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The word '''dizziness''' is commonly used to designate a whole variety of sensations, from a vague sense of weakness to a definite feeling of spinning. Like [[Pain|pain]], dizziness is a purely subjective experience. In general usage, the words dizziness and vertigo are often used interchangeably, but technically, as medical terms used in [[Health Sciences|health science]], these two conditions are different. In [[vertigo]], a false sensation of movement is always present. In dizziness, unlike vertigo, there is ''no'' universally accepted definition of the quality of the sensation. Instead, the term is used in a variety of ways to indicate a feeling of weakness, near loss of consciousness, or even anxiety. Dizziness, or light-headedness, is sometimes associated with fainting (also called syncope), but may occur even when the person complaining of it shows no decrease in alertness.  
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'''Dizziness''' is defined as "an imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness".<ref name="MeSH">{{cite web |url=http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?term=dizziness |title=Dizziness |accessdate=2007-12-20 |author=National Library of Medicine |authorlink= |coauthors= |date= |format= |work= |publisher= |pages= |language= |archiveurl= |archivedate= |quote=}}</ref> Dizziness is commonly used to designate a whole variety of sensations, from a vague sense of weakness to a definite feeling of spinning. Like [[Pain|pain]], dizziness is a purely subjective experience.


The feeling of dizziness is normally noted under certain circumstances, such as extreme fatigue or hunger. Dizziness is commonly felt in abnormal conditions like poor blood perfussion to the brain because of low blood pressure, and when blood levels of carbon dioxide are driven down by prolonged hyperventialtion. Despite the fact that there are situations in which the presence of dizziness is predictable, it remains a misunderstood condition in the health sciences. When dizziness persists as a chronic or recurrent complaint without a clear abnormality of neurologic responses, breathing, or blood circulation, the symptom is often ascribed to a psychiatric condition or dismissed as a psychosomatic complaint. This may partly be due to the difference between what the lay person complaining of a feeling of dizziness means by the word, and the more specific meaning that the owrd has in Medicine and the health sciences.
Dizziness should be distinguished from the term [[vertigo]]. [[Vertigo]] is a specific form of dizziness in which a false sensation of movement is present. In dizziness, unlike vertigo, there is ''no'' universally accepted definition of the quality of the sensation. Instead, the term may indicate a feeling of weakness, a near loss of consciousness, or general anxiety.


=Cultural aspects of dizziness=
Dizziness should be distinguished from [[syncope]]. In syncope, also called fainting, there is loss of consciousness.
A feeling of dizziness may be feared, discounted or even welcomed depending on the identity and cultural background of the person experiencing it. In the 19th Century, western girls and women who easily became "faint" were often admired as showing refinement. On the other hand, admission of feeling faint or dizzy has long been denigrated as showing weakness and can be particularly alarming to atheletes and soldiers.  


=Chronic non-specific dizziness=
==Cause/etiology==
For patients experiencing chronic dizziness, without vertigo, the condition is often outside of the ability of the health sciences to remedy in routine care.
According to a [[systematic review]] of original research articles, the most common causes of dizziness among patients who seek medical care are:<ref name="pmid10701780">{{cite journal |author=Kroenke K, Hoffman RM, Einstadter D |title=How common are various causes of dizziness? A critical review |journal=South. Med. J. |volume=93 |issue=2 |pages=160–7; quiz 168 |year=2000 |pmid=10701780 |doi=}}</ref>
Dizziness without any component of vertigo is technically called "nonspecific dizziness". The medical view of nonspecific dizziness as a condition tends to be sceptical. For example the definition of dizziness in the Stedman's Medical Dictionary is as follows: Imprecise term commonly used by patients in an attempt to describe various symptoms such as faintness, vertigo, disequilibrium, or unsteadiness. Etymology: A. S. [dyzig,] foolish.  
* Vertigo is the cause in 55% of patients
** Peripheral vestibulopathy in 44%
** Central vestibulopathy in 11%
** Cardiac causes of dizziness can cause vertigo according to a separate study<ref>{{Cite journal
| doi = 10.1007/s11606-008-0801-z | volume = 23 | issue = 12 | pages = 2087-2094 | last = Newman-Toker
| first = David | coauthors = Fei Dy, Victoria Stanton, David Zee, Hugh Calkins, Karen Robinson | title = How Often is Dizziness from Primary Cardiovascular Disease True Vertigo? A Systematic Review | journal = Journal of General Internal Medicine | accessdate = 2008-12-18 | date = 2008-12-01 | url = http://dx.doi.org/10.1007/s11606-008-0801-z
}}</ref>
* psychiatric causes in 16%
* other conditions in 26%
* unknown cause in 13%


