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Dizziness

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Dizziness

Dizziness
Classification and external resources
ICD-10 R42
ICD-9-CM 780.4
DiseasesDB 17771
MedlinePlus 003093
eMedicine neuro/693
MeSH D004244

Dizziness is an impairment in spatial perception and stability.[1] Because 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 room.[5]

Contents

  • Classification 1
  • Differential diagnosis 2
  • Mechanism 3
  • Epidemiology 4
  • See also 5
  • References 6
  • External links 7

Classification

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

Differential diagnosis

Many conditions are associated with dizziness. 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/dysequilibrium, and 10% nonspecific dizziness.[7] The medical conditions that often have dizziness as a symptom include:[7][8][9][10]

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.[9]

Common physiological causes of dizziness include:

  • inadequate blood supply to the brain due to:
    • a sudden fall in blood pressure[9]
    • heart problems or artery blockages[9]
  • loss or distortion of vision or visual cues[9]
  • disorders of the inner ear[9]
  • distortion of brain/nervous function by medications such as anticonvulsants and sedatives[9]
  • result of side effect from prescription drugs, including proton-pump inhibitor drugs (PPIs)[12] and Coumadin (warfarin) causing dizziness/fainting [13]

Epidemiology

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

See also

References

  1. ^ "dizziness" at Dorland's Medical Dictionary
  2. ^ Dizziness at the US National Library of Medicine Medical Subject Headings (MeSH)
  3. ^ Reeves, Alexander G., Swenson, Rand S. (2008). "Chapter 14: Evaluation of the Dizzy Patient". Disorders of the Nervous System: A Primer. Dartmouth Medical School. 
  4. ^ a b Branch, Jr, William T., Barton, Jason (February 10, 2011). "Approach to the patient with dizziness". UpToDate. 
  5. ^ a b c Neuhauser HK, Lempert T (November 2009). "Vertigo: epidemiologic aspects". Semin Neurol 29 (5): 473–81.  
  6. ^ Post RE, Dickerson LM (August 2010). "Dizziness: a diagnostic approach". Am Fam Physician 82 (4): 361–8, 369.  
  7. ^ a b Chan Y (June 2009). "Differential diagnosis of dizziness". Curr Opin Otolaryngol Head Neck Surg 17 (3): 200–3.  
  8. ^ Tusa RJ (March 2009). "Dizziness". Med. Clin. North Am. 93 (2): 263–71, vii.  
  9. ^ a b c d e f g "Dizziness and Vertigo". Merck Manual. 2009. 
  10. ^ Bronstein AM, Lempert T (2010). "Management of the patient with chronic dizziness". Restor. Neurol. Neurosci. 28 (1): 83–90.  
  11. ^ O'Connor RE, Brady W, Brooks SC, et al. (November 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation 122 (18 Suppl 3): S787–817.  
  12. ^ http://www.fda.gov/Drugs/DrugSafety/ucm245011.htm
  13. ^ http://www.rxlist.com/coumadin-side-effects-drug-center.htm

External links

  • Dizzytimes.com Online Community for Sufferers of Vertigo and Dizziness
  • Dysautonomia Youth Network of America, Inc.
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