Dizziness, Vertigo and Dysequilibrium

Dizziness is one of the most common complaints encountered in the primary care setting, sharing equal time with headaches and lower back pain. Currently, 50% of patients seen in the primary care setting receive no diagnosis for their complaints of dizziness, yet 70% receive a prescription for Meclizine, which is vestibular suppressant.

 

Various studies estimate 10-20% of the US population have symptoms of dizziness. And that is a lot of people who need help in addressing the underlying cause, rather than suppressing the symptoms with medication--which, in most cases, will actually slow down your recovery.

 

But what is dizziness?

 

The term dizziness is a non-specific description involving disorientation of space or lack of steadiness as one moves through their environment. For some this term may be used in an attempt to describe vertigo, which is a symptom that involves the sensation or illusion of spinning. Dysequilibrium, on the other hand, is the feeling of unsteadiness on ones feet or difficulty with balance. These three symptoms are the most common descriptors used to describe when one feels "dizzy" and they often can be experienced as a continuum of symptoms together.

For example, a person can be have a constant sense of dizziness and unsteadiness on their feet, yet also experience vertigo with specific body positions or directions of movement.

Additional symptoms one may use to describe their sensation of dizziness includes, light headness, feeling faint, foggy headed, floating, drunk, nauseous, anxious, and a fear of going out side or into a supermarket.

Determining the cause of these symptoms requires a detailed history, examination and diagnostic testing that can provide us with objective measurements involving the central and peripheral (inner ear) sensory processing regions of the brain.

A detailed history involves obtaining specific information about how you experience your symptoms. Your health and medication history prior to when these symptoms first began. If they came on suddenly or occurred gradually over time. What types of activities trigger the symptoms. How long they last. And any other associated symptoms that you may be experiencing. 

 

The 3 most important sensory systems for maintaining balance and orientation are:

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Visual System

Vestibular System

Somatosensory system