The dizzy feeling you get after stepping off a carousel is fleeting for most. For others, like Nicholson, persistent bouts of dizziness are a daily occurrence, and may be a symptom of any number of diseases or disorders. If a specialist is not consulted, the underlying cause of dizziness may remain a mystery for months or even years.
Nicholson’s family doctor sent her to Majid Fotuhi, M.D., Ph.D., director of Sinai Hospital’s Balance and Dizziness Clinic. According to Fotuhi, 40 percent of all adults will visit their doctors at some time complaining of dizziness. “It’s actually the third most common complaint next to headaches and back pain.”
The staff of Sinai’s Balance and Dizziness Clinic treat the whole person with an interdisciplinary approach using the most advanced technology. Diagnosis requires a variety of testing. This may include wearing a light video goggle with infrared cameras to record eye movements. Blowing gentle warm and cool air currents into the ear is another part of the process. In some cases, a neurological evaluation, video electronystagmography (ENG) recordings and blood tests are done.
Most patients can be diagnosed and receive a treatment plan within one to two weeks. The causes of dizziness are treatable with medications, lifestyle modifications and surgical procedures.
Dizziness is always a symptom of something else, and there are as many as 30 different conditions that can cause it. For example:
Heart disease. When blood pressure gets to the brain too slowly, because of narrowed atherosclerotic blood vessels, it can cause faintness. Taking steps to correct the underlying problem likeblood pressure control and changing your diet may have a major impact on the problem of dizziness.
Meniere’s disease
“This can best be described as glaucoma in the ear,” Fotuhi says. “Pressure from fluids in the inner ear builds up and triggers attacks of vertigo. Once the cause is diagnosed, it can be treated with a diuretic and a low-salt diet.”
Benign paroxysmal positional vertigo
Some patients complain of dizziness when they lie down. This complaint is linked to a disruption of the balance mechanism in the human brain regulated by the inner ear, says Fotuhi. The fluid in the inner ear has the consistency of honey and flows over hair cells. When a person moves, the fluid shifts, the cells are activated, and a signal is sent to the brain. Dizziness occurs when there is an imbalance in the signals coming from the two ears or if the flow is blocked in one ear.
Vestibular migraine
This common cause of dizziness, especially among young women, is often misdiagnosed with depression or other psychiatric conditions. “Even though they are suffering from a variant of migraine, there may be no headaches, nausea or symptoms other than the dizziness. Fortunately, once a correct diagnosis is made, treatments can be made with migraine medications, which reduce the frequency of dizziness attacks and make each attack less severe,” Fotuhi says.
Nicholson spent years worrying about her dizzy spells until she was diagnosed with Lyme disease (a symptom of which is dizziness). “I thought I was losing my mind,” says Nicholson. “Now that I know what condition I have and that it can be treated, I feel like a new person.”
For more information about Sinai’s Balance and Dizziness Clinic, call 410-601-WELL (9355).
Majid Fotuhi, M.D., Ph.D., is the director of Sinai Hospital’s Balance and Dizziness Clinic. He is also the author of The Memory Cure: How to Protect Your Brain Against Memory Loss and Alzheimer’s Disease (McGraw-Hill, 2004), which includes a dynamic 10-step memory protection plan.
Related Links:
Sinai Division of Neurology
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