Dizziness: Lightheadedness and Vertigo

Topic Overview

Dizziness is a word that is often used to describe two different feelings. It is important to know exactly what you mean when you say "I feel dizzy" because it can help you and your doctor narrow down the list of possible problems.

• Lightheadedness is a feeling that you are about to faint or "pass out." Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Lightheadedness often goes away or improves when you lie down. If lightheadedness gets worse, it can lead to a feeling of almost fainting or a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are lightheaded.
• Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall.

Although dizziness can occur in people of any age, it is more common among older adults. A fear of dizziness can cause older adults to limit their physical and social activities. Dizziness can also lead to falls and other injuries.

Lightheadedness

It is common to feel lightheaded from time to time. Lightheadedness usually is not caused by a serious problem. It often is caused by a momentary drop in blood pressure and blood flow to your head that occurs when you get up too quickly from a seated or lying position (orthostatic hypotension).

Lightheadedness has many causes, including:

• Allergies.
• Illnesses such as the flu or colds. Home treatment of your flu and cold symptoms usually will relieve lightheadedness.
• Vomiting, diarrhea, fevers, and other illnesses that cause dehydration.
• Very deep or rapid breathing (hyperventilation).
• Anxiety and stress.
• The use of tobacco, alcohol, or illegal drugs.

A more serious cause of lightheadedness is bleeding. Most of the time, the location of the bleeding and the need to seek medical care are obvious. But sometimes bleeding is not obvious (occult bleeding). You may have small amounts of bleeding in your digestive tract over days or weeks without noticing the bleeding. When this happens, lightheadedness and fatigue may be the first noticeable symptoms that you are losing blood. Heavy menstrual bleeding also can cause this type of lightheadedness.

An uncommon cause of lightheadedness is an abnormal heart rhythm (arrhythmia), which can cause fainting spells (syncope). Unexplained fainting spells need to be evaluated by a doctor. To check your heart rate, see taking a pulse .

Many prescription and nonprescription medicines can cause lightheadedness or vertigo. The degree of lightheadedness or vertigo that a medicine causes will vary.

Vertigo

Vertigo occurs when there is conflict between the signals sent to the brain by various balance- and position-sensing systems of the body. Your brain uses input from four sensory systems to maintain your sense of balance and orientation to your surroundings.

• Vision gives you information about your position and motion in relationship to the rest of the world. This is an important part of the balance mechanism and often overrides information from the other balance-sensing systems.
• Sensory nerves in your joints allow your brain to keep track of the position of your legs, arms, and torso. Your body is then automatically able to make tiny changes in posture that help you maintain your balance (proprioception).
• Skin pressure sensation gives you information about your body's position and motion in relationship to gravity.
• A portion of the inner ear , called the labyrinth, which includes the semicircular canals, contains specialized cells that detect motion and changes in position. Injury to or diseases of the inner ear can send false signals to the brain indicating that the balance mechanism of the inner ear (labyrinth) detects motion. If these false signals conflict with signals from the other balance and positioning centers of the body, vertigo may occur.

Common causes of vertigo include:

• Inner ear disorders, such as benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, or labyrinthitis.
• Injury to the ear or head.
• Migraine headaches, which are painful, debilitating headaches that often occur with vertigo, nausea, vomiting, and sensitivity to light, noise, and smell.
• Decreased blood flow through the arteries that supply blood to the base of the brain (vertebrobasilar insufficiency).

Less common causes of vertigo include:

• A noncancerous growth in the space behind the eardrum (cholesteatoma).
• Brain tumors and cancer that has traveled from another part of the body (metastatic).

Immediate medical attention is needed if vertigo occurs suddenly with loss of function. Vertigo that occurs with loss of function in one area of the body can mean a problem in the brain, such as a stroke or transient ischemic attack (TIA).

