II. Definitions
- Dizziness
- Non-motion Sensation of impaired spatial orientation
III. Epidemiology
- Dizziness accounts for 2.5% of emergency department visits
IV. History: Types by Characteristic
-
Vertigo
- Do you feel as if the room is spinning, or that you are on an amusement park ride?
-
Presyncope
- Do you feel suddenly light headed as you may fall to the ground, as if you arose too fast?
-
Vasovagal Syncope?
- Is it brought on with prolonged standing, sitting, heat or stress and associated with sweats and Nausea?
-
Dysequilibrium
- Do you have difficulty maintaining your balance when standing or walking?
-
Muscle Weakness
- Do you feel generally Fatigued or tired?
- Lightheadedness
- Sensation of Faintness or reeling when not characterized by Vertigo, Presyncope, Dysequilibrium
- Images
V. Precautions: Critical measures
- Prevent complications related to Dizziness
- See Fall Prevention in the Elderly
- Falls and other accidents
- Identify serious causes of Dizziness
- Presyncope (14% of Dizziness presentations)
- Cerebrovascular Accident
- CNS Lesions (especially posterior CVA) account for 3% of Dizziness presentations
- Dizziness is a presenting symptom in up to 25% of Cerebrovascular Accidents
- Factors more suggestive of Central DIzziness cause
- Atrial Fibrillation
- Vague non-whirling Dizziness Sensation
- Advanced age
- Age 50-70: 3.5% central cause
- Age 70-80: 7.4% central cause of Dizziness
- Age 80-90: 16.7% central cause of Dizziness
- References
VI. Types: Dizziness Causes
-
Vertigo (45-54%)
- Definition
- Sense of motion (e.g. spinning) despite being still
- False or distorted Sensation of self-motion in any direction
- Peripheral Vertigo is always episodic
- Continuous Dizziness is due to behavioral phenomenon
- Peripheral Vertigo examples
- Pitfalls: Central Vertigo
- Posterior Circulation (vertebrobasilar) Cerebrovascular Accident
- Non-Vascular Central Causes of Vertigo (e.g. Acoustic Neuroma, Brainstem lesions, MS)
- Associated Conditions
- Definition
-
Dysequilibrium or Ataxia (16%)
- Off-balance or Unsteadiness (Postural)
- Examples
-
Presyncope (14%)
- Sensation of loss of consciousness
- Examples
- Associated Conditions
- Lightheadedness (10%)
- Vague Sensations not fitting in above categories
- Examples
- Hyperventilation (e.g. Panic Disorder)
- Associated Conditions
VII. References
- Ondrejka (2014) Crit Dec Emerg Med 28(10): 11-7
- Post (2010) Am Fam Physician 82(4): 361-8 [PubMed]
- Kroenke (1992) Ann Intern Med 117:898-904 [PubMed]
- Bisdorff (2009) J Vestib Res 19(1-2):1-13 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Definition (ICF) | Sensation of motion involving either oneself or one's environment; sensation of rotating, swaying or tilting. |
| Definition (ICF-CY) | Sensation of motion involving either oneself or one's environment; sensation of rotating, swaying or tilting. |
| Definition (NCI_CTCAE) | A disorder characterized by a disturbing sensation of lightheadedness, unsteadiness, giddiness, spinning or rocking. |
| Definition (NCI) | A sensation of lightheadedness, unsteadiness, turning, spinning or rocking. |
| Definition (MSH) | An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. |
| Concepts | Sign or Symptom (T184) |
| MSH | D004244 |
| SnomedCT | 206740007, 158144005, 139526005, 69096003, 162257004, 267176004, 271789005, 404640003 |
