Dizziness is a rather non-specific term that may have many different meanings. It may mean any of the following:
- A sensation of spinning (self or surroundings) : Vertigo
- Feeling off balance and falls due to it : Disequilibrium
- Feeling of weakness and impending fainting : Presyncope
- Vague symptoms like lightheadedness, etc.
Dizziness in the morning is fairly common complaint and can be due to a very wide variety of causes. Also, in nearly every one out of five cases, no cause of dizziness can be identified. Dizziness is also an adverse effect of numerous drugs, including the antihypertensive drugs.
Dizziness can be dangerous sometimes, especially in certain scenarios like driving a vehicle, operating heavy machinery, construction work at a height, etc. An episode of dizziness in these conditions can cause serious injury or even death.
Dizziness and Blood Pressure
Dizziness can be associated with both high blood pressure and low blood pressure. Dizziness, especially in morning can occur as a symptom of hypertension. It can be associated with other symptoms of hypertension like headache, etc. or can be the only symptom present. In persons with blood pressure under control by use of anti-hypertensive drugs, dizziness could be one of the side effects of these medications.
Dizziness can also occur in orthostatic hypotension (postural hypotension). In this condition, the dizziness characteristically occurs when a person stands up from a lying or sitting down position. Dizziness, especially presyncope can be caused by various cardiac conditions (e.g. arrhythmias, aortic stenosis, carotid artery stenosis, etc.) that can result in a sudden fall of blood pressure.
Other Important Causes of Dizziness
Vertigo refers to a false sense of motion (most commonly spinning sensation). Vertigo is the presenting form of dizziness in nearly 50% of the cases. Vertigo is generally caused by an abnormality in the inner ear or the nerve carrying information from inner ear to the brain. Some of the common causes of vertigo are benign paroxysmal positional vertigo (BPPV), vestibular neuritis, labyrinthitis, Meniere’s disease, migrainous vertigo and acoustic neuroma. Vertigo in Meniere’s disease and labyrinthitis is usually associated with hearing loss.
Heart attack, cardiac arrhythmias, postural hypotension, carotid artery stenosis and aortic stenosis are some of the common causes of presyncope.
Inner ear abnormalities, vision disturbances, joint problems, muscle weakness and some neurological conditions can cause disequilibrium. Stroke and transient ischemic attacks can also result in disequilibrium. However, usually there are other associated features of stroke or TIA.
Lightheadedness can occur in anxiety, depression, panic disorders, hyperventilation syndrome and some inner ear disorders.