Vertigo, the sensation of one's surroundings are spinning around them is a common symptom of dizziness.
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ENT surgery
Dizziness is an impairment in spatial perception and stability.[1] The term dizziness is imprecise:[2] it can refer to vertigo, presyncope, disequilibrium,[3] or a non-specific feeling such as giddiness or foolishness.[4]
Dizziness is a common medical complaint, affecting 20-30% of persons.[5] Dizziness is broken down into 4 main subtypes: vertigo (~25-50%), disequilibrium (less than ~15%), presyncope (less than ~15%) and nonspecific dizziness (~10%).[6]
Vertigo is the sensation of spinning or having one's surroundings spin about them. Many people find vertigo very disturbing and often report associated nausea and vomiting.[7]
Presyncope describes lightheadedness or feeling faint; the name relates to syncope, which is actually fainting.
Disequilibrium is the sensation of being off balance and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.
Non-specific dizziness may be psychiatric in origin. It is a diagnosis of exclusion and can sometimes be brought about by hyperventilation.[4]
Contents
1Mechanism and causes
2Diagnosis
2.1Differential diagnosis
3Epidemiology
4Disequilibrium
5See also
6References
7External links
Mechanism and causes
Many conditions cause dizziness because multiple parts of the body are required for maintaining balance including the inner ear, eyes, muscles, skeleton, and the nervous system.[8] Thus dizziness can be caused by a variety of problems, and may reflect a focal process (such as one affecting balance or coordination) or a diffuse one (such as a toxic exposure or low perfusion state).
Common physiological causes of dizziness include:
inadequate blood supply to the brain due to:
a sudden fall in blood pressure[8]
heart problems or artery blockages[8]
loss or distortion of vision or visual cues[8]
disorders of the inner ear[8]
distortion of brain/nervous function by medications such as anticonvulsants and sedatives[8]
result of side effect from prescription drugs, including medications such as anti-epileptic drugs, sedatives, proton-pump inhibitors (PPIs),[9] and Coumadin (warfarin) [10]
Diagnosis
Differential diagnosis
Dizziness may occur from an abnormality involving the brain (in particular the brainstem or cerebellum), inner ear, eyes, heart, vascular system, fluid or blood volume, spinal cord, peripheral nerves, or body electrolytes. Dizziness can accompany certain serious events, such as a concussion or brain bleed, epilepsy and seizures (convulsions), strokes, and cases of meningitis and encephalitis. However, the most common subcategories can be broken down as follows: 40% peripheral vestibular dysfunction, 10% central nervous system lesion, 15% psychiatric disorder, 25% presyncope/disequilibrium, and 10% nonspecific dizziness.[11] Some vestibular pathologies have symptoms that are comorbid with mental disorders.[12]
While traditional medical teaching has focused on determining the cause of dizziness based on the category (e.g. vertigo vs presyncope), recent research suggests that this analysis is of limited clinical utility.[13][14]
Medical conditions that often have dizziness as a symptom include:[11][15][8][16]
Age-diminished visual, balance, and perception of spatial orientation abilities
a stroke is the cause of isolated dizziness in 0.7% of people who present to the emergency department.[7]
Epidemiology
About 20–30% of the population report to have experienced dizziness at some point in the previous year.[7]
Disequilibrium
This section is about the loss of sense of balance. For other uses, see Disequilibrium.
In medicine, disequilibrium refers to impaired equilibrioception that can be characterised as a sensation of impending fall or of the need to obtain external assistance for proper locomotion.It is sometimes described as a feeling of improper tilt of the floor, or as a sense of floating. This sensation can originate in the inner ear or other motion sensors, or in the central nervous system. Neurologic disorders tend to cause constant vertigo or disequilibrium and usually have other symptoms of neurologic dysfunction associated with the vertigo. Many medications used to treat seizures, depression, anxiety, and pain affect the vestibular system and the central nervous system which can cause the symptom of disequilibrium.[18]
See also
Balance disorder
Broken escalator phenomenon
Chronic subjective dizziness
Coriolis effect (perception)
Equilibrioception
Ideomotor phenomenon
Illusions of self-motion
Motion sickness
Postural orthostatic tachycardia syndrome
Proprioception
Seasickness
Spatial disorientation
The spins, a state of dizziness and disorientation due to intoxication
Vertigo
References
^"dizziness" at Dorland's Medical Dictionary
^Dizziness at the US National Library of Medicine Medical Subject Headings (MeSH)
^Reeves, Alexander G.; Swenson, Rand S. (2008). "Chapter 14: Evaluation of the Dizzy Patient". Disorders of the Nervous System: A Primer. Dartmouth Medical School.
