Dizzy Dean, great baseball pitcher of 1930s-1940s, once quipped, "The doctors x-rayed my head and found nothing." That is as good an analogy as any in describing what often happens to patients with symptom of dizziness. They see a doctor, get an MRI scan (the x-ray of 21st century) and nothing is found.
To extend baseball theme, patients sometimes complete a triple-play—going from family doctor to ear specialist to neurologist. And when all is said and done, none of doctors is willing to own symptom. Each says it's other doctors' problem!
So where does that leave patient? Probably out of a lot of bucks and getting more frustrated by minute!
But, upon close analysis of symptom, a case of dizziness can give up its secrets. It turns out that word "dizziness" gets used to describe a variety of experiences, and those different experiences can themselves result from a number of underlying causes.
So way one gets to first base is to sort through patterns and narrow down list of possibilities. In analyzing symptom of dizziness, sometimes a multiple-choice approach works best. Most people can select one of following three descriptions as most resembling their symptom:
#1. A sense of motion, perhaps spinning, rotating or even just drifting in space. It doesn't matter if person feels they are spinning or that room around them is spinning: both mis-perceptions have same significance. These perceptions are known as "vertigo."
#2. A feeling of unsteadiness or imbalance in body more than in head.
#3. A feeling of light-headedness, wooziness, giddiness, or even verging on losing consciousness.
That term "dizzy" can sometimes have still other connotations is illustrated by Mr. Dean's own nickname. He probably didn't get it because of attacks of imbalance. In fact, pitcher supplied his own explanation with another of his famous quips: "The good Lord was good to me. He gave me a strong body, a good right arm, and a weak mind."
Let's focus on more usual three patterns.
Distinguishing among these patterns helps separate cases involving head's balance (vestibular) system from those that don't. In short, pattern #1 (vertigo) is most likely to involve a disturbance in balance system, while pattern #3 (light-headedness) is least likely. Instead, light-headedness or wooziness can be due to a momentary drop in blood pressure (for example, when standing up too quickly) or due to same factors that produce outright fainting. Pattern #2 (bodily imbalance) is somewhere in-between—-sometimes caused by a disturbed balance system and sometimes due to something else.
The vestibular system consists of left and right inner ears, certain pathways within brainstem (junction between upper brain and spinal cord) and nerves that connect inner ears to brainstem. A problem in any of these components can lead to symptom of vertigo. But kinds of problems that can disturb brainstem—-like stroke, tumor or multiple sclerosis—-are quite different and usually more serious than most conditions that disturb inner ears or their associated nerves.