FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

EVEN SHORT "DIZZY SPELLS" CAN SIGNAL SERIOUS DISEASE

Question: I've had several dizzy spells lately. I haven't gone to the doctor because the spells cleared up quickly, and my doctor is so busy that it takes a week or two to get an appointment to see her. Is it safe to assume my dizziness is not very serious since the spells clear up quickly?

Answer: Dizziness can be caused from a number of conditions. Many are primarily a nuisance and not related to long-term health problems, while others are a warning of serious conditions to come. The length of the dizziness has little bearing on the seriousness of the underlying cause, so it is necessary to consider other symptoms when deciding whether or not to see your doctor. Now, I'll explain some of those. The term "dizziness" can be applied to a variety of symptoms and, therefore, is too general to be of much guidance. It will help clarify the nature of your disorder if you can describe the sensation with words that are more specific than simply saying you feel "dizzy." Is it a sensation of light-headedness, faintness, imbalance, or movement like you or the room is spinning? Also, paying attention to other symptoms you are experiencing will help you hone in on the potential problem. Dizziness that's accompanied by a fast or skipping heartbeat suggests that the heart may be the cause of dizziness. This may or may not be serious, but it is a problem that you clearly should bring to the attention of your doctor. Light-headedness that occurs an hour after taking a cold or sinus remedy and clears up six to 12 hours later is probably a side effect of the medication and not a sign of more serious trouble. You may still need to see your doctor, but not for the dizziness. Instead he may be able to help you to find a medication that helps with the cold or allergy symptoms without causing the dizziness or light-headed feelings. However, just stopping the medication will eliminate the dizziness itself. Vertigo, the sense of whirling or irregular motion of you or your environment, is often described as dizziness. One type of vertigo -- that you only notice when you move your head -- is common and usually the result of a minor problem with the balance mechanism of the inner ear. This type of vertigo can be due to a number of things, including the use of alcohol or other drugs, infection, or causes that we can't readily identify. Vertigo associated with simultaneous ringing in the ears and decreased hearing suggests the possibility of another type of inner ear problem called Meniere's disease. More serious problems such as brain tumors, strokes or other abnormalities of the nervous system can also cause vertigo. Light-headedness or a sense of imbalance may result from a problem with vision. Cataracts and eye muscle problems are particularly prone to causing these symptoms. A simple test for these is to close the eyes. If the dizziness quickly goes away, the problem is probably related to a visual difficulty. In summary, then, if your symptoms appear only when you take a particular medication or alcohol, you really don't need your doctor to figure out the proper treatment. Most other causes of dizziness should be investigated more thoroughly with the assistance of your family doctor. The specific cause of your symptoms may even require a physician who specializes in disorders of the ears, nose and throat (otorhinolaryngologist) or of the nervous system (neurologist).

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.