Many believe that the common causes of vertigo or dizziness are the same. Do the terms dizziness, light-headedness, disequilibrium or unsteadiness and vertigo mean the same thing?
These words are not synonyms, and clarification is important if you are to adequately describe each to the doctor as each one requires a different treatment. More important is identifying the triggers.
This article takes a deep dive into presenting the distinctions and symptoms from reviewed literature and discusses some triggers.
The mechanism of balance in the body is complex. We generally do not appreciate it until something goes wrong. There can be several reasons why it may not be functioning as it should. Some general causes include:
- Normal aging process
- Neurological disorders.
- Cardiovascular reasons such as changes in blood pressure.
- Ear-related issues (sometimes from injury or sometimes from birth).
- Head injuries or trauma.
- Use of certain medication.
- Pregnancy and other hormonal changes.
Seek immediate medical care if you experience recurrent, severe, sudden, or prolonged and unexplained dizziness, vertigo, or dis-equilibrium.
To do this requires understanding the differences between each of these terminologies we so frequently throw around.
So…..What Are the Differences?
To better understand the differences, you will need a quick review of the process of balance in the body. Refer to a previous article in MetamorphosisHub – Poor Balance in Seniors – Why Oh Why?
The body maintains its balance with sensory information from three systems – vision, muscles and joints, and the vestibular (inner ear).
Information coming in from these three systems is processed by the brain. Feedback is sent to the eyes to help maintain steady vision and to the muscles to help maintain posture and balance.
A healthy vestibular system supplies reliable information about spatial orientation. When the vestibular system malfunctions or is damaged, it is unable to resolve moments of sensory conflict,
Dizziness, vertigo, and disequilibrium are common symptoms reported by older adults during visits to their doctor. Many people often use the word dizziness to describe any sensation that makes them feel off balance and faint.
Confusing feelings one might have, and call dizziness are:
- Unsteadiness (a sense of imbalance, falling over or staggering when standing or walking) – dis-equilibrium.
- Feeling light-headed or a sensation of being faint.
- Feeling of uneasiness that can occur when one suffers from a cold or flu
- Dizzy feeling caused by breathing too rapidly (hyperventilation), by fatigue or anxiety
Vertigo is different.
In this case, you get a false sensation that you or your surrounding is spinning, moving or twirling around when you are not actually moving.
All three symptoms are linked by a common cause – a malfunction in the vestibular system.
This is a general term that describes light-headedness, floating or fainting sensation, or unsteadiness. It can be a primary sign of a vestibular disorder in addition to a wide range of cardiovascular, neurological, metabolic, vision, and psychological problems.
When you stand for a long period, blood can pool (due to gravity) in the legs which can deprive the brain of a level of oxygen and nutrients.
Because the brain is in control of all movements, it will attempt to correct this by stopping gravity from continuing to pull blood to the legs.
The only way it can do this is to cause you to fall so that you are in a horizontal position.
Dizziness can also occur when getting up fast from lying down. Because the blood is unable to quickly reach the brain from the pumping of the heart, the brain is briefly deprived of necessary oxygen.
This is the perception of movement, either of self or of surrounding objects. With vertigo, the world around you keeps moving even when a person is still.
It is a truly uncomfortable feeling and can be debilitating. It is generally short but has an extraordinarily strong perception.
I have personally experienced this and can honestly say that the suddenness of the onset makes the perception all the more scary. The first time it happened to me, I could not comprehend the sensation and I screamed for help.
Vertigo is also called BBPV (Benign Paroxysmal Positional Vertigo). The small pieces of bone-like calcium in the balance center of the inner ear help us maintain normal balance.
When small pieces break away, they float into the small canals of the inner ear. Moving the head in different directions causes these dislodge pieces to affect balance and create the sensation that the room is spinning
Frequent episodes of vertigo are usually a sign of a vestibular dysfunction, especially when triggered by changes in the positioning of the head.
Disequilibrium or Imbalance
This refers to unsteadiness, imbalance, or loss of equilibrium that is often accompanied by spatial disorientation.