Alcohol and many prescription and nonprescription medicines can cause lightheadedness or vertigo. These problems may develop from:

• Taking too much of a medicine (overmedicating).
• Alcohol and medicine interactions. This is a problem, especially for older adults, who may take many medicines at the same time.
• Misusing or abusing a medicine or alcohol.
• Drug intoxication or the effects of withdrawal.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

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Emergencies

• Loss of consciousness and inability to rouse the person
• Signs of shock
  • In adults and older children
  • In children
• Seizure (convulsion)
• Sudden, severe vertigo with nausea or vomiting and the inability to walk or stand
• Persistent loss of function, such as:
  • Partial or complete inability to move (paralysis) a part or all of one side of the body (face, arm, and leg), or persistent numbness
  • Loss of vision in one or both eyes
  • Confusion or altered behavior, such as unusual aggressive or combative behavior
  • Inability to speak, difficulty speaking, or difficulty understanding speech
• Sudden, severe headache and is the worst headache you have ever had
• Chest pain that is crushing or squeezing, increases in intensity, or occurs with any other symptoms of a heart attack
• Sudden change in your normal heart rate (pulse rate less than 50 or more than 150 beats per minute). Note: To check your heart rate, see taking a pulse .
• Heart palpitations with any of the following symptoms:
  • Chest pain
  • Shortness of breath
  • Decreased alertness
  • Vision changes

Check Your Symptoms

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Chest pain: Go to the topic Chest Pain.
• Change in your heart rate: Go to the topic Change in Heartbeat.
• Headache: Go to the topic Headaches.
• Hyperventilation: Go to the topic Hyperventilation.
• Head injury: Go to the topic Head Injury, Age 4 and Older.

	Yes	Have you had vertigo with a temporary loss of function, and all your symptoms are now gone? When to See a Doctor See significance of temporary loss of function if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Have you had vertigo with a temporary loss of function and all symptoms are now gone? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Do you have vertigo? When to See a Doctor See significance of vertigo with or without other symptoms if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have signs of serious illness? Yes Do you have vertigo with new ringing in your ears (tinnitus) or new hearing loss? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have vertigo with persistent nausea and vomiting that is causing moderate dehydration? Yes Do you have new vertigo? Yes Has your vertigo changed significantly? Yes Do you have continuous mild vertigo that is interfering with your daily activities? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild vertigo with nausea or vomiting and mild dehydration for longer than 24 hours? Yes Have you had mild vertigo and a mild headache for longer than 24 hours? Yes Have you had mild vertigo with occasional loss of balance for longer than 24 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Does vertigo frequently interfere with your normal activities? Yes Do you frequently have vertigo that has not been checked by your doctor? Yes Have you had vertigo for longer than 5 days? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Did your lightheadedness or vertigo begin following an injury? When to See a Doctor See significance of an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have lightheadedness that is getting worse, but you do not have signs of shock? Yes Do you have moderate to severe vertigo following a head injury? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have persistent mild vertigo following a head injury? Yes Do you have persistent lightheadedness following an injury? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild to moderate vertigo for 24 hours or longer after an ear injury? Yes Have you had lightheadedness that comes and goes for 2 to 3 days after an injury? Yes Have you had mild persistent vertigo for 2 to 3 days after an injury? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Have you had spells of lightheadedness or fainted? When to See a Doctor See significance of spells of lightheadedness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: Call 911 or other emergency services immediately if the person remains unconscious after fainting. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Have you fainted more than 1 time when trying to stand up? Yes Have you had more than 4 episodes of moderate to severe lightheadedness in the past 24 hours? Call your health professional today if you answer "Yes" to the following question. Yes Have you had more than 4 episodes of mild lightheadedness in the past 24 hours? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Do you think that your vertigo or lightheadedness may be caused by a medicine? When to See a Doctor See significance of medicines if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you think that your vertigo or lightheadedness is caused by a medicine? Note: If you answered "Yes": Call the doctor who prescribed the medicine to determine whether you should stop taking the medicine or take a different one. An appointment may not be needed. If you are taking a nonprescription medicine, stop taking the medicine. Call your doctor if you feel you need to continue taking the medicine. If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• Ringing in the ears (tinnitus): Go to the topic Ringing in the Ears.
• Ear problems: Go to the topic Ear Problems, Age 4 and Older.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Emergencies

• Loss of consciousness and inability to rouse the person
• Signs of shock
  • In adults and older children
  • In children
• Seizure (convulsion)
• Sudden, severe vertigo with nausea or vomiting and the inability to walk or stand
• Persistent loss of function, such as:
  • Partial or complete inability to move (paralysis) a part or all of one side of the body (face, arm, and leg), or persistent numbness
  • Loss of vision in one or both eyes
  • Confusion or altered behavior, such as unusual aggressive or combative behavior
  • Inability to speak, difficulty speaking, or difficulty understanding speech
• Sudden, severe headache and is the worst headache you have ever had
• Chest pain that is crushing or squeezing, increases in intensity, or occurs with any other symptoms of a heart attack
• Sudden change in your normal heart rate (pulse rate less than 50 or more than 150 beats per minute). Note: To check your heart rate, see taking a pulse .
• Heart palpitations with any of the following symptoms:
  • Chest pain
  • Shortness of breath
  • Decreased alertness
  • Vision changes

