Shin Beh, M.D. Answers Questions On: Dizziness and Vertigo
What is the difference between dizziness and vertigo?
People sometimes use the words “dizziness” and “vertigo” interchangeably. “Dizziness” is a generic term that many people use to describe feeling off-balance, lightheaded, or faint, or when they have vertigo.
True vertigo refers more specifically to a spinning sensation and the perception that you or your environment is rotating. Some people experience a feeling of tumbling.
How common is dizziness?
Because there are so many causes of dizziness, it’s extremely common and nearly everyone experiences it in their lifetime.
The causes of dizziness and vertigo can include inner-ear problems, migraines, tumors, neurological and cardiovascular disease, and stroke, and can vary from the relatively benign to the life-threatening.
Dizziness becomes even more common as people get older. About half of people 85 and older suffer from some kind of dizziness, and in those above the age of 65, about one-third of visits to primary care physicians are due to dizziness.
Can dizziness be severe and chronic?
Dizziness can be so persistent or severe that it affects people’s quality of life. I have patients who say they can no longer function properly, go out in public, or drive because of their dizziness. Some people become housebound because even walking in public spaces can be problematic.
Depending on the underlying condition, people with chronic dizziness can have multiple episodes of dizziness that occur many times a day or a week – or they can be dizzy on a constant basis.
Due to the highly variable nature of dizziness, and because there are many, many different causes of dizziness, it is very important for me to sit down with the patient and obtain a thorough history.
How do you treat patients whose dizziness is caused by a neurological issue?
The care I provide depends on the cause of the dizziness.
For instance, patients I diagnose with vertigo caused by migraine headaches (vestibular migraines) are treated with migraine medications. Patients with nystagmus – a condition that causes the eyes to jerk back and forth and subsequently results in the perception that the visual environment is bouncing around – also can be treated with certain medications to try to control this very distressing condition.
If a patient develops balance problems from their dizziness, I very often refer them for gait and balance training with a physical therapist. Patients who have trouble with tolerating motion or visual stimuli, as well as certain balance disorders may require treatment with a vestibular therapist.
Certain conditions, like brain tumors or vascular malformations, often require surgical intervention, and in these cases, I will refer the patient to a neurosurgeon or neuro-otologist for further management.