| LNC | LA7428-1 |
| English | Dizziness, WOOZINESS, [D]Dizziness (context-dependent category), [D]Dizziness, dizziness (symptom), dizziness, Woozy, Dizzyness, Dizziness [Disease/Finding], wooziness, dizzy, dizzying, woozy, Dizziness symptom, [D]Dizziness (situation), DIZZINESS, Dizzy, Dizziness (finding) |
| French | ETOURDISSEMENT, Etat nébuleux, Etat vertigineux, SENSATION DE TETE QUI TOURNE, Étourdissement, Sensation vertigineuse |
| Portuguese | TONTURA, Com tonturas, Embriagado, ALCOOLIZACAO, Tonturas, Tontura |
| German | SCHWINDEL, schwindlig, schwummrig, BENEBELTSEIN, Schwindelgefuehl, Schwindel |
| Dutch | licht in het hoofd, duizelig, duizeligheid, Duizeligheid |
| Italian | Intontito, In preda a capogiro, Capogiro |
| Spanish | Mareado, Aturdido, [D]mareos (categoría dependiente del contexto), ATURDIMIENTO, MAREO, [D]mareos (situación), [D]mareos, Aturdimiento, mareo (hallazgo), mareo, Mareo |
| Japanese | 浮動性めまい, ふらふら感, ﾒﾏｲｶﾝ, ﾌﾗﾌﾗｶﾝ, ﾌﾄﾞｳｾｲﾒﾏｲ, めまい感, 眩暈感 |
| Swedish | Svindel |
| Czech | závrať, Závrativý, Malátný, Závrať |
| Finnish | Heitehuimaus |
| Russian | GOLOVOKRUZHENIE, ГОЛОВОКРУЖЕНИЕ |
| Croatian | OMAGLICA |
| Polish | Oszołomienie |
| Hungarian | Szédülés, Szédülékenység, Bizonytalan |
| Norwegian | Svimmelhet |
Ontology: Syncope (C0039070)
| Definition (MEDLINEPLUS) |
Fainting is a temporary loss of consciousness. If you're about to faint, you'll feel dizzy, lightheaded, or nauseous. Your field of vision may "white out" or "black out." Your skin may be cold and clammy. You lose muscle control at the same time, and may fall down. Fainting usually happens when your blood pressure drops suddenly, causing a decrease in blood flow to your brain. It is more common in older people. Some causes of fainting include
When someone faints, make sure that the airway is clear and check for breathing. The person should stay lying down for 10-15 minutes. Most people recover completely. Fainting is usually nothing to worry about, but it can sometimes be a sign of a serious problem. If you faint, it's important to see your health care provider and find out why it happened. |
| Definition (NCI) | A spontaneous loss of consciousness caused by insufficient blood supply to the brain. |
| Definition (NCI_CTCAE) | A disorder characterized by spontaneous loss of consciousness caused by insufficient blood supply to the brain. |
| Definition (NCI_FDA) | Extremely weak; threatened with syncope. |
| Definition (NCI_CDISC) | Sudden loss of consciousness with loss of postural tone, not related to anesthesia, with spontaneous recovery as reported by patient or observer. A subject may experience syncope when supine. Syncope is often caused by insufficient blood supply to the brain. |
| Definition (NCI) | Extremely weak; threatened with syncope. |
| Definition (MSH) | A transient loss of consciousness and postural tone caused by diminished blood flow to the brain (i.e., BRAIN ISCHEMIA). Presyncope refers to the sensation of lightheadedness and loss of strength that precedes a syncopal event or accompanies an incomplete syncope. (From Adams et al., Principles of Neurology, 6th ed, pp367-9) |
| Definition (CSP) | fainting due to a sudden fall of blood pressure below the level required to maintain oxygenation of brain tissue. |
