Suffering from dizziness?
Dizziness can take many forms. What you experience as a patient can differ from person to person.
Common causes of dizziness
Dizziness can have many different causes. Because of these varied causes, it is sometimes difficult to make an accurate diagnosis and provide the right treatment.
- Loose otoliths in the inner ear (BPPV)
- Peripheral vestibular loss
- Hyperventilation
- Ménière's disease
- Inflammation of the vestibular system (vestibular neuritis)
- Migraine attack
- Circulatory disorder or bleeding in the vestibular system and/or cerebellum
- Orthostatic hypotension
More about dizziness
You may feel light-headed or unsteady. You might feel as if the world around you is spinning, or as though you are spinning yourself. Sometimes you lose your sense of place and feel as if you might fall. Dizziness can also be accompanied by anxiety, sweating, nausea and vomiting. Dizziness is very common in the Netherlands — for 3 to 14% of patients visiting their GP, it is the main complaint. Dizziness can seriously affect daily life because it often leaves people feeling insecure and, particularly in older adults, can lead to reduced independence.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV diagnosis
A proper diagnosis requires examination. Using the Dix-Hallpike manoeuvre — in which the head and upper body are tilted backwards from a sitting position — the vertigo can be reproduced. A typical eye movement, called nystagmus, is usually visible.
BPPV cause
The exact cause of BPPV is not fully understood. It is thought that loose otoliths in the inner ear, dislodged by rapid position changes, settle on the sensory cells of the vestibular system. This briefly overstimulates those cells and triggers spinning vertigo. BPPV can occur after a head injury, ear surgery, an inner-ear infection or circulatory issue, or after prolonged bed rest. In many cases, however, no clear cause can be identified.
BPPV treatment
The most effective treatment for BPPV is a repositioning manoeuvre of the loose otoliths. Using a specific technique, the otoliths are moved to a different part of the vestibular system. They can no longer overstimulate the sensory cells, and the vertigo resolves.
BPPV course
BPPV is a benign form of dizziness that can resolve spontaneously within weeks or months. Repositioning treatment is usually preferred, because despite being benign the symptoms can make you feel quite unwell. Most patients are symptom-free within 3 to 4 sessions. However, BPPV recurs in roughly 1 in 3 patients and treatment then needs to be repeated.
Frequently asked questions about dizziness
Have another question? We are happy to help!