Find Out When Dizziness is a Big Deal


When is Dizziness a Big Deal?


Everyone has felt a little dizzy at one time or another. Harmless dizziness can start after a roller coaster ride, watching a fast paced 3-D movie or with jet lag. But, there are also stories of serious health problems that begin with, “At first I was feeling a little dizzy…”

Dizziness is an unpleasant feeling and it can be scary. Most people worry that they may be having a stroke when they experience new symptoms of dizziness.


Dizziness can give you the sensation that you are spinning or that the room is spinning, which is often described as vertigo. It can make you feel lightheaded, or faint, as if you are going to pass out.  Sometimes, dizziness can make you feel off balance, as if you might fall. It can be so severe that you feel shaky or wobbly. In some instances, dizziness can give you the sense of being on a rocking or swaying boat. Dizziness can feel like your surroundings aren’t quite stable. Or it can feel as if you are a little dissociated or dazed, as if your head is in a cloud. 


Sometimes dizziness occurs with other symptoms.


Vomiting or diarrhea

Headaches or migraines

Chest pain

Shortness of breath


Ringing in the ears

Double vision

Blurred vision


Weakness of arms or legs

Slurred speech

Tingling around the mouth

Overall weakness


Dizziness is never beneficial and it is certainly never pleasant.

Dizziness is one of the most common complaints that patients mention during a visit to the doctor. There are several causes of dizziness, and a stroke is indeed one of them. One of the characteristics of cerebellar stroke and brainstem stroke, in particular, is dizziness. Usually, when someone is having a stroke or a TIA, there are other symptoms in addition to the dizziness.

Rarely, dizziness without other symptoms can be the only sign of a stroke or a TIA.

In general, dizziness may be a sign that your body is trying to tell you something.

When should you worry?

If dizziness is accompanied by other symptoms, it is important to get it checked out. When dizziness is severe, it may be a sign of a sudden change in heart function or a sign of another serious problem. When dizziness affects balance, coordination and walking, it is important to get the issue diagnosed and resolved as soon as possible.


Dizziness can be the sign of a several serious health problems.

Dehydration- loss of body fluid, either from lack of proper hydration, excessive sweating, vomiting, diarrhea or a metabolic problem.

Heat Stroke

Heart rhythm irregularities- arrhythmia is a disorder of heart rhythm that can cause a compromise in blood supply to the brain, resulting in a sensation of dizziness or even a watershed stroke.

Hypertension- high blood pressure can affect the blood vessels throughout the body and may result on an ischemic stroke or a hemorrhagic stroke.

Hypotension- low blood pressure can cause low blood supply to the brain or a watershed stroke and may result from dehydration.

Stroke- any type of stroke can cause dizziness, but particularly a stroke involving the brainstem.

Mini Stroke- TIA can result from a reversible stroke-like event that causes similar symptoms to that of a stroke.

Heart attack- results from a lack of blood supply to the blood vessels of the heart. This often results in a low or irregular blood supply to the brain, causing a sensation of dizziness.

Ear disease- can cause difficulties with perception of balance because the ears are important in maintaining balance and coordination.

Infection- an infection can wear out the body, resulting in weakness, and lack of appetite, nausea, vomiting, diarrhea, dehydration and hypotension.

Meningitis- an infection of the brain lining, causes head pain and dizziness.

Encephalitis-is a more serious infection, involving the actual brain tissue and is generally accompanied by fevers.

Neuropathy- is a loss of sensory fibers in the nerves. This can cause difficulty with balance and coordination, often making it difficult to walk. People with neuropathy often feel dizzy in the shower when eyes are closed because they cannot adequately feel their feet on the ground.

Brain tumor- can cause dizziness due to pressure on the brain, particularly if the brainstem is involved.

Medication side effects- a number of medications cause dizziness. It can take time to adjust to new medications that cause dizziness. Sometimes the dizziness wears off within a few days. Your doctor or pharmacist can advise you about what to expect when it comes to dizziness. 

Migraine headaches- often accompanied by dizziness, either before, during or after a migraine. When the dizziness and migraines follow a predictable pattern, the symptoms are less worrisome.

Fatigue-can cause dizziness, lightheadedness and a dazed feeling without significant long terms effects.


Dizziness is a common problem and it can be a sign of a mild problem or a more serious problem. It is a good idea to have your dizziness evaluated by a doctor so that it can be resolved.  Often when dizziness is not the sign of a severe problem, such as stroke, heart attack or brain tumor, a thorough evaluation is complicated and lengthy. But getting an answer and relief is well worth it.



Martin Samuels and David Feske, Office Practice of Neurology,  2nd Edition, Churchill Livingston, 2003

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