Dizzy spells and giddy turns –  vertigo and its relatives.jpg

Dizzy spells and giddy turns –  vertigo and its relatives

By DR THOMAS KAISER drsnotes@algarveresident.com

Dr Thomas Kaiser is the Medical Director of the Vale do Lobo Medical Centre and is a specialist in traditional General Practice for the whole family, state of the art aesthetic and cosmetic medicine.

DIZZINESS, FEELING faint and giddy are symptoms that are a minefield for doctor and patient.

These symptoms are common and sometimes the cause is easy to identify. More often the origin is not so easy to trace and the diagnostic process is lengthy and frustrating.

But making an exact diagnosis is very important, particularly when these episodes of dizziness come with weakness and feeling faint as they can be a sign of a stroke that is about to happen. Unfortunately, there are many other illnesses that can provoke the same sensations.

The cause can be lying inside the brain, for example epilepsy, stroke, tumour and trauma.

A second diagnostic group is related to the ears and the organ of balance like an inflammation of the labyrinth or middle ear cavity. Large amounts of obstructing ear wax can sometimes also cause imbalance.

Not uncommonly, new bi-focal glasses can lead to the patient feeling giddy.

Causes outside of the brain are acute and chronic intoxications, low and too high blood pressure, heart rhythm problems and cervical spine arthritis with secondary nerve compression. Low and high sugar concentrations in our blood stream can also make us feel faint. Polyneuropathy is another possible diagnosis.

There are also many cases that are related to hyperventilation and panic situations.

Family doctor

An interesting illness is the ‘panic swaying giddiness’, which is a harmless and common form of giddiness that occurs often if patients who have had serious imbalance reactions before and now fear new ones are coming on.

As you can see, the list of possible diagnosis is long and after an initial assessment, the general practitioner needs the help of specialists like cardiologists, eye and ear consultants and often the neurologist is needed as well.

I am a firm believer of the good old policy that the management of the patient should be co-ordinated by the family doctor as it can be frustrating if one specialist after the other only looks into a certain area in the patient’s complex symptoms.

Even in well reputed teaching hospital centres the successful diagnosis is not always made. It is important not to leave the patient alone with his problem but to try to alleviate the symptoms if no name was found.

The worst mistake though is to ignore giddiness that keeps recurring as, especially in this field, prevention of more serious problems is better than cure.

On another note, I have good news for you. The new influenza vaccine has arrived. Most people, especially more mature patients with chronic heart and lung problems or diabetes, but also people that work in busy offices and public places will benefit from the flu jab.

The vaccine is well tolerated and the protection rate is high.

Dr Thomas Kaiser can be contacted by telephone on (00351) 289 398 009 or by emailing drsnotes@algarveresident.com