Have you suffered or suffering from dizziness?
Next to headache, the one of the most common symptom suffered by most of adult population is dizziness, giddiness vertigo or chakkar. However, this term has been used by patient populations to Convey different symptoms in brain. Anything abnormal happening in brain is reported by patient as dizziness or giddiness whether it is fainting or an event of darkness before eyes, falling on ground because of sudden lack of balance or transient inability to comprehend ongoing events in the surrounding or even paralysis are all reported by patients as dizziness.
On the other hand, any feeling of a rotational or non-rotational movement of the surroundings with or without nausea vomiting is called objective vertigo whereas feeling of such rotational movement inside head is called subjective vertigo. Normally human beings maintain a feeling of stability in any posture whether in sitting, standing or lying down. This depends on balanced information reaching brain from balancing apparatus inside ear coordinating with visual input from eyes, input from joints especially of feet and neck. These arrive at brain and synthesis of all this information within balancing center of brain takes place to be conveyed to specialized areas within brain to make us feel aware of stable environment.
All this information arises from peripheral nerves, joints of the neck from balancing apparatus of both ears, balancing center cerebellum, brain stem and synthesizing with input from the emotional areas of brain. Any imbalance in coordinated synthesis in any component at any level produce dizziness or vertigo.
A careful clinical history regarding characteristics of giddiness will give clues to its causation.The onset, duration of episodes, the situational position of the body/head when dizziness occurs are most important to be told to neurologist. The accompanying symptoms and findings on neurological examination will point towards the causation especially when MRI and CT scan of brain are noncontributory to reveal the cause. The accompanying symptoms of hissing sound called tinnitus (an ear disease), vomiting, double vision, speaking difficulty, inability to balance standing or walking, imbalance while sitting or using limbs may indicate a stroke despite limbs having normal power.
Many times when all the peripheral information reaching brain is normal but despite that dizziness persists for weeks to months to years then the chances are that an imbalance in emotional neural circuitry in brain prevent the proper synthesis and thus distorts the perception of environment.
The causes of dizziness or vertigo in different age groups differ. In senior citizens, they can be multiple causes adding together to produce symptoms of giddiness. This age group should be intensively investigated to detect an undercover current of different diseases. Many a times aging of cervical spine is a red herring and becomes an escape diagnosis allowing the real culprit/cause go unattended to.
The treatment is very rewarding if the correct cause is detected. On the other hand merely pharmacological suppression of symptoms of giddiness may allow serious illnesses to produce catastrophe without being detected.