DIZZINESS  [ back to Glossary Index ]
Dizziness is a symptom not a disorder. Patients often complain of dizziness after head trauma, but may be referring to very different problems by use of the same term. The common complaints which underlie the statement "I’m feeling dizzy," are lightheadedness (feeling feint), dysequilibrium (imbalance) and having the room spin with a change in head position (true vertigo). Only positional vertigo involves disturbance of the vestibular system. It may or may not be accompanied by nausea, vomiting, hearing loss or ringing in the ears. When a patient with post-concussion-syndrome makes persistent complaints of dizziness, his physician will usually send him to a neurologist, who will then employ a battery of tests to determine the source of the complaint. The usual battery includes cluding audiogram, caloric testing, tilt table (for cardiac insufficiency) and ENG (electro-nystagnogram for detection of brain stem damage). Dizziness after head trauma can last hours, days, weeks, months or years. Persistent, severe dizziness is disabling. Mild dizziness can be effectively treated with medications and occupational therapy. It is best to see a neurologist initially. If the neurologist is not able to fully explain or relieve the dizziness, he will bring in other specialists such as ENT and neuro-otology. Dizziness can be caused by stretch injury to the vestibulo-cocchlear nerve, inflammation of the membranous labyrinth of the inner ear or by accumulation of debris in the fluid filled cochlea. Within the cochlea. are tiny hair cells which transmit fluid wave energy to the nerve responsible for hearing. Resting atop the hair cells are the otoliths or "ear stones" (tiny pebble like structures made of calcium). Closed head trauma can knock the otoliths off their perch, and create ear gravel which triggers vertigo and nausea with head motion.