Check Your Symptoms

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Chest pain: Go to the topic Chest Pain.
• Change in your heart rate: Go to the topic Change in Heartbeat.
• Headache: Go to the topic Headaches.
• Hyperventilation: Go to the topic Hyperventilation.
• Head injury: Go to the topic Head Injury, Age 4 and Older.

	Yes	Have you had vertigo with a temporary loss of function, and all your symptoms are now gone? When to See a Doctor See significance of temporary loss of function if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Have you had vertigo with a temporary loss of function and all symptoms are now gone? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Do you have vertigo? When to See a Doctor See significance of vertigo with or without other symptoms if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have signs of serious illness? Yes Do you have vertigo with new ringing in your ears (tinnitus) or new hearing loss? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have vertigo with persistent nausea and vomiting that is causing moderate dehydration? Yes Do you have new vertigo? Yes Has your vertigo changed significantly? Yes Do you have continuous mild vertigo that is interfering with your daily activities? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild vertigo with nausea or vomiting and mild dehydration for longer than 24 hours? Yes Have you had mild vertigo and a mild headache for longer than 24 hours? Yes Have you had mild vertigo with occasional loss of balance for longer than 24 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Does vertigo frequently interfere with your normal activities? Yes Do you frequently have vertigo that has not been checked by your doctor? Yes Have you had vertigo for longer than 5 days? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Did your lightheadedness or vertigo begin following an injury? When to See a Doctor See significance of an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have lightheadedness that is getting worse, but you do not have signs of shock? Yes Do you have moderate to severe vertigo following a head injury? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have persistent mild vertigo following a head injury? Yes Do you have persistent lightheadedness following an injury? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild to moderate vertigo for 24 hours or longer after an ear injury? Yes Have you had lightheadedness that comes and goes for 2 to 3 days after an injury? Yes Have you had mild persistent vertigo for 2 to 3 days after an injury? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Have you had spells of lightheadedness or fainted? When to See a Doctor See significance of spells of lightheadedness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: Call 911 or other emergency services immediately if the person remains unconscious after fainting. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Have you fainted more than 1 time when trying to stand up? Yes Have you had more than 4 episodes of moderate to severe lightheadedness in the past 24 hours? Call your health professional today if you answer "Yes" to the following question. Yes Have you had more than 4 episodes of mild lightheadedness in the past 24 hours? If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.
	Yes	Do you think that your vertigo or lightheadedness may be caused by a medicine? When to See a Doctor See significance of medicines if you need information to help you answer the question below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you think that your vertigo or lightheadedness is caused by a medicine? Note: If you answered "Yes": Call the doctor who prescribed the medicine to determine whether you should stop taking the medicine or take a different one. An appointment may not be needed. If you are taking a nonprescription medicine, stop taking the medicine. Call your doctor if you feel you need to continue taking the medicine. If you have answered "No" to the above questions, go back to Check Your Symptoms and continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• Ringing in the ears (tinnitus): Go to the topic Ringing in the Ears.
• Ear problems: Go to the topic Ear Problems, Age 4 and Older.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Home Treatment

Lightheadedness usually is not a cause for concern unless it is severe, does not go away, or occurs with other symptoms such as an irregular heartbeat or fainting. Lightheadedness can lead to falls and other injuries. Protect yourself from injury if you feel lightheaded:

• Lie down for a minute or two. This will allow more blood to flow to your brain. After lying down, sit up slowly and remain sitting for 1 to 2 minutes before slowly standing up.
• Rest. It is not unusual to develop lightheadedness during some viral illnesses, such as a cold or the flu. Resting will help prevent attacks of lightheadedness.
• Do not drive a motor vehicle, operate equipment, or climb on a ladder while you are dizzy.
• Do not use substances that can affect your circulation, including caffeine, tobacco, alcohol, and illegal drugs.
• Do not get dehydrated, which can cause or increase lightheadedness, when you have an illness that causes diarrhea, vomiting, or a fever. Drink more fluids, especially water. Other fluids are also helpful, such as fruit juice mixed to half-strength with water, rehydration drinks, weak tea with sugar, clear broth, and gelatin dessert. If you have another medical condition, such as kidney disease or heart disease, that limits the amount of fluids you are allowed to have, do not drink more than this amount without first talking to your doctor.

