Dizziness: Lightheadedness vs Vertigo and When to Be Seen

What it involves

MedlinePlus says dizziness is a term used for two symptoms: lightheadedness, a feeling that you might faint, and vertigo, a feeling that you or the world around you is spinning or moving. It also says most causes of dizziness are not serious and either get better on their own or are easy to treat. A visit is about finding which kind you have and ruling out the less common serious causes.

Who this is for

• Adults who feel lightheaded when they stand up or after a long time on their feet
• Adults who feel the room spinning when they turn their head or roll over in bed
• Patients who started a new medicine and then became dizzy
• Patients with dizzy spells that come and go and have not yet been looked at

What to expect

• Questions about when it started, what makes it worse, and how long it lasts
• A physical exam, with blood pressure and pulse checked sitting and standing
• A review of your medicines, recent illness, hydration, and stress
• A decision on whether tests or a referral are needed, and what to avoid in the meantime

Causes of lightheadedness

MedlinePlus says lightheadedness happens when the brain does not get enough blood. That can follow a sudden drop in blood pressure, dehydration from vomiting, diarrhea, or fever, or getting up too quickly after sitting or lying down, which is more common in older people. It can also come with the flu, a cold, allergies, low blood sugar, or medicines that lower blood pressure. The cold versus flu guide covers staying hydrated during a viral illness. Fluid loss from vomiting or diarrhea can leave you lightheaded when you stand, and the stomach flu and dehydration guide explains how to replace fluids and when to call. Dizziness after time outdoors in hot weather can be an early sign of heat exhaustion, which the heat exhaustion and heat stroke guide describes along with when to call 911.

Causes of vertigo

MedlinePlus lists benign positional vertigo, a spinning feeling that occurs when you move your head, labyrinthitis, a viral inner ear infection that usually follows a cold or flu, and Meniere disease, an inner ear problem that often brings hearing loss or ringing in the ears. Other causes it names include some medicines, stroke, multiple sclerosis, and seizures, which is why new or unusual vertigo should be evaluated. Ringing in the ears along with dizziness or feeling off balance is covered in the tinnitus guide, which lists when MedlinePlus says to contact a provider.

Call 911 or go to the ER if dizziness comes with these

MedlinePlus says to call 911 or go to an emergency room if you are dizzy and have:

• A head injury, or a fever over 101 degrees with headache or a very stiff neck
• Seizures, or trouble keeping fluids down
• Chest pain, an irregular heartbeat, or shortness of breath
• Weakness, inability to move an arm or leg, or a change in vision or speech
• Fainting with loss of alertness for more than a few minutes

Contact your provider if

MedlinePlus says to contact your provider if you have dizziness for the first time, new or worsening symptoms, dizziness after taking medicine, or hearing loss. If you have headaches along with the dizziness, the headache and migraine evaluation explains what that visit covers. If a blood pressure medicine is a suspect, do not stop it yourself; the hypertension visit is where doses are reviewed. Neck pain that comes with numbness, tingling, or weakness in an arm should be mentioned at the visit, and the neck pain evaluation lists the nerve symptoms MedlinePlus says to report. Dizziness that comes with numbness, weakness, or a change in speech is on the emergency list above, and the numbness and tingling guide lists the other signs that mean calling 911.

Home care that MedlinePlus suggests

For lightheadedness when you stand, MedlinePlus advises avoiding sudden posture changes, getting up slowly from lying down, staying seated for a few moments before standing, and holding on to something. For vertigo it advises resting and keeping still, avoiding sudden movements, and avoiding bright lights, TV, and reading during attacks. It also says to avoid driving, heavy machinery, and climbing until a week after symptoms disappear.

What the visit and tests can involve

MedlinePlus says a provider does a physical exam, asks about your history and symptoms, and may check your blood pressure and use an electrocardiogram, hearing tests, balance testing, or an MRI, depending on what is suspected. At the Loxahatchee and West Palm Beach offices an EKG is available if a rhythm problem is suspected. Other tests may require a referral.

Sources

• MedlinePlus — Dizziness