An Academic Research Center of Excellence Well AWARE NOVEMBER DECEMBER DIZZINESS AND VERTIGO: Spinning the Facts 2009 here is a common misunderstanding inner ear). Yearly, over ten million Americans when de!ning or describing experience balance or dizziness problems THE CENTER FOR PHARMACY CARE T the terms dizziness and vertigo. lasting three months or longer. Several Dizziness is a feeling of imbalance that studies have indicated that vestibular 1000 Fifth Avenue, Muldoon Building includes symptoms such as lightheadedness, disorders are consistently under diagnosed Monday – Friday 9:00 a.m. to 4:00 p.m. weakness or unsteadiness. The word and poorly treated. Dizziness and vertigo are dizziness is often used to describe more prevalent in middle-aged and elderly motion sickness associated with airplane, Complimentary Screenings and Services populations and signi!cantly contribute to rollercoaster or boat travel. By contrast, the increased risk of falls in these individuals. t #POFEFOTJUZ vertigo is a feeling of movement in which Both disorders may be caused by a number either the external world appears to be t #PEZDPNQPTJUJPOBOBMZTJT of factors including medications, infection spinning or moving or the individual feels and blood pressure changes. Dizziness and t 'BDJBMTLJOBOBMZTJT as if he/she is revolving in place. Common vertigo are not life-threatening, but may descriptions of vertigo include additional result in interruption of daily activities and a t 4FSVNHMVDPTFBOE"$UFTUJOHGPSEJBCFUFT complaints such as ringing in the ears or signi!cant decrease in the patient’s quality Living My Life® changes in ear pressure. Vertigo frequently of life. Treatment of both conditions is accompanies or even precedes a migraine non-traditional and may consist of position t $IPMFTUFSPMTDSFFOJOH headache. changes, surgery, and avoidance of triggering t 5PCBDDP$FTTBUJPO1SPHSBN Both dizziness and vertigo are considered factors. The signs and symptoms of these to be vestibular disorders (pertaining to the problems are listed in the accompanying table. t )FBMUI$BSF$PBDIJOH continued on back t .FEJDBUJPO5IFSBQZ.BOBHFNFOU Signs and Symptoms of Dizziness and Vertigo* t "OFNJB4DSFFOJOH Please call for an appointment, x5874. TYPICAL SIGNS AND SYMPTOMS WHEN TO CONSULT YOUR DOCTOR
Loss of balance Head injury
Nausea A new, di#erent or severe headache
Unsteadiness Fever ≥ 101o F
Wooziness Very sti# neck
Lightheadedness Blurred vision
Faintness Hearing loss
Weakness Speech impairment
Fatigue Leg or arm weakness
Di"culty concentrating Loss of consciousness Blood Pressure Screening Blurred vision during quick Falling or di"culty walking t /PWFNCFS BNOPPO head movements t %FDFNCFS BNOPPO Chest pain or rapid or slow heart rate You or your surroundings are rd Numbness or tingling 3 Floor, Duquesne Union spinning/moving (vertigo) No appointment necessary
* Adapted from: Dizziness; MayoClinic.com, 2008 (Accessed 20 October 2009) DIZZINESS AND VERTIGO: Spinning the Facts
reduction in episodes of dizziness. CAUSES OF DIZZINESS When performing the procedure, the AND VERTIGO physician moves the patient’s head A sense of dizziness or vertigo may in a number of speci!c positions for a arise unexpectedly. Vertigo may short period of time. This procedure speci!cally be caused by benign can move crystals from the extremely paroxysmal positional vertigo (BPPV), sensitive part of the ear to a more a condition related to movement benign location, thus reducing the of crystals in the inner ear from frequency and severity of symptoms. one area to a location of greater If necessary, this method of sensitivity. This results in severe treatment can be repeated. spinning accompanied by nausea Photo by: michele cat Name: your medication for dizziness may cause dizziness used under Creative For other vestibular conditions, you and vomiting. Vertigo may also be Commons License; http://www.!ickr.com/photos/asv/2573670832/. (Accessed 20 October 2009) may be instructed by a physical caused by in%ammation in the inner therapist to perform several ear, migraine headache, acoustic neuroma balance exercises involving movement (non-cancerous growth of a nerve in the or vertigo is severe as these symptoms may of the head. You may be advised to take inner ear), or rapid changes in motion. be a sign of a bacterial or viral infection or over-the-counter (OTC) medications Meniere’s disease is a relatively