Dizziness is a painless sensation of spatial disorientation which often includes a loss of balance. Your sense of balance is maintained by the interaction of several parts and systems of your body, which include your: inner ears, eyes, skin, muscles and joints, and central nervous system (brain and spinal cord).

Often dizziness is accompanied by other symptoms such as unsteadiness, lightheadedness (feeling like you are going to faint), wooziness, visual difficulties, lack of coordination, confusion, profuse sweating, and vertigo.

Vertigo is a feeling that the room is spinning or that you are spinning; or it may feel as if you are being impelled forward, backward or to either side. You may experience motion sickness along with vertigo. The symptoms worsen with head movement or walking, and abate gradually.

Some people experience brief stiffening; some experience an inability to urinate. Dizziness often feels as if the room is spinning or as if you are spinning, turning, or rocking. You may also have the symptoms of motion sickness which are: nausea, vomiting, headache, and fatigue.

Dizziness may occur in any position, but usually you will experience it while standing or walking. Often dizziness is relieved by sitting or lying down. Dizziness may worsen if you are in certain situations, such as walking in crowds or on the stairs

• What causes dizziness?
• What are the cardiac causes of dizziness?
• How will my doctor determine the cause of my dizziness?
• How is dizziness treated?
• If I feel dizzy, what should I do?

What causes dizziness?
There are dozens of causes of dizziness. Psychiatric illness or emotional distress are major causes. Anxiety, for example, may make you breathe rapidly (hyperventilate), which can cause dizziness. Conversely, dizziness may make you anxious.

Inner ear diseases which may be caused by injury, infection, allergy, tumors and other diseases, account for large portion of the occurrences of dizziness.

Finally, the remaining instances of dizziness are caused by cardiovascular (heart) , neurological ( brain) and other diseases such as hypoglycemia, migraine, seizures, and stroke. Often these diseases have "syncope" (fainting) as a symptom, and dizziness as a warning sign of the impending faint.

If dizziness occurs after you quickly sit or stand up, and then improves immediately, when you change your position, you may have prevented a fainting spell.

Multiple sensory deficits may cause dizziness. Your chances of experiencing dizziness increase if you have diabetes or other conditions which impair your eyesight, motor functioning, and or sense of position. A loss of sensory input may lead to a lowered sense of equilibrium. The use of a cane is often recommended to aid your sense of spatial orientation.

If the part of your brain which controls acceleration of movement and speed is dysfunctional, you may also experience dizziness. This portion of the brain is called the, "cerebellum." Cerebellar dysfunciton and multiple sensory deficits are the most common causes of dizziness in the elderly.

What are the cardiac causes of dizziness?
Among the most common cardiac causes of dizziness is an inadequate inadequate flow of blood to the brain. Inadequate blood flow is caused by a variety of reasons including: coronary artery disease, high blood pressure, anemia, or arrhythmias (irregular heart beats). Certain substances, such as nicotine and caffeine, can also lower the blood flow to the brain.

Dizziness may be a symptom of low blood pressure.

How will my doctor determine the cause of my dizziness?
Your doctor will take a medical history and perform a physical examination.

He may ask you for a step-by-step account of the dizzy spell from the point when you first noticed something wrong, to the moment of resolution.

Your physician may order other tests including: blood pressure, neurological, hearing, electrocardiograms (ECGs), echocardiograms, exercise testing , and Holter or event testing. These last two tests enable your physician to get graphic recordings of the electrical activity of your heart during normal daily activities.

The physical examination may include checking your ears, nose, throat, and vision. To test for inner ear problems, your doctor may perform certain in-office tests or maneuvers which involve having you sit in various positions and having you turn your head in various directions.

Depending on the results of these tests, your doctor may choose to have an electrophysiology study performed. He may order tilt-table testing, Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI). scans.

You may be asked to complete a dizziness diary and return for a second visit. In the diary, you will catalogue your symptoms. You will include the events which seem to cause the dizziness, such as standing, turning your head, or experiencing emotional distress, and the events which seem to alleviate the dizziness, such as sitting, squatting, or lying down. You will also discuss the duration of the symptoms and how you feel after the dizziness abates. Alternatively, some doctors will send an extensive questionnaire to you prior to the first visit.

How is dizziness treated?
Most dizziness can be treated. Your doctor will treat the underlying illness. For example, if your dizziness is caused by specific cardiovascular (heart and circulation system) problems, you may be asked to increase your intake of fluids, make a habit of standing up slowing, and discontinue or reduce your consumption of certain substances.

If I feel dizzy, what should I do?
If you have had dizzy spells, you should avoid rapid changes in position. When you feel dizzy, refrain from driving, climbing stairs or ladders, or operating dangerous equipment during the spell. If dizziness is caused by hyperventilation, you may experience relief by breathing in and out of a paper bag.

Should you experience dizzy spells, consult with your health care provider to get the proper diagnosis and to receive the appropriate advise and treatment.