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DEAR MAYO CLINIC: I am 68 and have periodic spells of dizziness. They don't last long and I don't seem to have any other symptoms. Should I see a doctor? What might these spells indicate?
ANSWER: Dizziness is a common problem with many possible causes. They can range from relatively minor issues, such as a certain medication triggering dizziness, to more serious underlying medical problems. When dizziness persists, as in your case, it is a good idea to see your doctor and have the condition evaluated.
Although the term "dizziness" sounds quite specific, there are actually several kinds of dizziness. One involves feeling a loss of balance, as if you're unsteady on your feet or feel like you may fall. Another includes a sensation of being lightheaded or feeling faint, as if you might pass out. A third is feeling as if you're spinning or that the world is spinning around you. This type of dizziness is called vertigo.
It is helpful for you to be able to describe to your doctor exactly what you're experiencing during episodes of dizziness. Your description can offer clues to the potential source of the problem. For example, conditions that affect the balance mechanism in your inner ear frequently lead to dizziness with a feeling of vertigo that happens when you move your head.
One such condition is called benign paroxysmal positional vertigo, or BPPV. One of the most common causes of vertigo, BPPV is characterized by brief episodes of mild to intense feelings of spinning. The spinning sensations are triggered by specific changes in the position of your head, such as tipping your head up or down, or by lying down, turning over or sitting up in bed. When you keep your head still, symptoms of BPPV improve.
Another frequent cause of dizziness is reduced blood flow to your entire brain. This can be triggered by a common condition known as orthostatic hypotension or postural hypotension. The disorder is a form of low blood pressure that happens when you stand up from sitting or lying down. It often causes brief episodes of lightheadedness just after you stand and improves after you've been upright for a minute. Dehydration can also lower blood flow to the brain and lead to dizziness.
More serious conditions related to reduced blood flow to the brain include cardiovascular disorders, such as hardening of the arteries, or arteriosclerosis, and heart rhythm problems. A tumor or mass in the brain also can lead to dizziness. If left untreated, these conditions tend to get worse over time.
Some types of prescription drugs can cause dizziness. Some of the common ones include antidepressants, medications that control high blood pressure, sedatives, anti-seizure medications and tranquilizers.
A medical appointment can help narrow down the possibilities of what is causing your dizziness. Reviewing your symptoms, medical history, family history and current medications with your doctor may offer some clues. A thorough physical evaluation, as well as additional tests and exams based on your situation can help your doctor determine a diagnosis.
When dizziness keeps coming back, it's important to have the condition evaluated. If left unchecked, dizziness puts you at risk for falling and that can lead to serious injury. So make an appointment to see your doctor.
If you develop other symptoms along with your dizziness, such as chest pain, shortness of breath, heart palpitations, changes in your vision or speech, leg or arm weakness, or seizures, seek emergency medical care right away. These could be symptoms of a serious medical problem, such as a heart attack or stroke. -- Paul Takahashi, M.D., Primary Care Internal Medicine, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. To submit a question, write to: firstname.lastname@example.org. For health information, visit www.mayoclinic.com.)