Vertigo vs. Dizziness

[risnerrose]

What is the difference between vertigo, dizziness, being light-headed, and/or faintness?  I often feel that my brain is spinning inside my skull (not the room or my body moving, just my brain) . . . what is that called???

[Quixotic1]

Hi, Sherry,  There is a huge amount of confusion surrounding some of these terms.  This is because patients describe them subjectively.  What one person describes may be way different from what another person describes with the same problem.

First off people describe all of those things generically as dizzy.  Dizzy is a totally non-specific word used to mean all manner of sensations that make you feel as though you might lose your balance and fall.  Dizzy is a sensation felt in your head.

There are two main categories of dizziness.

1) The first is not a problem of the balance center of the brain, but rather of the cardiovascular system and the blood pressure.  The terms doctors might use for this with patients is faintness or lightheadedness or pre-syncope.  The blood pressure in the person has dropped and the person feels as though they might lose consciousness and fall to the ground in a faint.  The head may be tingly, the vision may dim or "gray out."  Often the person can no longer hear well the noises around them.  Them heartbeat will speed up and often they break out in a sweat.  Their legs feel weak as though they will buckle.   If they don't sit down and put their heads down, the ultimate result is usually fainting or syncope (sin'-coh-pee) Many people have experienced fainting - this kind of dizziness is the physical feelings associated with fainting.

There is an expression that some of you might understand called the "head rush."  This is when you stand up too quickly and the world gets fuzzy, your heart beats hard and you feel as though you might faint.  This is lightheadedness or faintness.  It can also happen when you've stood too long, possibly in the heat,  and the feeling washes over you and you feel like you can no longer stand and might lose consciousness.  The brain doesn't seem to be working well and the thinking functions are often slowed.

People all call this feeling dizzy - because they don't feel confident in their ability to stay upright and the world seems to swim about them.

2)  The second kind of dizziness is the kind caused by problems with the balance organs of the body, whether they be in the inner ear, the brainstem or the brain.  These are not associated with loss of consciousness (though we might certainly wish they would be!).  We lose our certainty of where we are in space.  Either we, or the world around us, seems to shift or whirl or spin.  There is a sensation that there is movement that shouldn't be there.

A common feeling that many people can relate to is the sensation we may have after being on a boat for a long while.  Then for a time after we get to firm land we may occasionally still feel as though we are on the rocking boat - especially when we rest.  We will still feel the rocking, yet we know that we are on steady land.  The sensation of movement is false.  This is vertigo.

Some doctors state that you can tell if something is true vertigo by whether a person feels that they themselves are moving or whether the world is moving around them.  This is a false definition.  People will describe true vertigo both ways.  They will also descibe this sensation as being "dizzy."

Vertigo has many different sensations that are possible with it.  They may have persistent or intermittent sense of unease in where they are with regard to the ground.  It may seem to shift around under their feet and cause them to need to grasp for the walls or furniture to stay upright.  Vertigo does not feel like you will lose consciousness, though you may wish you would.  You are totally aware of what is happening.

In the type of vertigo called BPPV (Benign Paroxysmal Positional Vertigo) a person may be fine and feel very steady in space until their head moves into a certain position, say - tilted back looking upward.  In the critical position they may suddenly feel like the world whirls madly around them or like they are falling violently into space.  If they are upright this may cause a sudden violent fall or lurch into something closeby.  The sensation is fairly brief (10 seconds or so) but they may feel usteady and nauseated for hours afterward.  They do not lose concsiousness.  BPPV is a mechanical problem in the inner ear and is very treatable (for those of you that recognize this description).

If the irritation to the inner ear of brainstem is more sustained a person may have attacks of hours to many days of feeling like they or the world is constantly moving.  This is often associated with severe nausea.  Basic activities of daily life can be difficult or impossible.  It may be hard to walk straight or to judge distances for reaching, or impossible to drive.  Examples of this type of vertigo might be that seen in MS or Meniere's Disease.

During true vertigo a person may be seen to have jerking movements of their eyes called "nystagmus."  In BPPV the nystagmus happens just during those several seconds of several whirling.  In more sustained vertigo the nystagmus may be present all, or a great deal, of the time.

People with damage to the vestibular (steadiness in space and balance) may be very sensitive to motion, such as riding in cars, or sudden turning of their heads.  Such things may or may not bring on severe bouts of whirling, but may make them feel les secure about their ability to remain upsight and insecure about where "down" is, for example.  People with vertigo are often sensitive to barometric pressure and feel worse with the coming of storms (ie. falling barometric pressure).  Their conditon may be worsened during plane flights and going over moutain passes.

Sherry - I have never heard of anyone describe their "brain whirling,"  but people perceive and describe things in their own way.  I suspect that you are describing true vertigo, especially if it is hard for you to move about steadily during these episodes.  Do these episodes happen when you move your head into certain positions?  It would be interesting if you could get someone to look at your eyes during an episode and see if they are jerking.  If so, get a video of it at some time to show your neurologist.

Well, this was just a quick brain dump about dizzyiness.  I have a nice blurb on vestibular function and dysfunction planned for a Health Page, but this is a start.

