dizzy Dizziness is a common non-specific clinical symptom, including vertigo, lightheadedness, imbalance, and a feeling of heaviness in the head and lightness in the feet. Its etiology is complex and its manifestations are diverse. Common causes include diseases of the vestibular system, such as benign paroxysmal positional vertigo, posterior circulation ischemia, as well as non-vestibular system diseases, such as anemia, hypertension, psychogenic or psychosomatic dizziness, etc. The main manifestations of dizziness include dizziness, blurred vision, head fullness, feeling of heaviness in the head and lightness in the feet, accompanied by fatigue, nausea, vomiting, tinnitus, insomnia, unstable emotions, and other symptoms.

Dizziness is a common non-specific symptom in clinical practice, including vertigo, lightheadedness, imbalance, and a feeling of heaviness in the head or lightness in the legs. Its etiology is complex, and the manifestations are diverse. The main causes include diseases of the vestibular system, such as benign paroxysmal positional vertigo, posterior circulation ischemia, as well as non-vestibular system diseases, such as anemia, hypertension, psychogenic or psychogenic dizziness, etc. The main manifestations of dizziness include lightheadedness, vertigo, heaviness in the head, a sensation of spinning, and may be accompanied by fatigue, nausea, vomiting, tinnitus, insomnia, and emotional instability.

According to the symptoms, dizziness can be categorized into the following different states:

Vertigo

Patients feel a subjective sensation of self or surrounding objects rotating or shaking, mainly manifested as visual rotation or self-rotation, often accompanied by nausea, and in severe cases, may have symptoms such as vomiting, sweating, and elevated blood pressure.

This can be seen in Meniere's disease, vestibular disorders, benign paroxysmal positional vertigo (otolithic disease), vestibular migraine, brainstem lesions, etc.

Pre-syncope

Mainly characterized by dizziness, darkening of vision, chest tightness, palpitations, weakness, etc., occurring before syncope, often caused by cardiovascular events, including hypotension, anemia, hypovolemia, hypoglycemia, severe arrhythmias, etc.

Imbalance

Refers to symptoms of unsteady or unsteady movement during activity, often seen in Parkinson's disease, ataxia, peripheral neuropathy, etc.

Feeling of heaviness in the head or lightness in the legs

Refers to paroxysmal or persistent dizziness, a feeling of unclear thinking in the brain, and may have a feeling of heaviness in the head and tightness in the head. Common causes include hypertension, psychological factors, and adverse drug reactions. It is often seen in cases of overwork and lack of sleep, but can be relieved after adequate rest. For patients, dizziness can occur as a single symptom or may occur simultaneously or successively with vertigo or imbalance.

According to the etiology, dizziness is mainly divided into vestibular system disease-related dizziness and non-vestibular system disease-related dizziness.

Vestibular system disease-related dizziness

It can be further divided into peripheral and central vestibular system disease-related dizziness.

Peripheral vestibular system disease-related dizziness: Caused by lesions between the inner ear vestibule and the extracranial segment of the vestibular nerve. Mainly seen in Meniere's disease, labyrinthitis, vestibular neuronitis, drug poisoning, positional vertigo, and motion sickness.

Central vestibular system disease-related dizziness: Caused by lesions involving the intracranial segment of the vestibular nerve, vestibular nuclei and their fiber connections, cerebellum, and cerebrum, etc. Mainly due to intracranial vascular lesions, space-occupying lesions, and can also be seen in vestibular migraine, epileptic dizziness, cervical dizziness, post-traumatic dizziness, etc.

However, some diseases involve both peripheral and central vestibular impairment, such as vestibular migraine.

Non-vestibular system disease-related dizziness

Mainly refers to dizziness related to psychiatric disorders or other diseases, mainly manifested as a feeling of unsteadiness, often accompanied by a sense of unclear thinking.

Psychiatric disorders

Patients with psychiatric disorders often experience symptoms such as difficulty falling asleep, irritability, early awakening, fatigue, decreased interest, palpitations, poor appetite, pain, and may be accompanied by symptoms such as sweating, chills, and sometimes even a sense of terror about balance disorders.

