Most causes of dizziness (light-headedness) are minor. It is important to differentiate simple dizziness from vertigo (a spinning sensation or the feeling that you or the room around you is moving). Vertigo often indicates an inner ear problem but it can also signify a problem with the cerebellum or the brainstem.

Serious disorders may cause light-headedness such as insufficient blood flow and oxygen supply to the brain, such as can be caused by a rapid drop in blood pressure. Serious disorders that can cause light-headedness (usually in addition to other symptoms) include heart problems such as a valve disorder or heart attack, stroke, and severe hypotension or shock.

Light-headedness is a fainting feeling that often accompanies the flu, common cold or dehydration. Light-headedness without other symptoms is usually not serious.

Most fainting spells are not dangerous, but if there is any question call for medical help. Sudden loss of consciousness (vasovagal faint) happens more easily when a person is upright. A simple faint is rarely preceded by symptoms such as pain, pressure, constriction in the chest or shortness of breath -- but generalized weakness, nausea, tunnel vision, and sweating may occur.

Dizziness can also be caused by a poorly functioning balance mechanism in the inner ear. This balance mechanism also helps control eye movements, so often the environment seems to be spinning around. Most dizziness and vertigo has no definite cause and is commonly attributed to a viral infection of the inner ear especially in young otherwise healthy people. However, vertigo may be a sign of stroke, multiple sclerosis, seizures or rarely, a degenerative neurological disorder. In such conditions, other symptoms and signs usually accompany the vertigo.

Light-headedness:

• severe pain
• hyperventilation
• headache
• injury
• fright
• low blood pressure
• getting blood drawn
• strenuous coughing
• straining during a bowel movement or bladder emptying
• standing up too quickly after lying down or sitting especially in older people (see hypotension)
• pressure on the carotid sinus in the neck (a shirt collar may be too tight)
• various medications including anti-hypertensives
• heart beating too slow (below 30 times a minute) or too fast (around 200 times a minute)

Vertigo:

• viral infection of the inner ear
• alcohol intoxication
• medications, especially tranquilizers, many heart drugs, anticonvulsants, aspirin, Dilantin, Gentamycin, narcotics, sedatives, Streptomycin and others
• classical migraine or common migraine
• drug abuse and dependence
• drug allergies
• middle ear surgery or trauma
• tympanic membrane perforation
• ear diseases (otitis media, labyrinthitis, mastoiditis, cholesteatoma, vestibular neuronitis, Meniere's disease)
• visual impairment
• stroke
• seizure
• neuro-degenerative illness
• multiple sclerosis
• brain tumor

• There has been complete loss of consciousness.
• The room seems to spin around (vertigo).
• Dizziness is preventing daily activities.
• Medication is the suspected cause. Talk to your health care provider before taking the next dose of medication.
• Light-headedness lasts for more than 3 weeks.
• Other symptoms are also present, especially chest pain, numbness and tingling, or other serious symptoms.

• quality
  • Does dizziness occur with a change in body position?
  • How severe is the dizziness?
  • Does the room seem to move (vertigo)?
• time pattern
  • When did it begin?
  • Is the person always dizzy?
  • Does dizziness come and go (episodic)?
  • How long does it last (how many hours)?
  • Did another illness develop after the dizziness began?
    • How much later did the illness develop?
• associated complaints
  • Does dizziness occur with nausea and vomiting?
  • Is there a significant amount of stress or anxiety?
  • What other symptoms are occurring at the same time?

• blood pressure measurements and tests
• ECG
• hearing tests
• neurological tests
• balance testing (ENG) may be required.
• MRI