| Concepts | Sign or Symptom (T184) |
| MSH | D013575 |
| ICD9 | 780.2 |
| ICD10 | R55 |
| SnomedCT | 206727002, 206725005, 206731008, 271594007, 271211004, 29423006, 158137001, 158135009, 271785004, 158133002, 139532000, 162263008, 309585006, 272030005 |
| LNC | MTHU020851, LA16987-2 |
| English | Fainting, Syncope, Syncopes, COLLAPSE TRANSIENT, FAINTNESS, FALLING OUT, Fainted, PASSED OUT, SWOONING, Syncope and collapse NOS, [D]Syncope, [D]Syncope and collapse, [D]Syncope and collapse NOS, A faint, Passed out, [D]Fainting (context-dependent category), [D]Syncope and collapse (context-dependent category), [D]Syncope and collapse NOS (context-dependent category), [D]Fainting, fainting (syncope), syncope, fainting, fainting (symptom), Syncopal attack, Falling out, Swooning, Faint, Syncope [Disease/Finding], attacks syncopal, disorders syncope, fainting episodes, falls out, Attack(s);fainting, collapse syncope, faint, fainted, faints, syncope attack, out pass, pass out, attacks fainting, out passed, syncopes, fainting/syncope, Swoon, syncope fainting, faintness, swoons, out passes, swooning, passed out, syncope collapse, fainting syncope, [D]: [fainting] or [collapse] (disorder), [D]Syncope and collapse NOS (situation), Syncope (finding), [D]: [fainting] or [collapse] (situation), [D]Syncope and collapse (situation), [D]Fainting (situation), Fainting (finding), Fainting [D], Faint symptom, [D]: [fainting] or [collapse], SYNCOPE, FAINT, FAINTING, Syncope and collapse, Syncope symptom, Syncope attack, Syncope (disorder), Syncope and collapse (disorder), Syncope symptom (disorder), Fainting/syncope, attack; syncope, attack; unconsciousness, collapse; general, fainting; fit, fit; fainting, general; collapse, loss of consciousness; attack, syncope; syncope, unconsciousness; attack, Syncope, NOS, Faintness, Collapse fleeting, Collapse transient, fainting attacks, swoon |
| French | SYNCOPE, Collapsus passager, Tendance lipothymique, Syncope et collapsus, Evanouissements, Collapsus transitoire, Chutes fréquentes, Pâmoison, Lipothymie, COLLAPSUS TRANSITOIRE, DECES, ETAT SYNCOPAL, EVANOUISSEMENT, PERTE DE CONNAISSANCE, A perdu connaissance, Syncope, Évanouissement |
| Portuguese | SINCOPE, DESMAIO, Síncope e colapso, Ataque de síncope, Colapso transitório, Esvaimento, Perda de consciência, Desmaiado, Colapso passageiro, COLAPSO TRANSITORIO, DEBILIDADE, DESFALECIMENTO, DESMAIADO, Desmaio, Síncope |
| Spanish | DESVANECIMIENTO, SINCOPE, DESMAYO, Colapso transitorio, Desfallecimiento, Episodio sincopal, Síncope y colapso, Privación de sentido, Alferecía, Pérdida de conocimiento, Desvanecimiento, Colapso fugaz, [D]desvanecimiento (categoría dependiente del contexto), [D]síncope y colapso (categoría dependiente del contexto), [D]síncope y colapso SAI (categoría dependiente del contexto), CAIDA, COLAPSO TRANSITORIO, DESFALLECIMIENTO, desvanecimiento, desvanecimiento (hallazgo), [D]síncope y colapso SAI, [D]desvanecimiento (situación), síncope (hallazgo), [D]síncope y colapso SAI (situación), [D]síncope y colapso (situación), [D]desvanecimiento, [D]síncope y colapso, desmayo, síncope (trastorno), síncope - síntoma (trastorno), síncope - síntoma, síncope y colapso (trastorno), síncope y colapso, síncope, Desmayo, Síncope |
