You were just minding your beeswax when you suddenly became dizzy. What did you do to deserve this? Probably nothing, but here’s the load down.
What is dizziness anyways?
“Dizziness” is a bit of a tricky word. It could mean one of two things:
Vertigo: A spinning sensation.
Lightheadedness: Feeling like you’re going to faint. Also called “presyncope”.
Distinguishing between the two is critical to narrowing down why you’re having dizziness.
The most common cause of vertigo
The most common cause of vertigo by far is Benign Paroxysmal Peripheral Vertigo (BPPV). When this happens, you get a spinning sensation lasting seconds to a few minutes whenever you reposition your head.
If you recall back to your highschool biology class, you might’ve learned about these things behind our ears called semicircular canals. We have 3 of these loops in each ear. The loops contain rocks and we use them to figure out how our bodies are oriented relative to the ground.
When one of the rocks become misaligned, we get a spinning sensation because our body has a hard time figuring out where we are. If two of the rocks tell our body we’re rightside up but the other one says we’re sideways, we’re going to get a spinning sensation. This alignment problem is called BPPV.
Other causes of vertigo
Here’s a non-exhaustive list of other less common causes of vertigo:
Meniere’s Disease: A spinning sensation lasting minutes to hours. This isn’t affected by how you position your head. This is often associated with tinnitus, which is when you get a ringing sound in your ears. It’s also associated with feeling like your ears are full, which can also be described as a pressure in your ears.
Vestibular Neuritis: A spinning sensation that’s there constantly for days. It typically occurs suddenly and is quite a lot more severe than the other two. It can happen after an upper respiratory tract infection like the common cold (a viral infection that has nothing to do with cold weather) or the flu. It’s associated with hearing loss in one ear. This is generally synonymous with labyrinthitis.
Cerebellar Problems: Vertigo can also be caused by strokes, transient ischemia attacks (ie. mini-strokes) and brain tumors. But if you’re a perfectly healthy person with no risk factors, the chances are very slim that it’s caused by this. Similarly, if you have risk factors, you may need to be careful. Things like stroke and transient ischemia attacks typically happen suddenly and usually with other stroke symptoms. Brain tumors usually cause a constant gradually worsening vertigo over months. The vertigo is constant because tumors don’t just suddenly go away.
Medications: Certain medications are associated with causing vertigo. These include medications such as: Aspirin, NSAIDs (Ibuprofen, naproxen, etc), tobramycin (antibiotic), gentamycin (antibiotic), loop diuretics (water pill), amiodarone (heart medication), quinine or cisplatin (chemotherapy drug). Now you’re wondering whether your Advil is causing this. Well, it’s pretty rare for it to be causing this but it could be possible. The best clue is whether your vertigo started shortly after you started the medication.
Migraines: Sometimes migraines can actually cause spinning sensations. Like everything else in this list, it’s pretty rare.
What can I do about BPPV?
If you have BPPV, the best treatments are:
Vestibular physiotherapy: Similar to how people go to physiotherapy for a back strain, there’s a special type of physiotherapy to realign the rocks in the semicircular canals. Not every physiotherapist is able to do this because it requires additional training. Usually the physiotherapist teaches you some exercises you can try to do at home, because it could take many tries before the rocks realign.
Betahistine: This is a medication to help you feel less of the spinning sensation.
What about lightheadedness?
It’s a large topic, so we’ll talk about this next time.
