ear, nose, and throat disorders
Dizziness and Vertigo
Introduction
Dizzinessis an imprecise term patients often use to describe various related sensations, including Faintness (a feeling of impending syncope) Light-headedness Feeling of imbalance or unsteadiness A vague spaced-out or swimmy-headed feeling A spinning sensation Vertigois a sensation of movement of the self or the environment when there is no actual movement. Usually the perceived movement is rotary—a spinning or wheeling sensation—but some patients simply feel pulled to one side. Vertigo is not a diagnosis—it is a description of a sensation. Both sensations may be accompanied by nausea and vomiting or difficulty with balance, gait, or both. Perhaps because these sensations are hard to describe in words, patients often use “dizziness,” “vertigo,” and other terms interchangeably and inconsistently. Different patients with the same underlying disorder may describe their symptoms very differently. A patient may even give different descriptions of the same “dizzy” event during a given visit depending on how the question is asked. Because of this discrepancy, even though vertigo seems to be a clearly delineated subset of dizziness, many clinicians prefer to consider the two symptoms together. However they are described, dizziness and vertigo may be disturbing and even incapacitating, particularly when accompanied by nausea and vomiting. Symptoms cause particular problems for people doing an exacting or dangerous task, such as driving, flying, or operating heavy machinery. Dizziness accounts for about 5 to 6% of physician visits. It may occur at any age but becomes more common with increasing age; it affects about 40% of people over age 40 at some time. Dizziness may be temporary or chronic. Chronic dizziness, defined as lasting>1 month, is more common among older people. 