Depicting the character 暈 (dizziness) in the seal script of Ancient Chinese
Specialty ENT surgery

Dizziness is an impairment in spatial perception and stability.[1] The term dizziness is imprecise:[2] it can refer to vertigo, presyncope, disequilibrium,[3] or a non-specific feeling such as giddiness or foolishness.[4]

One can induce dizziness by engaging in disorientating activities such as spinning.

  • Vertigo is the sensation of spinning or having one’s surroundings spin about them. Many people find vertigo very disturbing and often report associated nausea and vomiting. It represents about 25% of cases of occurrences of dizziness.[5]
  • Disequilibrium is the sensation of being off balance and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.
  • Presyncope is lightheadedness, muscular weakness, and feeling faint as opposed to a syncope, which is actually fainting.
  • Non-specific dizziness is often psychiatric in origin. It is a diagnosis of exclusion and can sometimes be brought about by hyperventilation.[4]

A stroke is the cause of isolated dizziness in 0.7% of people who present to the emergency department.[5]


Dizziness is broken down into 4 main subtypes: vertigo (~50%), disequilibrium (less than ~15%), presyncope (less than ~15%) and lightheadedness (~10%).[6]


  • Excessive accumulation of heat inside body or being in a hot environment for too long.[7]
  • Heat syncope/ is a sudden dizziness that can happen when you are active in hot weather. If you take a heart medication called a beta blocker or are not used to hot weather, you are even more likely to feel faint.[7]


Many conditions cause dizziness because multiple parts of the body are required for maintaining balance including the inner ear, eyes, muscles, skeleton, and the nervous system.[8]

Common physiological causes of dizziness include:

  • inadequate blood supply to the brain due to:
    • a sudden fall in blood pressure[8]
    • heart problems or artery blockages[8]
  • loss or distortion of vision or visual cues[8]
  • disorders of the inner ear[8]
  • distortion of brain/nervous function by medications such as anticonvulsants and sedatives[8]
  • result of side effect from prescription drugs, including proton-pump inhibitor drugs (PPIs)[9] and Coumadin (warfarin) causing dizziness/fainting [10]


Differential diagnosis[edit]

Many conditions are associated with dizziness. Dizziness can accompany certain serious events, such as a concussion or brain bleed, epilepsy and seizures (convulsions), strokes, and cases of meningitis and encephalitis. However, the most common subcategories can be broken down as follows: 40% peripheral vestibular dysfunction, 10% central nervous system lesion, 15% psychiatric disorder, 25% presyncope/disequilibrium, and 10% nonspecific dizziness.[11] Some vestibular pathologies have symptoms that are comorbid with mental disorders.[12] The medical conditions that often have dizziness as a symptom include:[11][13][8][14]


About 20–30% of the population report to have experienced dizziness at some point in the previous year.[5]

See also[edit]


  1. ^ dizziness” at Dorland’s Medical Dictionary
  2. ^ Dizziness at the US National Library of Medicine Medical Subject Headings (MeSH)
  3. ^ Reeves, Alexander G.; Swenson, Rand S. (2008). “Chapter 14: Evaluation of the Dizzy Patient”. Disorders of the Nervous System: A Primer. Dartmouth Medical School.
  4. ^ a b Branch Jr., William T.; Barton, Jason J. S. (February 10, 2011). “Approach to the patient with dizziness”. UpToDate.
  5. ^ a b c Neuhauser HK, Lempert T (November 2009). “Vertigo: epidemiologic aspects” (PDF). Semin Neurol. 29 (5): 473–81. doi:10.1055/s-0029-1241043. PMID 19834858.
  6. ^ Post RE, Dickerson LM (August 2010). “Dizziness: a diagnostic approach”. Am Fam Physician. 82 (4): 361–8, 369. PMID 20704166.
  7. ^ a b “Hot Weather Safety for Older Adults”. National Institute on Aging. Template:NIH, This article incorporates text from the United States National Library of Medicine, which is in the public domain.. 2016-06-15. Retrieved 2019-05-15. line feed character in |others= at position 146 (help)CS1 maint: others (link)
  8. ^ a b c d e f g “Dizziness and Vertigo”. Merck Manual. 2009.
  9. ^ Research, Center for Drug Evaluation and. “Drug Safety and Availability – FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)”. www.fda.gov. Retrieved 17 April 2018.
  10. ^ “Common Side Effects of Coumadin (Warfarin Sodium) Drug Center – RxList”. rxlist.com. Retrieved 17 April 2018.
  11. ^ a b Chan Y (June 2009). “Differential diagnosis of dizziness”. Curr Opin Otolaryngol Head Neck Surg. 17 (3): 200–3. doi:10.1097/MOO.0b013e32832b2594. PMID 19365263.
  12. ^ Lawson, B. D., Rupert, A. H., & Kelley, A. M. (2013). Mental Disorders Comorbid with Vestibular Pathology. Psychiatric Annals, 43(7), 324.
  13. ^ Tusa RJ (March 2009). “Dizziness”. Med. Clin. North Am. 93 (2): 263–71, vii. doi:10.1016/j.mcna.2008.09.005. PMID 19272508.
  14. ^ Bronstein AM, Lempert T (2010). “Management of the patient with chronic dizziness”. Restor. Neurol. Neurosci. 28 (1): 83–90. doi:10.3233/RNN-2010-0530. PMID 20086285.
  15. ^ O’Connor RE, Brady W, Brooks SC, et al. (November 2010). “Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care”. Circulation. 122 (18 Suppl 3): S787–817. doi:10.1161/CIRCULATIONAHA.110.971028. PMID 20956226.

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