“I randomly feel dizzy”

Vertigo, also known as dizziness, is a common problem. Approximately 30 percent of all people in Germany have been affected at least once in their lives. And the chances of vertigo complaints increase significantly with age: more than 30% of 60-year and older and 50% of those aged 85-years and older suffer from recurring dizziness or loss of balance. For doctors, the characterization and categorization of vertigo symptoms is very important. There are several ways to better describe the type of vertigo: how long does the dizziness attack last, specific triggers, and accompanying symptoms.

How long does vertigo last?

An important indication in diagnosing is: How long does the dizziness attack last? And how long are the intervals between individual dizziness attacks? Here you can find the most important differences regarding the duration of vertigo attacks:

Acute dizziness

Acute dizziness

Acute vertigo attacks last from seconds to minutes: e.g., with brief blood circulatory problems in the brain or with benign paroxysmal positional vertigo (BPPV), usually triggered by head movements.

Episodic dizziness

Episodic dizziness

Vertigo with a duration of minutes up to hours: e.g. with Menière’s disease or migraine-induced dizziness.

Persistent dizziness

Persistent dizziness

Severe prolonged vertigo with a duration of days up to weeks: e.g. neuropathia verstibularis or vestibular neuritis (acute failure of the balance system in connection with nausea).

Chronic dizziness

Chronic dizziness

Vertigo that continues for more than three months or recurs off and on: e.g., with MS, chronic cardiovascular disorders with impaired blood circulation, phobic postural vertigo, but also with multifactorial dizziness (dizziness in old age).

What is the cause of vertigo?

Vertigo attacks can occur without any obvious triggers – this is the case with e.g., Menière's disease, certain cardiovascular problems or migraines. In many cases, however, triggers for dizziness can be identified clearly:

  • If certain head movements, e.g., when turning in bed or looking up, make you dizzy might be indicative of a benign positional vertigo (BPPV).
  • If getting up from a sitting or reclined position triggers a dizziness attack, a physician might consider orthostatic vertigo – a response to a drop in blood pressure when shifting into in an upright position.
  • If e.g., car rides or boat trips trigger dizziness, it usually is a case of kinetosis, commonly called "motion sickness". It is often accompanied with nausea and vomiting.
  • Psychogenic or somatoform vertigo attacks (stress dizziness) are triggered by certain social situations, such as conflicts in relationships or certain stress settings in the workplace.

It’s better to discuss it with your doctor

Not only can certain movements or situations trigger vertigo. It can also occur as accompanying symptoms of various other diseases. Therefore, it is always important to discuss dizziness symptoms with your physician.

Accompanying symptoms

Patients often don’t only suffer from dizziness alone but also present with additional symptoms. Certain accompanying symptoms point to certain causes. Therefore, describing the accompanying symptoms is important for any diagnosis.

Severe vegetative (affecting the involuntary nervous system) accompanying symptoms, such as nausea or breaking into sweats can point to a disorder of the balance system itself.

Spontaneously occurring migraine dizziness often goes along with a heightened sensitivity to light and noise. Light and noise can be also triggers with this type of vertigo.

The rotational vertigo with Menière's disease is typically associated with impaired hearing and ringing (tinnitus) in one ear. Also, ear fullness can be an accompanying symptom with Menière’s disease.

The apparent vibrating or trembling of an object you fix with your eyes on is called oscillopsy. This phenomenon also occurs with e.g. vestibular neuritis.

In contrast, sometime the eyeballs themselves might tremble. Such a nystagmus (eye tremor) can be found in e.g. benign positional paroxyxsmal vertigo (BPPV) and neuropathia vestibularis or vestibular neuritis.

These accompanying symptoms suggest an emotional or mental (psychogenic) connection with depressions or phobias (somatoform vertigo).

Black spots before your eyes to the point of a collapse of the circulatory system (syncope) suggest a drop in blood pressure upon getting up (orthostatic vertigo) or cardiac arrhythmia.

If these accompanying symptoms of dizziness occur, they might be an indicative of MS or a stroke.

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