| German | SYNKOPE, ohnmaechtig, Kollaps fluechtig, synkopale Attacke, bewusstlos werden, Synkope und Kollaps, Kollaps voruebergehend, schwummrig, ohnmaechtig werden, Ohnmachtsanfall, BEWUSSTLOSIGKEIT FLUECHTIG, KOLLAPS KURZDAUERND, OHNMACHT, OHNMAECHTIG WERDEN, SCHWAECHEANFALL, Ohnmacht, Synkope |
| Dutch | kortdurende collaps, flauwte, flauw, flauwteaanval, flauwvallen, voorbijgaande collaps, syncope en collaps, uitvallen, flauwgevallen, aanval van syncope, Flauwvallen/syncope, aanval; bewusteloosheid, aanval; syncope, algemeen; collaps, bewusteloosheid; aanval, bewustzijnsverlies; aanval, collaps; algemeen, flauwvallen; toeval, syncope; aanval, toeval; flauwvallen, Syncope en collaps, syncope, Collaps, Flauwvallen, Syncope |
| Italian | Attacco sincopale, Sfaldarsi, Sincope e collasso, Collasso transitorio, Malore, Svenuto, Svenimento, Sincope |
| Japanese | 卒倒, 一過性虚脱, 浮動性めまい感, 失神発作, ｼｯｼﾝ, ｲｯｶｾｲｷｮﾀﾞﾂ, ｿｯﾄｳ, ｼｯｼﾝﾎｯｻ, ﾌﾄﾞｳｾｲﾒﾏｲｶﾝ, ｷｾﾞﾂ, 脳貧血, 気絶, 失神 |
| Swedish | Svimning |
| Czech | synkopa, Tranzientní kolaps, Synkopický záchvat, Omdlívající, Mdloba, Synkopa a kolaps, Synkopa, Výpadek, Upadnout do bezvědomí, Pocit závratě, mdloba |
| Finnish | Pyörtyminen |
| Russian | SINKOPE, OBMOROK, OBMOROK POSTURAL'NYI, POTERIA SOZNANIIA, PREDOBMOROCHNOE SOSTOIANIE, ОБМОРОК, ПОТЕРЯ СОЗНАНИЯ, ОБМОРОК ПОСТУРАЛЬНЫЙ, ПРЕДОБМОРОЧНОЕ СОСТОЯНИЕ, СИНКОПЕ |
| Korean | 실신 및 허탈 |
| Croatian | SINKOPA |
| Polish | Zapaść, Omdlenie |
| Hungarian | Ájult, Syncopés roham, Syncope és collapsus, Átmeneti collapsus, Ájulásérzés, Múló collapsus, Syncope, Ájulás, Elájulás, Összeesés |
| Norwegian | Synkope, Besvimelse |
Ontology: Lightheadedness (C0220870)
| Concepts | Sign or Symptom (T184) |
| MSH | D004244 |
| ICD10 | R42 |
| SnomedCT | 206742004, 69096003, 271791002, 158146007, 386705008 |
| English | Lightheadedness, LIGHT-HEADED FEELING, [D]Light-headedness, [D]Light-headedness (context-dependent category), lightheadedness (symptom), lightheadedness, Light-headed feeling, Light-headed, Light headedness, Light Headedness, Light-Headedness, headed lighted, headedness light, lightheaded, feel headed light, headed light, light head, light-headed, light-headedness, feeling headed light, light headed, Light-headedness (finding), [D]Light-headedness (situation), Light-headedness, Lightheaded, Dizziness - light-headed, Feels light headed, Lightheadedness (finding), light headedness |
| Dutch | licht gevoel in hoofd, licht in hoofd |
| French | Etourdissements, Etourdi, Tête légère, Sensation de tête légère, Sensation ébrieuse, SENSATION DE TETE VIDE |
| German | Schwindelgefuehl, Schwindel, schwindlig, Benommenheit, KOPFLEERE |
| Italian | Stordimento mentale, Intontito, Sensazione di confusione mentale, Confusione della mente, Vertigini |
| Portuguese | Sensação de atordoamento, Atordoamento, Atordoado, Sensação de Cabeça Leve, SENSACAO DE "CABECA LEVE" |
| Spanish | Vahído, Mareo, Mareado, Sensación de aturdimiento, [D]vahído (categoría dependiente del contexto), Desvanecimiento, SENSACION DE ATOLONDRAMIENTO, [D]vahído (situación), [D]vahído, desvanecimiento, sensación prelipotímica (hallazgo), sensación prelipotímica |
| Japanese | 頭部ふらつき感, 頭部ふらふら感, ﾄｳﾌﾞﾌﾗﾌﾗｶﾝ, ﾄｳﾌﾞﾌﾗﾂｷｶﾝ |
| Czech | Závrať, Trpící závratí, Pocit závrati, závrativost |
| Hungarian | Szédülékenység, Szédülékeny, Szédülésérzés |
| Norwegian | Ørhet |
