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Dizziness Not Always Child's Play

Stop the Spinning

If You're Dizzy, See a Doctor continued...

If your primary care doctor thinks your dizziness is due to a heart problem, for example, you would be sent to a cardiologist. If your symptoms suggest a brain or nerve problem, you would be sent to a neurologist. And if the problem seems to be psychological in nature, your may be referred to a psychiatrist or psychologist.

But don't just get a bunch of tests without some idea of where the problem lies. Samuels and otolaryngologist Richard L. Prass, MD, PhD, both say that expensive tests can be a waste of money unless ordered by a specialist looking for something specific.

How can a doctor tell where to send you? Samuels says that the type of dizziness you describe can point a primary care provider in the right direction. He identifies four distinct types: vertigo, lightheadedness, disequilibrium, and anxiety.

Type 1 -- Vertigo

"Vertigo is the feeling of motion when there is no motion," Samuels says.

It's a feeling common to every child who's spun himself around and around. "But if it happens in the course of normal daily living, it is a symptom -- one that accounts for half of all dizzy complaints," he says.

Vertigo means there is a problem with the vestibular system of the inner ear -- the part of the nervous system that tells you which way is down (the sense of gravity), and also lets you sense the position of your head.

"When the vestibular system is malfunctioning, people have a sensation of motion either of their head or of their relation to the earth below them -- that is the symptom of vertigo," Samuels says.

 

There are two very common causes of vertigo:

  • Infectious agents, such as the viruses that cause the common cold or diarrhea. "A week after infection some people get vertigo," Samuels says. This harmless condition usually goes away by itself within 6-8 weeks, although drugs are available if it is severe.
  • Benign paroxysmal positional vertigo or BPPV. This is another harmless condition caused by movement of the otolith -- a tiny calcium particle the size of a grain of sand -- from the part of the ear that senses gravity to the part that senses head position. The person feels as if their head is turning when it isn't. A two-minute therapy done right in the doctor's office can move the otolith back where it belongs and fix the problem.

Another cause of vertigo is Meniere's disease, a disorder characterized by long-lasting episodes of severe vertigo.

"A person usually can't do anything but lie down or they get very nauseated," says Prass, president of Atlantic Coast Ear Specialists and assistant professor at Eastern Virginia Medical School, in Norfolk.

"Other typical symptoms of Meniere's disease are tinnitus -- a roaring and obnoxious buzzing [in the ear], hearing loss, and a feeling of pressure or fullness in the ear," he says. In fact, symptoms of Meniere's disease may be what led van Gogh to cut his ear off.

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