=Medical evaluation of the dizzy patient=
Dizziness may be caused by miscelleneous disorders such as sinusitis or otitis.<ref name="pmid8135132">{{cite journal| author=Sloane PD, Dallara J, Roach C, Bailey KE, Mitchell M, McNutt R| title=Management of dizziness in primary care. | journal=J Am Board Fam Pract | year= 1994 | volume= 7 | issue= 1 | pages= 1-8 | pmid=8135132 | doi= | pmc= | url= }} </ref><ref name="pmid7325057">{{cite journal| author=Haid T| title=Vertigo originating from inflammation of the paranasal sinuses (the so-called sinugenic vertigo). | journal=Adv Otorhinolaryngol | year= 1981 | volume= 27 | issue=  | pages= 190-7 | pmid=7325057 | doi= | pmc= | url= }} </ref>


In this study, serious causes were infrequent: [[cerebrovascular disease]] (6%), cardiac [[arrhythmia]] (1.5%), and brain tumor (<1%).<ref name="pmid10701780"/>


The feeling of dizziness is prompted by certain circumstances, such as extreme fatigue or hunger{{citation}}. Dizziness is also commonly felt in abnormal conditions like poor blood perfusion to the brain because of low blood pressure or [[arrhythmia]], and when blood levels of carbon dioxide are driven down by prolonged hyperventilation. Despite the fact that there are situations in which the presence of dizziness is predictable, it remains a misunderstood condition in the health sciences that is sometimes interpreted as an arbitrary complaint by a patient who has no physical illness.


It is doubtful that hyperventilation is a cause of chronic dizziness.<ref name="pmid8684155">{{cite journal |author=Hornsveld HK, Garssen B, Dop MJ, van Spiegel PI, de Haes JC |title=Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome |journal=Lancet |volume=348 |issue=9021 |pages=154–8 |year=1996 |pmid=8684155 |doi=}}</ref>


==Cultural aspects of dizziness==
A feeling of dizziness may be feared, discounted or even welcomed depending on the identity and cultural background of the person experiencing it. In the 19th Century, western girls and women who easily became "faint" were often admired as showing refinement and gentility. On the other hand, admission of feeling faint or dizzy has long been denigrated as showing weakness and can be particularly alarming to athletes and soldiers. Because of the underlying values ascribed to a person experiencing the sensation of dizziness in different cultures, a person may be more or less likely to admit to feeling this sensation.


[[Category:Health Sciences Workgroup]]
==Chronic non-specific dizziness==
For patients experiencing chronic dizziness, without vertigo or evidence of balance problems, the condition is often outside of the ability of the health sciences to remedy in routine care.
Dizziness without any component of vertigo is technically called "nonspecific dizziness". The medical view of nonspecific dizziness as a condition tends to be skeptical. For example the definition of dizziness in the Steadman's Medical Dictionary is as follows: Imprecise term commonly used by patients in an attempt to describe various symptoms such as faintness, vertigo, disequilibrium, or unsteadiness. Etymology: A. S. [dyzig,] foolish.
 
Causes of dizziness that persists for more than two weeks after initially seeking health care are:<ref name="pmid1443950">{{cite journal |author=Kroenke K, Lucas CA, Rosenberg ML, ''et al'' |title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care |journal=Ann. Intern. Med. |volume=117 |issue=11 |pages=898–904 |year=1992 |pmid=1443950 |doi=}}</ref>
 
* vestibular disorders (29%)
** benign positional vertigo (BPV) (16%)
* psychiatric disorders (6%)
* presyncope (3%)
* dysequilibrium (1%)
* hyperventilation (<1%)
 
Only 52% of the patients in this study had a single cause.<ref name="pmid1443950"/>
 
==Medical evaluation of the dizzy patient==
There are several important findings in the description of dizziness in addition to the quality of the dizziness.  Over-reliance on the quality of the dizziness may lead diagnostic errors.<ref name="pmid17976351">{{cite journal |author=Stanton VA, Hsieh YH, Camargo CA, ''et al'' |title=Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians |journal=Mayo Clin. Proc. |volume=82 |issue=11 |pages=1319–28 |year=2007 |pmid=17976351 |doi=}}</ref>
 
==Prognosis==
Among adults over aged 65, one study found that dizziness is a risk factor for stroke only if vertigo is present.<ref name="pmid2316424">{{cite journal |author=Evans JG |title=Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness |journal=Age Ageing |volume=19 |issue=1 |pages=43–9 |year=1990 |pmid=2316424 |doi=}}</ref>
 
==See also==
* [[Syncope]]
 
==References==
{{reflist}}[[Category:Suggestion Bot Tag]]

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Dizziness is defined as "an imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness".[1] Dizziness is commonly used to designate a whole variety of sensations, from a vague sense of weakness to a definite feeling of spinning. Like pain, dizziness is a purely subjective experience.

Dizziness should be distinguished from the term vertigo. Vertigo is a specific form of dizziness in which a false sensation of movement is present. In dizziness, unlike vertigo, there is no universally accepted definition of the quality of the sensation. Instead, the term may indicate a feeling of weakness, a near loss of consciousness, or general anxiety.

Dizziness should be distinguished from syncope. In syncope, also called fainting, there is loss of consciousness.

