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.