common other serious disease. such as meclizine (Antivert, Bonine) or cause of vertigo that, in its severe form, dimenhydrinate (Dramamine). Prescription can be incapacitating. The disease is due to VISITING YOUR PHYSICIAN drugs such as diazepam (Valium) may be excessive accumulation of %uid in the inner Since dizziness is often short-lived and used to relieve anxiety while corticosteroids ear. Faintness, whether associated with di"cult to describe, patients should be well such as prednisone are bene!cial for inner dizziness or vertigo, is generally due to a prepared to discuss their problem during ear problems related to in%ammation. sudden drop in blood pressure upon rapid their doctor’s appointment. It is important Scopolamine patches (TransdermScop) standing. In addition, faintness may occur to consider a few factors related to the event. placed behind the ear are often e#ective in in conditions in which the heart may not The following points should be evaluated at preventing dizziness and motion sickness supply su"cient blood such as heart failure, UIFUJNFZPVFYQFSJFODFEJ[[JOFTTPSWFSUJHP associated with travel. Meniere’s disease is blocked arteries due to high cholesterol, t What activity were you performing? often treated with diuretics to reduce the irregular heartbeat, etc. Other causes of volume of %uid in the inner ear while surgery lightheadedness include other disorders of t What did you recently eat? is a potential option in resistant cases. the inner ear, anxiety and hyperventilation. t Did you take any medication(s) just prior Vertigo associated with migraine headaches Recurrent imbalance problems may be to the event? is generally best managed by avoiding due to sensory disorders, joint and muscle t Have you been experiencing symptoms of triggering factors such as stress and problems or allergies. Medications such a viral or bacterial infection? speci!c foods. In addition, your physician as analgesics (pain relievers) and muscle may prescribe migraine medication and t Have there been any major changes in relaxants can also be a source of dizziness. recommend that you maintain regular your lifestyle or additional stress? Caution is always advised when a patient patterns of sleep and exercise. Lastly, other is driving or operating machinery while Finally, attempt to describe in detail your underlying causes of dizziness and vertigo taking these types of products. Finally, it is exact experience of dizziness or vertigo. For such as anxiety, infection, stroke and heart important to contact a physician if dizziness instance, speci!cally explain whether you problems must be managed by the physician. felt you were spinning or if objects around If dizziness appears to be an adverse e#ect you were turning. Having this information of medication, patients should consult their prepared in advance will greatly assist your physician or pharmacist. It may be necessary physician in determining the cause of your to reduce the dose or prescribe a new symptoms. medication. AWARE Many individuals will have occasional bouts ell TREATMENT AND MANAGEMENT WA publication of: of dizziness or lightheadedness; however, The treatment options for dizziness and more frequent and severe episodes may be Mylan School of Pharmacy vertigo are dependent on the physician’s indicators of serious underlying disease. These Center for Pharmacy Care diagnosis of your condition. BPPV is patients must be evaluated by a physician Pharmaceutical Information Center (PIC) commonly and successfully treated with and treated appropriately. Although most Additional information on newsletter topics: a painless procedure known as canalith cases are responsive to treatment, dizziness Pharmaceutical Information Center repositioning. It is performed by an Ear, and vertigo may have a signi!cant impact 412-396-4600 Nose & Throat specialist in the physician’s on a patient’s quality of life and, on occasion, [email protected] o"ce and frequently results in a signi!cant result in job loss and incapacitation. Questions about screenings or programs: Christine O’Neil, Pharm.D, B.C.P.S. For more information regarding Dizziness and Vertigo, please visit the 412-396-6417 following Web sites: Newsletter Contributors t IUUQNBZPDMJOJDDPN tIUUQWFTUJCVMBSPSH tIUUQXXXOJEDEOJIHPW John G. Lech, Pharm.D Emily J. Lunz, Pharm.D. Candidate XXXEVRFEVQIBSNBDZ Meghan T. Lardin, Pharm.D. Candidate 326162 10/09