvres the position of the head to resolve benign paroxysmal positional vertigo. You must inform the doctor about any neck or back condition, blood vessel problems prior to starting canalith repositioning.
  • Balance therapy: This is recommended to individuals who are experiencing dizziness due to inner ear conditions like vestibular neuritis. Balance therapy is also known as vestibular rehabilitation and involves specific exercises to train the body’s balance system to become less sensitive to motion.
  • Psychotherapy: Anxiety can lead to dizziness as well. Psychotherapy can help in such cases.

Q.  What to expect during your appointment?

  1. During the visit, your doctor will perform a physical examination first to narrow down the causes and symptoms of dizziness. Following that, they will ask you questions about how or when it occurs, the situations in which it occurs, the severity of symptoms and whether there are any other symptoms that occur along with the dizziness.
  1. The doctor will then check your balance by checking your eyes and ears, observing your posture and perform a neurological physical exam and other tests. They might also recommend a CT scan or MRI depending on the suspected cause of your dizziness.

Q.  What tests might I have for dizziness?

  1. Depending on what has been established from your diagnosis, the doctor may recommend further tests that might be relevant. Some of them might include –
  • A hearing test
  • A blood test
  • MRI or CT scan
  • Heart tests like ECD or echocardiogram
  • Specialist tests for inner ear function and balance

Q.  What are the surgical methods of treating vertigo?

  1. Most of the times, surgery isn’t appropriate for the treatment of vertigo. But there are certain situations in which surgery may be performed. Surgical treatment for vertigo can be of two types.
  1. Corrective surgical treatments: Extreme caution must be exercised if a corrective surgical procedure is being considered for the treatment of vertigo. In all cases, going for a corrective treatment is considered risky, and it is recommended to go for a second opinion. Some of the conditions where corrective surgery may be performed are
  • Perilymph fistula: An artificial opening in the eardrum may help to prevent the pressure fluctuations between the middle ear and the outside world.
  • Microvascular compression syndrome: Moving a blood vessel of the vestibular nerve may be required which can be done by microvascular compression surgery.
  • Meniere’s disease: Inner ear plumbing may be improved with Endolymphatic sac shunt surgery.
  • Chronic ear diseases, such as chronic otitis media, chronic mastoiditis, cholesterol granuloma and tympanosclerosis: Procedures followed include atticotomy and certain types of mastoidectomy.
  1. Destructive surgical treatments: These procedures intend to eliminate vertigo, but the patient has to possibly sacrifice their hearing abilities. They are considered only when the general medical treatment and vestibular rehabilitation didn’t work well to manage the symptoms of vertigo. After undergoing destructive treatment, vestibular rehabilitation therapy is appropriate for patients. Some of the destructive surgical procedures are
  • Transtympanic gentamicin treatment or chemical labyrinthectomy
  • Acoustic neuroma surgery
  • Gamma knife (radiation) treatment

Request an appointment