Cause/etiology

According to a systematic review of original research articles, the most common causes of dizziness among patients who seek medical care are:[2]

  • Vertigo is the cause in 55% of patients
    • Peripheral vestibulopathy in 44%
    • Central vestibulopathy in 11%
    • Cardiac causes of dizziness can cause vertigo according to a separate study[3]
  • psychiatric causes in 16%
  • other conditions in 26%
  • unknown cause in 13%

Dizziness may be caused by miscelleneous disorders such as sinusitis or otitis.[4][5]

In this study, serious causes were infrequent: cerebrovascular disease (6%), cardiac arrhythmia (1.5%), and brain tumor (<1%).[2]

The feeling of dizziness is prompted by certain circumstances, such as extreme fatigue or hunger. Dizziness is also commonly felt in abnormal conditions like poor blood perfusion to the brain because of low blood pressure or arrhythmia, and when blood levels of carbon dioxide are driven down by prolonged hyperventilation. Despite the fact that there are situations in which the presence of dizziness is predictable, it remains a misunderstood condition in the health sciences that is sometimes interpreted as an arbitrary complaint by a patient who has no physical illness.

It is doubtful that hyperventilation is a cause of chronic dizziness.[6]

Cultural aspects of dizziness

A feeling of dizziness may be feared, discounted or even welcomed depending on the identity and cultural background of the person experiencing it. In the 19th Century, western girls and women who easily became "faint" were often admired as showing refinement and gentility. On the other hand, admission of feeling faint or dizzy has long been denigrated as showing weakness and can be particularly alarming to athletes and soldiers. Because of the underlying values ascribed to a person experiencing the sensation of dizziness in different cultures, a person may be more or less likely to admit to feeling this sensation.

Chronic non-specific dizziness

For patients experiencing chronic dizziness, without vertigo or evidence of balance problems, the condition is often outside of the ability of the health sciences to remedy in routine care. Dizziness without any component of vertigo is technically called "nonspecific dizziness". The medical view of nonspecific dizziness as a condition tends to be skeptical. For example the definition of dizziness in the Steadman's Medical Dictionary is as follows: Imprecise term commonly used by patients in an attempt to describe various symptoms such as faintness, vertigo, disequilibrium, or unsteadiness. Etymology: A. S. [dyzig,] foolish.

Causes of dizziness that persists for more than two weeks after initially seeking health care are:[7]

  • vestibular disorders (29%)
    • benign positional vertigo (BPV) (16%)
  • psychiatric disorders (6%)
  • presyncope (3%)
  • dysequilibrium (1%)
  • hyperventilation (<1%)

Only 52% of the patients in this study had a single cause.[7]

Medical evaluation of the dizzy patient

There are several important findings in the description of dizziness in addition to the quality of the dizziness. Over-reliance on the quality of the dizziness may lead diagnostic errors.[8]

Prognosis

Among adults over aged 65, one study found that dizziness is a risk factor for stroke only if vertigo is present.[9]

See also

References

  1. ↑ National Library of Medicine. Dizziness. Retrieved on 2007-12-20.
  2. ↑ 2.0 2.1 Kroenke K, Hoffman RM, Einstadter D (2000). "How common are various causes of dizziness? A critical review". South. Med. J. 93 (2): 160–7; quiz 168. PMID 10701780. [e]
  3. ↑ Newman-Toker, David; Fei Dy, Victoria Stanton, David Zee, Hugh Calkins, Karen Robinson (2008-12-01). "How Often is Dizziness from Primary Cardiovascular Disease True Vertigo? A Systematic Review". Journal of General Internal Medicine 23 (12): 2087-2094. DOI:10.1007/s11606-008-0801-z. Retrieved on 2008-12-18. Research Blogging.
  4. ↑ Sloane PD, Dallara J, Roach C, Bailey KE, Mitchell M, McNutt R (1994). "Management of dizziness in primary care.". J Am Board Fam Pract 7 (1): 1-8. PMID 8135132. [e]
  5. ↑ Haid T (1981). "Vertigo originating from inflammation of the paranasal sinuses (the so-called sinugenic vertigo).". Adv Otorhinolaryngol 27: 190-7. PMID 7325057. [e]
  6. ↑ Hornsveld HK, Garssen B, Dop MJ, van Spiegel PI, de Haes JC (1996). "Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome". Lancet 348 (9021): 154–8. PMID 8684155. [e]
  7. ↑ 7.0 7.1 Kroenke K, Lucas CA, Rosenberg ML, et al (1992). "Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care". Ann. Intern. Med. 117 (11): 898–904. PMID 1443950. [e]
  8. ↑ Stanton VA, Hsieh YH, Camargo CA, et al (2007). "Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians". Mayo Clin. Proc. 82 (11): 1319–28. PMID 17976351. [e]
  9. ↑ Evans JG (1990). "Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness". Age Ageing 19 (1): 43–9. PMID 2316424. [e]
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