Dizziness and Motion Sickness

In Denver and Lone Tree, Colorado

Causes and Prevention

Feeling unsteady or dizzy can be caused by many factors such as poor circulationinner ear diseasemedication usageinjuryinfectionallergiesand/or neurological diseaseDizziness is treatablebut it is important for one of our ENT specialists to help you determine the cause so that the correct treatment is implementedWhile each person will be affected differentlysymptoms that warrant a visit to the doctor include a high feversevere headacheconvulsionsongoing vomitingchest painheart palpitationsshortness of breathinability to move an arm or lega change in vision or speechor hearing loss.

What is dizziness?

Dizziness can be described in many wayssuch as feeling lightheadedunsteadygiddyor feeling a floating sensationVertigo is a specific type of dizziness experienced as an illusion of movement of one’s self or the environmentSome experience dizziness in the form of motion sicknessa nauseating feeling brought on by the motion of riding in an airplanea roller coasteror a boatDizzinessvertigoand motion sickness all relate to the sense of balance and equilibrium.

Your sense of balance is maintained by a complex interaction of the following parts of the nervous system:

  • The inner ear (also called the labyrinth)which monitors the directions of motionsuch as turningrollingforward-backwardside-to-sideand up-and-down motions.
  • The eyeswhich monitor where the body is in space (i.e., upside downright side upetc.) and also directions of motion.
  • The pressure receptors in the joints of the lower extremities and the spinewhich tell what part of the body is down and touching the ground.
  • The muscle and joint sensory receptors (also called proprioception) tell what parts of the body are moving.
  • The central nervous system (the brain and spinal cord)which processes all the information from the four other systems to maintain balance and equilibrium.
  • The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems.

What causes dizziness?

Circulation: If your brain does not get enough blood flowyou feel lightheadedAlmost everyone has experienced this on occasion when standing up quickly from a lying-down positionBut some people have light-headedness from poor circulation on a frequent or chronic basisThis could be caused by arteriosclerosis or hardening of the arteriesit is commonly seen in patients who have high blood pressurediabetesor high levels of blood fats (cholesterol)It is sometimes seen in patients with inadequate cardiac (heart) functionhypoglycemia (low blood sugar)or anemia (low iron).

Certain drugs also decrease the blood flow to the brainespecially stimulants such as nicotine and caffeineExcess salt in the diet also leads to poor circulationSometimes circulation is impaired by spasms in the arteries caused by emotional stressanxietyand tension.

If the inner ear fails to receive enough blood flowthe more specific type of dizziness—vertigo—occursThe inner ear is very sensitive to minor alterations of blood flow and all of the causes mentioned for poor circulation to the brain also apply specifically to the inner ear.

Neurological diseases: A number of diseases of the nerves can affect balancesuch as multiple sclerosissyphilistumorsetcThese are uncommon causesbut one of our doctors may perform certain tests to evaluate these.

Anxiety: Anxiety can be a cause of dizziness and lightheadednessUnconscious overbreathing (hyperventilation) can be experienced as overt panicor just mild dizziness with tingling in the handsfeetor faceInstruction on correct breathing technique may be required.

Vertigo: An unpleasant sensation of the world rotatingusually associated with nausea and vomitingVertigo usually is due to an issue with the inner ear.

The common causes of vertigo are:

Benign Positional Vertigo: Vertigo is experienced after a change in head position such as lying downturning in bedlooking upor stoopingIt lasts about 30 seconds and ceases when the head is stillIt is due to a dislodged otololith crystal entering one of the semicircular balance canalsIt can last for daysweeksor monthsThe Epley “repositioning” treatment by one of our specialists is usually curativeBPV is the most common cause of dizziness after (even a mild) head injury.

Meniere’s disease: An inner ear disorder with attacks of vertigo (lasting hours)nauseaor vomitingand tinnitus (loud noise) in the earwhich often feels blocked or fullThere is usually a decrease in hearing as well.

Migraine: Some individuals with a prior classical migraine headache history can experience vertigo attacks similar to Meniere’s diseaseUsually there is an accompanying headachebut can also occur without the headache.

Infection: Viruses can attack the inner earbut usually its nerve connections to the braincausing acute vertigo (lasting days) without hearing loss (termed vestibular neuronitis)Howevera bacterial infection such as mastoiditis that extends into the inner ear can completely destroy both the hearing and equilibrium function of that earcalled labyrinthitis.

Injury: A skull fracture that damages the inner ear produces a profound and incapacitating vertigo with nausea and hearing lossThe dizziness will last for several weeks and slowly improve as the other (normal) side takes overBPV commonly occurs after head injury.

Allergy: Some people experience dizziness and/or vertigo attacks when they are exposed to foods or airborne particles (such as dustmoldspollensdanderetc.) to which they are allergic.

When should I seek medical attention?

Call 911 or go to an emergency room if you experience:

  • Dizziness after a head injury.
  • Fever over 101°Fheadacheor a very stiff neck.
  • Convulsions or ongoing vomiting.
  • Chest painheart palpitationsshortness of breathweaknessa severe headacheinability to move an arm or legchange in vision or speechor fainting and/or loss of consciousness.

Consult one of our physicians if you:

  • Have never experienced dizziness before.
  • Experience a difference in symptoms you have had in the past.
  • Suspect that medication is causing your symptoms.
  • Experience hearing loss.

How is dizziness treated?

We will ask you to describe your dizziness and answer questions about your general healthAlong with these questionsone of our physicians will examine your earsnoseand throatSome routine tests will be performed to check your blood pressurenerve and balance functionand hearingPossible additional tests may include a CT or MRI scan of your headspecial tests of eye motion after warm or cold water or air is used to stimulate the inner ear (ENG—electronystagmography or VNG—videonystagmography)and in some casesblood tests or a cardiology (heart) evaluationBalance testing may also include rotational chair testing and posturographyOne of our physicians will determine the best treatment based on your symptoms and the cause of themTreatments may include medications and balance exercises.

Dizziness Prevention

Dizziness prevention can be accomplished by:

  • Avoiding rapid changes in position.
  • Avoiding rapid head motion (especially turning or twisting).
  • Eliminating or decreasing use of products that impair circulatione.g., tobaccoalcoholcaffeineand salt.
  • Minimizing stress and avoiding substances to which you are allergic.
  • Geting enough fluids.
  • Treating infectionsincluding ear infectionscoldsflusinus congestionand other respiratory infections.

If you are subject to motion sickness:

  • Do not read while traveling.
  • Avoid sitting in the rear seat.
  • Do not sit in a seat facing backward.
  • Do not watch or talk to another traveler who is having motion sickness.
  • Avoid strong odors and spicy or greasy foods immediately before and during your travel.
  • Talk to your doctor about medications.

Remember: Most cases of dizziness and motion sickness are mild and self-treatableBut severe cases and those that become progressively worse deserve the attention of a doctor with specialized skills in diseases of the earnosethroatequilibriumand neurological systems.