^ abBranch Jr., William T.; Barton, Jason J. S. (February 10, 2011). "Approach to the patient with dizziness". UpToDate.
^Karatas, Mehmet (2008). "Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes". The Neurologist. 14 (6): 355–64. doi:10.1097/NRL.0b013e31817533a3. ISSN 1074-7931. PMID 19008741.
^Post RE, Dickerson LM (August 2010). "Dizziness: a diagnostic approach". Am Fam Physician. 82 (4): 361–8, 369. PMID 20704166.
^ abcdefg"Dizziness and Vertigo". Merck Manual. 2009. Cite web requires |website= (help)
^Research, Center for Drug Evaluation and. "Drug Safety and Availability – FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)". www.fda.gov. Retrieved 17 April 2018.
^"Common Side Effects of Coumadin (Warfarin Sodium) Drug Center – RxList". rxlist.com. Retrieved 17 April 2018.
^ abChan Y (June 2009). "Differential diagnosis of dizziness". Curr Opin Otolaryngol Head Neck Surg. 17 (3): 200–3. doi:10.1097/MOO.0b013e32832b2594. PMID 19365263.
^Lawson, B. D., Rupert, A. H., & Kelley, A. M. (2013). Mental Disorders Comorbid with Vestibular Pathology. Psychiatric Annals, 43(7), 324.
^James, Ernest; Sirmans, Susan M.; Herbert L. Muncie, Jr (1 February 2017). "Dizziness: Approach to Evaluation and Management". American Family Physician. 95 (3): 154–162. ISSN 0002-838X. PMID 28145669.
^Kerber, Kevin A.; Newman-Toker, David E. (August 2015). "Misdiagnosing Dizzy Patients". Neurologic Clinics. 33 (3): 565–575. doi:10.1016/j.ncl.2015.04.009. PMID 26231272.
^Tusa RJ (March 2009). "Dizziness". Med. Clin. North Am. 93 (2): 263–71, vii. doi:10.1016/j.mcna.2008.09.005. PMID 19272508.
^Bronstein AM, Lempert T (2010). "Management of the patient with chronic dizziness". Restor. Neurol. Neurosci. 28 (1): 83–90. doi:10.3233/RNN-2010-0530. PMID 20086285.
^O'Connor RE, Brady W, Brooks SC, et al. (November 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S787–817. doi:10.1161/CIRCULATIONAHA.110.971028. PMID 20956226.
^"Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Chapter 123Vertigo and Associated Symptoms". Cite web requires |website= (help)
External links
Classification
D
ICD-10: R42
ICD-9-CM: 780.4
MeSH: D004244
DiseasesDB: 17771
External resources
MedlinePlus: 003093
eMedicine: neuro/693
Dizzytimes.com Online Community for Sufferers of Vertigo and Dizziness
Dysautonomia Youth Network of America, Inc.
v
t
e
Symptoms and signs: cognition, perception, emotional state and behaviour (R40–R46, 780.0–780.5, 781.1)
Cognition
Alteration of consciousness
Confusion (Delirium)
Obtundation
Psychosis
Delusions
Somnolence
Stupor
Sopor
Unconsciousness
Coma
Persistent vegetative state
Sleep
Syncope
Fainting/Syncope
Carotid sinus syncope
Heat syncope
Vasovagal episode
Other
Amnesia
Anterograde amnesia
Retrograde amnesia
Convulsion
Dizziness
Disequilibrium
Presyncope/Lightheadedness
Vertigo
Emotional state
Anger
Anxiety
Depression
Fear
Paranoia
Hostility
Irritability
Suicidal ideation
Behavior
Verbosity
Russell's sign
Perception/ sensation disorder
Hallucination (Auditory hallucination)
Olfaction
Anosmia
Hyposmia
Dysosmia
Parosmia
Phantosmia
Hyperosmia
Synesthesia
Taste
Ageusia
Hypogeusia
Dysgeusia
Parageusia
Hypergeusia
Authority control
GND: 4053994-5
LCCN: sh91003003
NDL: 00567583
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Langerhans cell histiocytosis with disequilibrium.
Nakamura T, Morimoto N, Goto F, Shioda Y, Hoshino H, Kubota M, Taiji H.SourceDepartment of Otolaryngology, Saiseikai Yokohama South Hospital, Japan.
Auris, nasus, larynx.Auris Nasus Larynx.2012 Dec;39(6):627-30. Epub 2012 Feb 10.
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