Quix

[saveone]

Very helpful.  I have always had difficulty explaining what I meant when I have tried to describe it.  It is not the same thing all the time.  Thanks, I look forward to the health page.

[risnerrose]

Thanks,

Very good info.  It will make a very beneficial health page.

I'm not sure where I fit in, but vertigo does seem closest.  These "spells" (as my grandmother would have called them) come with no advanced warning, and leave me afraid to move.  Sometimes shutting my eyes helps, but not always.  Fortunately, they don't last a long time . . . but I do feel "off" for quite a while afterwards.

[essdipity]

Please absolutely do write a health page on this. As many of our old-timers know, I dealt with the boat-raocking vertigo for nearly 6 months before it gradually faded. My neuro had nothing to say about this, yet if he finally decides I have only peripheral neuropathy, I will bop him with one of the oars from my boat.

Thanks,

ess

[Quixotic1]

Do you think that what I wrote here would be a good intro to a discussion of vertigo?  Sort of setting the stage with some discussion of how we use the words dizzy, vertigo and lightheaded?  If so, I can start the HP right now.

Q

[Quixotic1]

About vertigo being dismissed:  Not long ago I read a survey of the most common complaints which led people to see a doctor.  For Internists, Neurologists, and ENTs "Dizziness" was one of the most common.  So often it is hard to pinpoint the cause.  It is often an irritation of the inner ear caused by a virus, allergies or an ear infection.  I think they get in the habit of just dismissing it, because it will usually go away in a couple weeks' time and no workup is neccesary.  When people are told it is nothing the vast majority will just live with it and not complain further.

I also think that most docs are pitifully educated in treating vertigo.  When I lost my profession due to it, I went through a series of ENTs and Neuros who basically knew nothing except to give me Antivert.  It was not until I found my way to a superb, world-renowned oto-neurologist that I saw what could be done to diagnose and treat it.  Wow!  the difference was day and night!

For more expert discussions of all of the aspects of vertigo I recommend that you go to the site for the Vestibular Disorders Association, VEDA at

vestibular.org

To search for the nearest vestibular expert near you:

http://www.vestibular.org/find-medical-help/search-for-a-health-professional.php

Quix

[risnerrose]

I actually thought your post was already "health page" worthy!  

Sherry

[Quixotic1]

uhhh....I also think that most docs are pitifully UNeducated in treating vertigo.  

darn

[cjacks]

Sherry

I had a bout of vertigo in 82 that lasted for five hrs..  walking was not an option, hands and knees..no dr      I always called it  'My Drunken Sailor Episode'

In 91 I had it again,  w/nausea,  this time for six days..     I could just barely get to the bathroom on my hands and knees and even then I would fall over many times and  have to rest on my side ..   There was no way I could get to the dr.s office.  I couldn't take one step...   she SENT Antivert and some water pills , thinking it was water in my ear.  ???     Oy vey..

I've recently had some room spinning stuff,  I don't know what to call that . Maybe positional dizziness, I was laying down.  I do have vestibular balance issues but I 'm not sure if that was the cause, since it happened just a few times.

Jo

[risnerrose]

Hope this helps.

[scaredphysio]

Quixotic...that was so great...u explained it so clearly!  (im gonna keep it to explain to others).

Just to say to everyone...if the dizziness is positional and/or is BPPV...then please ask to be refered to a neuro-physio that is a specialist in vestibular management, who might be able to treat it.

Hope that helps...

Evie X

[risnerrose]

bumping back to the front page

[Lulu54]

I was just reading this after seeing it linked to another discussion on vertigo/dizziness.  Did this get made into a healthpage as discussed?  

I still am lacking the right words to describe my dizziness.... imagine me at a loss for words! LOL

Lulu

[GrannyJo6]

Wow, that was great, Quix! Very informative and would be a great Health Page! Nice to know terms to use that may actually mean something to a health care professional!

[Quixotic1]

Thanks, everybody!  I just realized this never made it into a Health Page.  I always intended to tweak it - and you all know the rest.

Q

[Lulu54]

I put the link to this onto the HP I started about *favorite things* so we can easily find it each time the topic comes up.  :-)

[risnerrose]

Bumping to front page

[Melissa072]

I have had the spinning feeling inside my head now since June 2007, 24/7.

This feeling never goes away, and it worsens with any head movement.

I also have several other ms symptons so if this is ms then wouldn't it be a progressive type if the vertigo has been there for 2 years straight????????

I feel like I've stepped off a boat and the moving hasn't stopped.

[puppythreads]

I am just curious, did you happen to take a plane trip around the time that the spinning feeling began?  I have heard that when  going on a plane your brain has some sort of adaptation mechanism to maintain balance, but when you get back on land, it is sometimes not able to shut itself off.   I saw it on Mystery Diagnosis once.  

For me, my dizziness is like that which you get after having a couple of beers, but it does not feel so good.  Sometimes it lasts only seconds, sometimes hours.  Not very pleasant.  I would much rather have the beer!

Two years is a long time to have this problem.  If you haven't gotten your ears checked out, I would think that would be a good idea.  Before they diagnosed my MS, a Dr. thought I had "Labrynthitis" which I guess is an infection of the middle ear.  I certainly hope you feel better soon.