If you have vertigo:

• Do not lie flat on your back. Prop yourself up slightly to relieve the spinning sensation.
• Move slowly to avoid the risk of falling.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Nausea or vomiting develops or increases.
• Moderate to severe dehydration develops.
• Fainting occurs.
• Your symptoms do not improve in 1 week with the use of home treatment.
• Your symptoms become more severe or frequent.

Prevention

You may be able to prevent lightheadedness caused by orthostatic hypotension by taking your time.

• Get up slowly from your bed or chair.
• Sit on the edge of the bed for a few minutes before standing.
• Sit up or stand up slowly to avoid sudden changes in blood flow to your head that can make you feel lightheaded.

In most cases, vertigo cannot be prevented. But some cases of vertigo are caused by head injuries. Taking the following safety measures can help lower your risk of getting a head injury that might lead to vertigo.

• Wear your seat belt when you are traveling in a motor vehicle. Secure young children in age-appropriate child car seats.
• Do not use alcohol or other drugs before playing sports or when operating an automobile or other equipment.
• Wear a helmet and other protective clothing whenever you are biking, motorcycling, skating, kayaking, horseback riding, skiing, snowboarding, rock climbing, or participating in any high-speed or impact sport.
• Wear a hard hat if you work in a construction job or in an industrial area.
• Do not dive into shallow or unfamiliar water.
• Do not keep firearms in your home. If you must keep firearms, lock them up and store them unloaded and uncocked. Lock ammunition in a separate area.

When you are dizzy, your risk of falling increases. You can make changes in your home to reduce your risk of falls.

• Remove raised doorway thresholds, throw rugs, and clutter.
• Repair loose carpet or raised areas in the floor that may cause you to trip.
• Rearrange furniture and electrical cords to keep them out of walking paths.
• Use nonskid floor wax and wipe up spills immediately, especially on ceramic tile floors.
• Keep stairways, porches, and outside walkways well lit. Use night lights in hallways and bathrooms.
• Install sturdy handrails on stairways and grab handles and nonskid mats inside and outside your shower or tub and near the toilet.
• Use shower chairs and bath benches.
• Add extra light switches if needed or use remote switches (such as clap-on switches) or timers on lights by doors and near your bed so that you will not have to get up quickly to turn on lights or walk across the room in the dark.
• Put things within easy reach so you do not need to reach overhead for them.
• Keep a cordless phone and a flashlight with new batteries by your bed.

Preventing falls

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• What is your major symptom, lightheadedness or vertigo?
• How long have you had your symptoms? Do they come and go, or are they always present?
• What were you doing when your symptoms started?
• How often do you experience dizziness?
• What makes your symptoms better or worse?
• Do you have other symptoms that may be related to your major symptom? Symptoms may include:
  • Changes in vision, such as blurred or double vision, halos, or spots.
  • Chest pain.
  • Confusion.
  • Fainting or falling.
  • Heart palpitations, irregular heartbeat, or an unusually slow or fast heart rate.
  • Nausea or vomiting.
  • Numbness or tingling.
  • Weakness or changes in your ability to stand or walk.
  • Ringing in the ears (tinnitus) or loss of hearing.
  • Shortness of breath or a feeling of suffocation.
• What medicines do you take? Make a list of both prescription and nonprescription medicines you use.
• Do you have any health risks?

Before seeing your doctor, it may be helpful to keep track of your symptoms. Use the questions above as a guide for what to include in your diary of symptoms (What is a PDF document?) .

Related Information

• Anxiety
• Benign Paroxysmal Positional Vertigo (BPPV)
• Change in Heartbeat
• Ear Problems and Injuries, Age 12 and Older
• Head Injury, Age 4 and Older
• Hyperventilation
• Iron Deficiency Anemia
• Labyrinthitis
• Ménière's Disease
• Ringing in the Ears (Tinnitus)
• Stress Management
• Transient Ischemic Attack (TIA)
• Vestibular Neuritis

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