"Head spinning": when dizziness is not just about fatigue

Dizziness is one of the most common symptoms, ranking among the top 5 reasons for seeking medical attention. It can appear suddenly, frighten with its intensity, and be a manifestation of over a hundred different diseases: from inner ear problems to serious brain damage or even psycho-emotional disorders. What exactly is dizziness, how to distinguish it from the diagnosis of vertigo, and when should you immediately seek medical help? To get professional answers to these questions, UNN turned to family doctor, medical director, and head of the scientific and educational department of the Ukrainian Academy of Biological Medicine, Maryna Huliy.

– Dizziness often frightens people, as it can be a symptom of many diseases. What, in your opinion, should be the first step for a person who experiences dizziness?

– A visit to the family doctor. However, in not all cases can a family doctor definitively establish the cause of such a condition. After all, dizziness can be a symptom of many diseases, so the patient is often referred to a narrow specialist – a neurologist, an otorhinolaryngologist, etc. In some cases, additional examination may be required.

– What is the difference between vertigo and "dizziness"?  

– Vertigo is a diagnosis that implies a malfunction of the vestibular apparatus, i.e., the structures of the inner ear responsible for balance. This condition can be caused by inner ear infections, inflammation of the auditory nerve, and other causes. Worldwide, this condition is called vertigo.

And, in fact, the term "dizziness" is not a diagnosis, but a symptom that accompanies a multitude of pathologies, namely: injuries and organic diseases of the brain and spinal cord (including atherosclerosis, stroke), vertebrogenic disorders, various somatic and psychosomatic diseases, mental disorders. In addition, dizziness can be a symptom of the toxic effects of certain medications or drugs.

– Dizziness is often associated with inner ear problems. Tell us, how exactly do the "ear-eye-brain" interact and why do disturbances in this system cause a sensation of spinning?

– To maintain balance, our body uses three systems: 

• visual – provides information about the environment; 

• vestibular (inner ear) – registers head movement and position; 

• sensory (proprioceptive) – determines body position in space. 

Disruptions in the functioning of any of these systems cause a sensation of spinning.

The reasons are diverse. The first is age-related changes in the vestibular apparatus: elderly people often lose balance, fall, and sustain injuries to the musculoskeletal system or head. The second is systemic diseases: polyneuropathy, glaucoma, cataracts. The third is motion sickness (seasickness) – a discrepancy between visual and vestibular signals. That is, when the eyes fix on a stationary horizon, but the vestibular apparatus registers swaying. In such a case, dizziness is accompanied by nausea and vomiting.

– Recent studies indicate a high prevalence of psychogenic dizziness associated with stress and anxiety. How can a patient understand that their condition may be related to mental rather than physical health?

– Psychogenic dizziness often arises against a background of anxiety disorders, panic attacks, or depression. In such cases, it is part of a vegetative reaction to stress and is accompanied by a feeling of fear, accelerated heart rate, sweating, and shortness of breath. People describe psychogenic dizziness as: "fog in the head," "feeling of instability," "the ground moving underfoot," "loss of connection with reality." Similar symptoms often worsen in stressful situations or when in a crowd.

– On September 27, this Saturday, the Ukrainian Academy of Biological Medicine will host the conference "Bioregulation – the trend of the future. Vertigo." The event will cover the topic of dizziness in children, pregnant women, and military personnel. What are the peculiarities and difficulties of diagnosis and treatment in these categories of patients?

– Children do not always clearly describe the symptom of dizziness. They may complain of "darkening in the eyes" or other vague manifestations. Dizziness in children can resemble a migraine attack, epilepsy, or a psychogenic state.

The causes of dizziness in children can be stress, fatigue, mental or physical overexertion, vegetative lability, anemia, hypoglycemia. Treatment involves eliminating triggers, correcting the body's condition, optimizing diet, sleep, and rest. It is important to avoid the use of toxic pharmacological agents. 

In pregnant women, dizziness is considered a physiological symptom. However, it can be a sign of serious conditions: anemia, preeclampsia, thromboembolism, cardiovascular dysfunction.

In military personnel, the main causes of dizziness are traumatic brain injury, acoustic barotrauma, chronic fatigue, and post-traumatic stress disorder (PTSD). The treatment of military personnel is handled by a multidisciplinary team, which includes a therapist, rehabilitation specialist, psychologist, neurologist, and other specialists.

In addition, animal therapy – treatment and rehabilitation with the help of animals – has proven effective in correcting the consequences of PTSD in military personnel, civilians, and children.

– People often ignore dizziness, considering it insignificant: low blood pressure or weather sensitivity. Name a few "red flags" when dizziness is a signal of serious health danger and requires immediate medical attention.

– Alarming signals are: 

• nausea and sweating – may indicate severe vegetative disorders; 

• increased sensitivity to light and noise – may indicate the presence of severe migraine; 

• hearing impairment and tinnitus – characteristic of Meniere's disease; 

• cognitive and motor disorders, decreased memory and attention, slowing of mental processes – symptoms of dyscirculatory encephalopathy (a consequence of traumatic brain injuries, atherosclerosis, or other organic brain lesions).

– The number of cases of vestibular migraine is increasing worldwide, especially among young women. What is this condition and what could be the reasons for the increase in cases of this disease? 

– Vestibular migraine is a form of migraine in which vestibular dysfunction – impaired balance, a sensation of spinning and swaying – is added to the classic symptoms: headache, photophobia (light sensitivity - ed.), nausea.

Vestibular migraine is one of the most common causes of recurrent dizziness in young women. They suffer 2-3 times more often than men. And the increase in cases of vestibular migraine in women today is associated with chronic stress, neurohormonal disorders, and the influence of gadgets.

Conclusion

The term "dizziness" is not always "ordinary weakness" or "fatigue." Of course, the head can "spin" from stress or even a change in weather, but sometimes it is the first sign of more serious health problems. And this signal should not be ignored. After all, our body always gives clues. And the most valuable thing you can do for yourself is not to wait until it "goes away on its own," but to consult a doctor in time. After all, health is an investment that always pays off handsomely.