Other diseases

Other systemic diseases, such as blood diseases (leukemia, anemia, etc.), endocrine diseases (such as hypoglycemia, hypothyroidism or hyperthyroidism, etc.), cardiovascular diseases (such as hypertension, hypotension, arrhythmias, myocardial ischemia, etc.), eye-related diseases (ocular muscle paralysis, ocular spasm, glaucoma, etc.), toxic diseases (such as acute febrile infections, uremia, severe hepatitis, etc.).

Different causes of dizziness require different treatment methods:

For patients with transient ischemic attacks or cerebral infarctions, drug treatment mainly includes antiplatelet drugs, anticoagulants, and intravenous thrombolytic drugs. The use of drugs carries a high risk of bleeding and should be used under the guidance of a professional.

For patients with a clear diagnosis of benign paroxysmal positional vertigo, it is recommended to undergo canalith repositioning maneuvers.

Most cases of vestibular neuronitis can resolve on their own, but for severe symptoms, antiemetic treatment can be used, and the use of glucocorticoids can aid in the recovery of vestibular function. Antiviral or antibiotic treatment can be used for secondary infections, and early vestibular rehabilitation training should be pursued.

For patients with a clear diagnosis of Meniere's disease, studies have shown that betahistine treatment is effective. For those who fail internal medicine treatment, surgical treatments such as intratympanic gentamicin injection, endolymphatic sac decompression, and vestibular nerve or labyrinthectomy can be considered.

For dizziness caused by infectious diseases, targeted antibiotic therapy should be applied after a clear diagnosis and identification of the pathogen.

The main treatment for cervical dizziness is correcting poor head and neck posture, physical therapy, and local blockade. Vasodilators such as betahistine can be used in the acute phase, and if conservative treatment is ineffective, surgical treatment can be considered.

For dizziness caused by anemia, treatment should be directed at the underlying cause.

For dizziness caused by unstable blood pressure or blood sugar, specific treatments for blood pressure and blood sugar should be administered. When blood pressure is high, antihypertensive drugs should be used appropriately, starting with oral administration, and if oral administration is ineffective, intravenous infusion can be considered. When blood pressure is below 70/50mmHg, dopamine or large-volume fluid resuscitation can be used. In cases of high blood sugar, insulin can be administered subcutaneously, and in cases of low blood sugar, glucose can be administered orally or intravenously.

For dizziness caused by a cold, rest is recommended, and febrile patients can take antipyretic drugs, while attention should also be paid to hydration. For severe dizziness, temporary symptomatic anti-dizziness drugs such as dimenhydrinate can be administered.

For dizziness induced by psychological factors such as anxiety or depression, with the guidance of a doctor, it may be necessary to add medications for anxiety and depression.

For patients with dizziness, the underlying cause should first be identified, and generally, there is no specific diet.

Dietary Recommendations

In terms of diet, it is recommended for patients to have regular meals, consume easily digestible foods, eat small meals frequently, and have a varied diet, paying attention to the balance of energy and nutrient intake.

It is advisable to have a low-salt, low-fat, and light diet.

Patients with hypertension, coronary heart disease, or cerebrovascular diseases should pay attention to their fiber intake, avoid overeating, prevent constipation, and avoid excessive straining during bowel movements to prevent cardiovascular accidents.

Dietary Restrictions

Avoid spicy foods, and during Meniere's disease attacks, sodium intake should be controlled.

Quit smoking and alcohol, and reduce the intake of coffee and tea.

Get enough rest, avoid excessive fatigue, and avoid staying up late, ensuring adequate sleep.

Engage in appropriate physical exercise according to one's own physical condition. For example, for diabetic patients, walking for half an hour after meals or light exercise can help lower postprandial blood sugar.

In daily life, ear digging actions should be minimized, and when removing earwax, gentle movements should be used, preferably with illuminated ear digging tools.

Avoid damaging the external auditory canal during ear digging, which may cause infection.

When bathing, avoid water entering the ears to reduce the occurrence of ear infections.

When experiencing dizziness, attention should be paid to preventing falls and sudden movements. If necessary, stable balance can be maintained with external support.

Do not drive or operate heavy machinery when feeling dizzy to avoid accidents.

When feeling dizzy, it may help to sit or lie down immediately, or lie down with closed eyes in a dark room.

Drink plenty of water, maintain a healthy diet, ensure adequate sleep, and avoid tension and anxiety.