By Nayyar Mujteba, MD, and David X. Cifu, MD Complaints of dizziness are among the most common and confusing symptoms reported by patients to vestibular specialists. However, dizziness can mean different things to different people. Mental confusion, blurred vision, headaches, standing difficulties, transient lightheadedness and ambulation disturbances are all forms of dizziness. Areas to consider are vertigo, faintness, vasovagal syncope, hypovolemia, vertebrovasilar insufficiency, postural hypotension and seizures. Vertigo occurs when a vestibular system disturbance causes a patient to feel as if the environment is continuously moving and spinning.
Vertigo starts with a deficiency in the inner ear vestibular apparatus.
The vestibular system alerts the brain to changes in head position. Any malfunction of the apparatus can lead to peripheral vertigo, which usually passes after a few minutes but can last for hours or days in more serious cases. In addition to the spinning sensation, patients may vomit or fall. Peripheral vertigo can start with a change in head position as a patient manifests horizontal rotary nystagmus-rapid, repetitive eye movement in a horizontal plane. These conditions present as a sudden, unremitting vertigo that lasts for several days before symptoms begin to subside.