Dizziness and Vertigo
We generally use one word - DIZZY- for two very different sensations. These sensations have very different causes. We need to be clear on which sensation we mean before we can figure out causes and treatments.
One sensation is a light-headed, kind of fainting, passing-out sensation. It’s what we feel after we breathe in and out rapidly (hyperventilation) ten or twenty times. This we call “little d” dizziness.
The other sensation is the merry-go-round, “I’m spinning”, “ the room is spinning”, on a boat kind of seasick feeling. This feeling is called vertigo.
DIZZY WITH A SMALL "d"
The British call this sensation "giddy". This sensation just about never comes from the ear.
Two basic origins for this experience are:
Metabolic...meaning a change in blood chemistry. In addition to hyperventilation, such changes can occur as a result of sedative
medications, or hormonal changes. Occasionally, such sensations are caused by a hyperventilation response to emotional stress.
Circulatory... occurs when the reflexes adjusting blood flow to the brain don't keep up with the brain's need. One example is the "head rush" of standing up to quickly after sitting for hours. Other causes include medications effects or blood vessel diseases.
The complete evaluation of this complaint falls within the usual practice of family or internal medicine.
VERTIGO...AN EAR PROBLEM?
With few exceptions, this sensation arises in the inner ear. The inner ear is the part of the ear buried deep in the ( temporal) bone on the side of the head including the organ of hearing...the cochlea, and the organ of balance.....the vestibular apparatus. Vertigo occurs when one ear malfunctions compared to the other. When both ears malfunction to the same degree, vertigo is rare, but severe difficulty walking and standing up is the result.
Hydrops of the ear is the term for fluid imbalances of the inner ear. Malfunctions in this system cause balance problems, severe dizziness (vertigo), accompanied by hearing loss and distortion, ear ringing (tinnitus), sensations of plugged ear, and ear pain from loud noises. Hydrops of the ear takes many forms. Often incorrectly applied to any kind of dizziness, the name "Meniere's Disease" refers to a special form of hydrops.
When the fluid imbalance affects only the cochlea, the symptoms can include periodic blockage sensations, ringing in the ear, and/or distortion or loss of hearing. When just the vestibular apparatus is involved, spinning, rocking, and moving sensations are experienced.
The off-balance and motion sensations can be so intense, they can cause nausea and vomiting....just like motion sickness. The cochlear and balance symptoms may occur together.