Most people experience dizziness, but it is rarely serious. It happens when people get up too fast, don’t eat or are dehydrated. All of these pass in a short period of time. Dizziness becomes a concern when it is persistent, goes away infrequently and happens with a number of additional symptoms. Frequent and severe symptoms may indicate a serious medical concern and can be of a neurological nature.

Dizziness can be a symptom of many different illnesses and is not a condition on its own. Knowing when you can self-diagnose and when it is needed to see a neurologist can make a difference in treatment.

What is Dizziness?

Dizziness is a term that refers to the sensations of unsteadiness, light-headedness, and spinning. People can also have the sensation that they are going to faint or have the inability to maintain balance.

Because the many causes of dizziness can also be symptoms of many different illnesses, the many types of dizziness can also help doctors solve the underlying issue.

Common Causes of Dizziness

Most dizziness is not a neurological issue and can be commonly caused by:

• Dehydration
• Low blood pressure
• Low blood sugar
• Ear infections or other inner ear disorders
• Stress or anxiety
• Some medications
• Too little sleep

Though the causes are commonly temporary, if you experience persistent symptoms, you should see a doctor.

When Does Dizziness Require a Neurological Evaluation?

In some situations, dizziness can be caused by problems with the brain and/or the nervous system, while in other situations, it can occur for other reasons and can be classified as nonspecific. Dizziness of a neurological origin can, in many cases, be associated with other symptoms and is a cause for concern.

Several conditions can make dizziness of a neurological origin more likely, including:

• Stroke
• Migraines that involve the vestibular system
• Multiple sclerosis
• Parkinson’s disease
• Brain tumors
• Some peripheral neuropathies

Some of these conditions can be time-sensitive, which is why it is important to be diagnosed and treated early.

What Symptoms Require Immediate Care?

A neurologist may consider the following symptoms as an associated condition to nonspecific or neurological dizziness:

• Recurring or persistent dizziness
• Impaired gait
• Ataxia
• Sudden onset of a severe headache
• Diplopia or blurred vision
• Speech abnormalities
• Hemiparesis or facial asymmetry
• Dysphagia
• Loss of coordination
• Confusion/disorientation and/or amnesia
• Syncope

These symptoms merit an immediate evaluation as they may be associated with a neurological condition.

How is Dizziness Evaluated?

To begin the evaluation, the neurologist will take a focused history on the onset, duration, and frequency of the dizziness as well as any associated symptoms and the current medication/treatment for the patient. The physician will then obtain a comprehensive history of the patient.

The evaluation may include:

• A Physical exam
• A Neurological exam
• Assessment of balance and coordination
• Assessment of eye movements
• Hearing exam (if an inner ear issue is suspected)
• Blood panel
• Brain MRI or CT scan (if needed)

Brain imaging is not indicated as a routine part of the dizziness workup. It will be ordered if the physician has a high concern for an underlying condition, based on the severity of the symptoms.

Treatment

Treatment for dizziness will depend on the aetiology of dizziness.

Identifying the cause as dehydration, hypotension, or a medication side effect may allow the symptoms to resolve. Other inner ear disorders may be more complex and require specific medications or the patient to perform certain balance exercises.

If the cause of dizziness is a neurological disorder, management of the dizziness will focus on management of that disorder. This may be medications, physiotherapy, balance rehabilitation, or a myriad of other specialities based on the presenting diagnosis.

There is a treatment plan that your neurologist will create to help your balance and dizziness, as well as prevent falls.

Can Dizziness be Avoided?

Dizziness has a number of causes, which may or may not be preventable. Causes that are potentially preventable may include some of the lifestyle habits listed below.

These habits include:

• Making sure you are drinking enough water.
• Having regular and healthy meals.
• Getting up more slowly after resting.
• Getting an adequate amount of sleep each night.
• Having regular exercises that improve strength.
• Controlling chronic medical conditions, such as hypertension, diabetes, etc.
• Limiting alcoholic beverages.

Having these habits benefits your health overall and may reduce occurrences of dizziness.

Conclusion

There are a lot of factors that may cause dizziness. Some of those factors may be dehydration, low blood pressure, or disorders in the nervous system. Dizziness that is not frequent is usually not a concern. However, when the episodes of dizziness become frequent, or if there are other symptoms such as speech issues, a lack of strength or poor balance, those concerns should always be addressed.

Our neurologists at Royal Care Neurosciences have the experience to bring you advanced and comprehensive care for your concerns with dizziness. Diagnosis, assessment, and Treatment in a timely fashion that is designed for you specifically will improve the symptoms you are experiencing and help the quality of life you are living.

Frequently Asked Questions

1. When is dizziness a concern?

Seek help if your dizziness becomes frequent, very disruptive, and long-lasting. Be especially concerned if you also have dizziness and feel weak, have slurred speech, have vision problems, or have trouble walking.

2. What neurological disorders can cause dizziness?

All of the following can cause dizziness or problems with balance: stroke, Parkinson’s Disease, Multiple Sclerosis, some brain tumours, and some migraine disorders.

3. What is involved in a dizziness work-up?

The dizziness work-up can involve many components. A health history and physical exam will certainly be done. A more extensive exam can involve balance testing, blood work, and imaging like an MRI or CT if a neurologic cause is of concern.