I'm So Dizzy, My Head Is Spinnin'...la la la

     Someone asked me yesterday what the difference was between having vertigo and feeling dizzy?  I attempted to explain my “understanding” of these two terms and quickly realized I didn’t have much knowledge for the basis of my discussion…which caused me to feel “dizzy”!  I was aware I understood for ME what the difference in terminology meant.  After all, I’ve had both dizziness AND vertigo from Multiple Sclerosis in the past and both conditions are pretty distinguishable…suffice it to say, you don’t ever WANT to have vertigo.  Just trust me on this one.

     So, in my state of “dizziness”, I got online to do a bit of research and find the correct medical terminology to explain and differentiate between feeling dizzy and having vertigo.  To that “someone” yesterday who posed this question, this blog’s for you…YOU know who you are!

     The word "vertigo" comes from the Latin "vertere", to turn + the suffix "-igo", a condition = a condition of turning about. Vertigo is medically distinct from dizziness, lightheadedness, and unsteadiness.  Dizziness is generally thought to be a symptom of something else, while vertigo is an actual state or possible secondary diagnosis.

     There are four, distinct states of “dizzy”…one of which IS vertigo.  So essentially, you can have both dizziness and vertigo at the same time, but may not necessarily always FEEL dizzy WITH vertigo (this is getting clearer by the moment, isn’t it?!?).  Those four distinct states are:

 

LIGHTHEADEDNESS:  a vague sensation of floating or wooziness.

 

PRESYNCOPE:  a more extreme form of lightheadedness.  It may or may not precede actual syncope (fancy term for “fainting”) and may be accompanied by tachycardia (rapid heart rate), palpitations (the sensation your heart is skipping beats or misfiring), or diaphoresis (excessive sweating).

 

DYSEQUILIBRIUM:  a sensation of unsteadiness.

 

VERTIGO:  a sensation or false sensation of movement, often described as spinning, twisting, rocking, tilting, or turning.

 

     When your medical practitioner is trying to figure out if you are dizzy or experiencing vertigo, they may ask questions like, “When you have dizzy spells, do you feel light-headed or do you see the world spin around you?”  If you answer “yes” to the spinning part, you may have vertigo.  Which by the way, your doctor may try to impress you by pronouncing it “ver-tie-go” versus the lay usage pronunciation, “ver-tee-go”.  They ARE always trying to impress us!

However you choose to pronounce your tomAYtoes or ToMatoes, vertigo just plain sucks as does dizziness!  Dizziness is the third most common symptom presented for medical consultation, falling only behind in line to chest pain and fatigue.  The symptoms of dizziness may be episodic or constant and often commonly make it difficult to walk.  Dizziness can last for seconds to months at a time.  Dizziness can be due to all sorts of things, such as low blood sugar, abnormal blood pressure, side effects or responses to medications, anemia, narrowing of the arteries, migraines, anxiety, and inner ear problems…the list of causes is quite extensive.      The causes of actual vertigo are a bitmore narrowed down to disorders of the central nervous system, the eyes or the inner ear.  It might be important here to “attempt” to explain how our sense of balance/equilibrium works…I say attempt, because I’m really just guessing here and I have no clue!  But I do have some pretty cool cut and paste information, so here goes: How does the body maintain its equilibrium? Dizziness, vertigo, and motion sickness all relate to the sense of balance and equilibrium. Researchers in space and aeronautical medicine call this sense spatial orientation, because it tells the brain where the body is "in space:" what direction it is pointing, what direction it is moving, and if it is turning or standing still. Your sense of balance is maintained by a complex interaction of the following parts of the nervous system: • The inner ears (also called the labyrinth), which monitor the directions of motion, such as turning, or forward-backward, side-to-side, and up-and-down motions. • The eyes, which monitor where the body is in space (i.e. upside down, rightside up, etc.) and also directions of motion. • The skin pressure receptors such as in the joints and spine, which tell what part of the body is down and touching the ground. • The muscle and joint sensory receptors, which tell what parts of the body are moving. • The central nervous system (the brain and spinal cord), which processes all the bits of information from the four other systems to make some coordinated sense out of it all. The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems. For example, suppose you are riding through a storm, and your airplane is being tossed about by air turbulence. But your eyes do not detect all this motion because all you see is the inside of the airplane. Then your brain receives messages that do not match with each other. You might become "air sick." Or, to use a true medical condition as an example, suppose you suffer inner ear damage on only one side from a head injury or an infection. The damaged inner ear does not send the same signals as the healthy ear. This gives conflicting signals to the brain about the sensation of rotation, and you could suffer a sense of spinning, vertigo, and nausea.        Now you have to admit, that’s some mighty cool scientific information…but perhaps way more than you wanted or needed to know!       So besides knowing “Vertigo” was a 1958 Alfred Hitchcock movie starring Jimmy Stewart and Kim Novak, what else have we learned here (specifically YOU, “someone”, who asked me this question in the first place??)?  VERTIGO IS THE ILLUSION OF MOVEMENT and unfortunately it IS often a sign or symptom of Multiple Sclerosis.      One of the drugs sometimes given (and also to test for true vertigo) is Valium.  For some reason, this benzodiazapine lessens the spinning…I won’t go into detailed explanation about THAT.  So just know if your medical practitioner suggests taking Valium for your vertigo, it’s not necessarily because they think you’re crazy (although don’t jump to rule that out prematurely!)       Most often Mser’s vertigo is caused because of …drum role, please…you guessed it….BRAIN DAMAGE!  And often that damage is found in the cerebellum (the ruler of balance and equilibrium in the brain)…that back-sided, chunky part of the brain, which sits just above the back of your neck (inside your skull, of course!) and is friends with your brain stem (running out of technical terms here).      I’ve got a lesion in my cerebellum.  I’ve had severe vertigo in the past.  Does this make me a dizzy blonde?  Perhaps.  Am I dizzy all the time?  Nope.  After my relapse last winter, which symptomatically consisted primarily of debilitating vertigo, I have been left with the inability to look up above my head.  I don’t get dizzy or have regular bouts of spinning unless I look above my head.  This does make star-gazing or peering at jets a more challenging task, but not unheard of.  I simply have to brace my balance and/or change my body alignment to look up.     Soooo…I currently suffer from dizziness, most likely brought on by steroid use.  Luckily the doctor at the emergency room took pity upon me and loaded me up with a HIGHLY effective drug called, “Zofran”…it’s a drug used primarily for nausea treatment with cancer patients.  It’s about $300.00 a bottle for 10 (thank goodness for good insurance), but I highly recommend it if you are suffering that gut-wrenching nausea from feeling dizzy…and I DON’T routinely recommend pharmaceuticals because I hate the drug company bastards!       Just lessening the nausea caused by my dizziness has lifted my spirits greatly these past two days!  So much so, I am now able to return to the computer and bang out silly blogs again without feeling the need to puke…bet you wish by now I still wanted to hurl?!?      I just wish now I could get that darned 1969 Tommy Roe song out of my head…you know the one… “I’m so dizzy, my head is spinnin’.  Like a whirlpool, it never ends.  And it’s you, girl, makin’ it spin.  You’re making me dizzy.”  That song’s enough to make me wanna puke again…