How is persistent dizziness investigated, and what should I do next if I constantly get dizzy spells?
Dizziness or giddiness means different things to different people. It is important for you to be able to describe the nature of your dizziness to your doctor. To help you, these are some common types of giddiness and the possible causes:
1. Vertigo - This refers to a sensation of the room is spinning. Quite often patients with vertigo do experience nausea and even vomiting. Common causes include:
a) Benign paroxysmal positional vertigo (BPPV) - This is a condition due to calcium deposits or "stones" in the inner ear balance system). Typical symptoms include vertigo that is triggered by sudden head movement (e.g. when looking up, turning your head to the right or left, or getting up from bed). The vertigo usually lasts between seconds to minutes. This can be easily diagnosed in the clinic with a clinical test known as Dix-Hallpike maneuver. BPPV can be treated by your ENT Specialist who will be able to perform an Epley's maneuver to "roll out the stones" from your inner ear canals.
b) Vestibular neuronitis - This is due to a viral infection of the balance nerve. Patients may experience vertigo that last for hours and is often associated with severe nausea and vomiting. Some patients experience ringing sound (Tinnitus) in the ear when this happens. The treatment includes taking anti-vertigo medications and ample rest.
c) Labyrinthitis - This refers to inflammation of the balance and hearing system. The typical symptoms include vertigo, tinnitus and hearing loss. Blood investigations and an MRI scan of the head region may be required to determine the cause (although most of the time it is due to a viral infection or an unknown cause). Treatment may include a course of oral steroids and anti-vertigo medications.
2. Feeling lightheaded or drowsy/spaced out- Possible causes of this include low blood pressure, low blood level, side effects of medications, dehydration, heart or brain conditions. You should visit a GP first if this is what you experience.
Depending on the likely cause of your giddiness, additional investigations include hearing test, blood tests, MRI of the brain and assessments for the heart.
Hope this helps and all the best!
Dr Gan Eng Cern
MBBS, MRCS, MMed, FAMS
38 Irrawaddy Road #08-45
Mount Elizabeth Novena Specialist Centre
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