What Type of Problems Cause Symptoms?
Problems caused may or may not be brought on by the vestibular system.
Problems Not Caused by the Vestibular System
Dizziness can be linked to a wide array of problems and is commonly linked to blood-flow irregularities from cardiovascular problems.
Some common non-vestibular causes of dizziness in older people (Vestibular Disorders Association VEDA,2020) are listed below:
- Severe degenerative spinal arthritis
- Heart attack
- Certain medications,
- Nervous-system disorders
- Blood pooling in the feet
- Stress, tension, or fatigue
- Vision disturbances
Problems Caused by the Vestibular System
Vestibular dysfunction commonly caused by head injury, aging, and viral infection may initiate symptoms of dizziness or vertigo.
Genetic and environmental factors, may also cause or contribute to vestibular disorders resulting in dizziness.
Vertigo is mostly caused by inner ear problems that affect balance.
There are several causes of dizziness, vertigo or disequilibrium related to vestibular system dysfunction. Some examples are listed below:
- Benign tumor growing on the vestibulo-cochlear nerve.
- Autoimmune inner ear disease
- Benign Paroxysmal Positional Vertigo (BPPV)
- Labyrinthitis – inflammation caused by a viral infection
- Middle ear pressure changes due to colds or allergies,
- Migraine associated vertigo
- Bacterial infection of the middle ear
- Mal de débarquement
- Ménière’s disease
- Meningitis – bacterial infection of the brain covering that may spread to the inner ear.
Common Causes Dos and Don’ts to Ease and Prevent Episodes of Dizziness
Recommendations from the National Health System (NHS uk) 2017 and Mayo Clinic (2020):
- Lie down until dizziness passes, then get up slowly.
- Be careful while lying down as you may experience nausea
- If you must walk, move slowly and carefully
- Limit movement of the head
- Loosen tight clothing
- Get plenty of rest
- Drink plenty of fluids especially water
- Avoid coffee, cigarettes, alcohol, and drugs
DON’T DO THIS
- Bend down suddenly
- Get up suddenly after sitting or lying down
- Do anything dangerous while you are dizzy – driving, climbing a ladder, or using machinery
- Lie totally flat if you feel that things are spinning.
Dos and Don’ts to Ease and Prevent Episodes of Vertigo
Recommendations from the National Health System (NHS uk) 2020 include the following:
- Sit down immediately you perceive the spinning sensation
- Move your head carefully during an episode and during all daily activities
- Lie still in a quiet, dark room to reduce the spinning sensation
- Try to relax – anxiety worsens it
- Sleep with your head slightly raised on two or more pillows
- Turn on the lights if you get up at night to go to the washroom
- Get out of bed slowly and sit on the edge of the bed for a minute before standing up
- Use a walking stick if you are at risk of falling
DON’T DO THIS
- Bend over to pick things up – lower yourself by squatting instead
- Stretch your neck such as when reaching up to a high shelf
Triggers of Vestibular Induced Symptoms
Triggers are the stimuli that can “call into action” or aggravate vestibular symptoms. Although they vary from person to person some general triggers include abrupt standing, and sudden movements of the head.
It is beneficial to track your triggers and learn to avoid them. “How do you do this?” you ask? By retracing your immediate activities and the nature of your environment before the episode. Avoidance is key.
While this article has addressed the common causes of vertigo or dizziness, as always, seek medical advice on treatment as there may be additional underlying causes.
Do you have some personal or additional insight into the causes of vertigo or dizziness? Please share them in the comment box below and I will surely respond to you.
- NHS (2017) Vertigo https://www.nhs.uk/conditions/vertigo/
- NHS (2020) Dizziness https://www.nhs.uk/conditions/dizziness/.
- Vestibular Disorders Association VEDA (2020) Causes of Dizziness https://vestibular.org/about-vestibular-disorders/causes-dizziness
- Mayo Clinic (2020) Dizziness https://www.mayoclinic.org/diseases-conditions/dizziness/symptoms-causes/syc-20371787