Individuals say "I am feeling giddy” for a wide variety of abnormal sensations, like spinning of the head, black out, falling down, and etcetera. This condition is distressful for the sufferer. It is also associated with risk of injury.

Faintness or dizziness is usually described as a light headedness by the person. It occurs commonly due to deficiency of blood, glucose or oxygen to the brain. Such conditions can be hypoglycemia (deficiency of glucose in blood), or severe dehydration, severe anemia and etcetera.  Those suffering from defects in the heart valves often suffer from syncope or fainting on exertion.  Faintness can occur after an epileptic seizure. School students, soldiers, and etcetera, those who have to stand for a long time, sometimes experience faintness due to pooling of blood in lower limbs, reducing supply to the brain. Elderly people sometimes complain of dizziness because of weakening of the proprioceptors of the limbs which help in maintaining the correct position.

The term vertigo (described by people as ‘feeling vertish’) technically refers to a sense of rotation of the head. But like faintness, people use it loosely to describe any abnormal sensation in the head.  Vertigo is caused due to disturbances in the balancing system of the body, whether in the brain or inside the ear. It may be physiological as in driving around hills or sea travel (motion sickness) or looking down from heights. Pathological vertigo, caused by some disease can be due to infection or trauma in the balancing organs in the brain or ear. Common conditions include ear infections or discharge, frequent cold leading to inflammation inside the ear, brain tumours, and etcetera. Drugs like gentamycin and quinine that have toxic effects on ear can also cause vertigo. Elderly persons may suffer from vertigo due to cervical spondylosis.

The affected person experiences a spinning sensation and falling either on left or right or both sides, depending on the side of damage. There is often associated nausea, vomiting, tinnitus (sounds heard inside the ear). In severe cases, there is difficulty in walking or standing straight.

Giddiness is also one of the most common psychosomatic complaints.  Many people, particularly young ones, pretend to be suffering from it for some personal gain.

Treatment is by drugs or surgery in case of tumours, but if the basic cause persists, relapse does occur. Drugs have to be taken for medical conditions like anaemia which can cause fainting or vertigo. Surgery is used for tumours in the brain or auditory nerve or severe cervical spondylosis.

It is better to prevent these conditions. Conditions causing dehydration or hypoglycaemia should be prevented or treated at the earliest. Those whose work involves standing for long hours should keep on moving their toes to improve circulation and prevent pooling of blood. Recurrent cold should be controlled by regular steam inhalation and avoidance of allergy producing substances if possible, ears should be always kept dry. Pricking or needling of ears should be avoided. Similarly, draughts of hot or cold air affecting the ears should be avoided during travelling by keeping the ears covered by cotton or head scarves. In case of cervical spondylosis, high pillows should not be used below the head for sleeping.  Bending of neck should be avoided.

It is important to use corrective eye glasses in case of any reduced vision. Because long standing     reduced vision also affects the equilibrium of the body, causing faintness.

Positional adaptation is very useful for those who suffer from recurrent giddiness. If it is experienced in a particular position or side, one should keep the head for few seconds in the same position. This will adapt the balancing part inside the ear to that position, thus providing relief.

Dr Rachna Pande, Specialist, internal medicine

rachna212002@yahoo.co.uk