When working in a balance disorders laboratory it never fails that when you ask someone, “what brings you in to see me today” their reply is, “I am dizzy”.
This limited description of symptoms is not very helpful in determining the source of ones symptoms and further questioning is required to better understand what is meant by, “I am dizzy”. Dizziness symptoms can be caused by a multitude of pathologies including ear, brain, and heart conditions to name a few.
Before treatment can be rendered the cause of the dizziness symptoms must first be discovered and being able to more accurately describe ones dizziness symptoms will allow for more efficient diagnosis.
What is dizziness?
In order to better describe dizziness symptoms some understanding of what dizziness actually means is required. The term dizziness is a broad term that encompasses a variety of sensations of an altered state of being including: lightheadedness, vertigo, disorientation, imbalance, blurred vision, or even motion intolerance.
To better understand what may be causing ones symptoms of dizziness it should be better established what is meant by the statement “I am dizzy”. Below are some of the more common dizziness sensations described with my own basic definition for each.
Vertigo – A false sensation of self or environmental motion. i.e The room is spinning or I feel like I am spinning or moving.
Lightheaded – An altered state of being where one feels that if this sensation worsened they may pass out or lose consciousness.
Imbalance – Unsteadiness while walking. i.e. When I am walking I feel unsteady but I am fine while sitting or lying down.
Disorientation – Loss of orientation to ones surroundings or confusion.
Motion Intolerance – Either physical (self) or visual (environmental) motion produces symptoms of nausea or a dizziness sensation.
These do not encompass all possible sensations of dizziness but rather are some of the more common dizziness sensations that one might feel. Just describing the symptom quality in greater detail than “dizziness” can be helpful in identifying the cause of the symptoms but it is not all that is required to fully understand the cause of dizziness.
Timing, Triggers & Onset
It is imperative to understand how long the symptoms last if they present in clearly defined episodes or if the dizziness sensation is constant. If the dizziness comes in episodes, take note of how long the episode last.
Whether the symptoms are constant, or if they present in an episodic fashion, it is also helpful to know when the symptoms first began and when was the last time you experienced this symptom.
i.e. “I feel a sensation of the vertigo (room spinning) that lasts for around 30-45 seconds in duration. I first experienced this sensation two months ago and I felt this earlier this morning.”
If the dizziness comes in episodes, are they spontaneous (no obvious triggers), or do certain physical or visual movements provoke an episode. Different conditions may have unique physical or visual movements that can provoke or trigger symptoms. Some conditions may not have anything that makes the symptoms better or worse. If the dizziness presents in episodes are there any lingering symptoms in between the episodes.
i.e. “I feel a sensation of the vertigo (room spinning) that lasts for around 30-45 seconds in duration and I most often experience this sensation when I lay down in bed, roll over in bed, or tilt by head backward or forward. In between these episodes, I do not experience any lingering symptoms of dizziness or imbalance. These symptoms began two months ago and the last time I experienced this was this morning when rolling over in bed. “
One can see with the above examples how much more specific and thus useful information was obtained by describing the dizziness symptom type, timing, triggers, and onset. This creates a much more detailed picture of what is meant by dizziness which allows for better directed assessment and treatment for the symptoms.
Associated Symptoms
Also, pay particular attention to any symptoms other than dizziness that occur before, after or during an episode of dizziness. If the dizziness is constant are there any other symptoms that began around the time the dizziness began?
Common associated symptoms can encompass a multitude of sensations, such as:
- changes in hearing,
- noises in ones ears,
- pressure or fullness in ear(s),
- ear pain,
- sensitivity to lights or sounds,
- headache,
- nausea,
- vomiting,
- sweating,
- heart racing
It may be difficult to pay attention to any associated symptoms because the dizziness makes you feel terrible but this can be essential in determining the cause of symptoms as some causes for dizziness have symptom overlap.
i.e. “I have experienced multiple episodes of spontaneous vertigo that lasted for several hours in duration. With each of these episodes I noticed decreased hearing, a roaring noise, and pressure in my right ear. Following the episode I did not have any lingering dizziness or imbalance but my hearing in my right ear is no longer the same as my left ear. This initially started 3 months ago. My last episode was 3 days ago.”
What if I have multiple symptoms?
Lastly, It is important to note if all of the episodes have been the similar or were/are some different than others. It is possible to have more than one cause for dizziness which may result in different symptoms with their own unique features.
If you have more than one dizziness symptom try to describe each symptom utilizing the above format including: symptom type, timing, triggers, onset, and associated symptoms.
What can you do?
Specifically describing dizziness symptoms including: dizziness type, timing, triggers, onset and associated symptoms will assist your healthcare provider in determining the cause of the dizziness and the best means of treatment.
