Many times, it happens due to environmental conditions or an underlying health condition. Vertigo is most often caused by conditions that affect your vestibular system, which is located in your inner ear. Your vestibular system helps provide your brain with information about your movement, positioning, and where you are in space. Vertigo may also be caused by conditions that impact your central nervous system. This includes your brain and spinal cord.
You may be wondering about lightheadedness , and how this sensation compares to dizziness and vertigo. When you feel lightheaded, you may also feel woozy or faint. In fact, lightheadedness can often happen before you pass out. Other symptoms you may have if you feel lightheaded include:. If you begin to feel dizzy or lightheaded, there are steps you can take to minimize your risk of injury. Although you may not always be able to prevent dizziness, vertigo, or lightheadedness, there are steps you can take to lower your risk of these sensations.
Depending on your medical history and symptoms, your doctor will likely order specific types of tests. Your treatment plan will focus on addressing the underlying cause of your symptoms. In many cases, treating the cause of dizziness, vertigo, or lightheadedness can help clear up these symptoms. Roughly the same as orthostasis. Spitting these out further we end up with Baron-Esquivias et al, subcategories of:.
Arrhythmia -- The most common cardiac cause of syncope is defined as abnormal slowing or quickness or irregularity of the heart beating. Arrhythmia accounts for only 7. Examples of arrhythmias are Moya, :. There are numerous drugs that can cause bradycardia, especially in persons affected by the "long-QT" syndrome.
An even smaller fraction of syncope in the ED was due to "cardiopulmonary" events 4. In the differential diagnosis of syncope one must also consider numerous non-cardiac causes of transient loss of consciousness.
One would think that in the "unknown in the ED" group there might be some rather serious conditions, motiving one to have followup for the "unknown". Remaining include. Albassam et al discussed the differences between cardiac syncope and seizure in great detail.
They stated that features that suggest seizure are:. Cherin et al, These associations seem very odd to us and we are dubious that they should be used to make any decisions about medications. Syncope, defined as transient loss of consciousness, is dangerous. There appears to be a tendency in the literature to overestimate the risk however. As an overview, it seems to be just a little more dangerous than getting older.
Solbiati et al , in a meta-analysis including 25 studies and patients in total reported that the one year mortality of syncope was 8. Of course, syncope mainly occurs in older people and this statistic might be less dramatic if one subtracted the expected mortality -- i.
So there are some major differences in studies attempting to quantify expectation of death after syncope. We think the Framingham data is more reasonable and think the meta-analysis of Solbiati et al is overly gloomy. According to Dipaola et al, the 48 hours following syncope are the highest risk times for a major adverse event. Dipaola et al, In reality, these studies are reporting mortality in persons who have had syncope, and the underlying cause of syncope is generally the cause of death Moya, Soteriades et al , figure to right reported survival after syncope defined as transient loss of consciousness , broken out by cause.
This was a very large "population" type study done in Framingham, Conn. Importantly, there was no effect on survival for individuals with "vasovagal" syncope also called "neural syncope above".
However, all other major categories - -including "unknown", neurological causes such as stroke , and individuals with cardiac causes of syncope did not survive as long as persons without syncope. Logically, one would expect that recurrent syncope would be far more dangerous than a "one time" syncope. Entem et al reported that arrhythmia was found in 33 of patients with syncope of unknown origin, using an implantable loop recorder, during a mean followup period of roughly a year.
Given that one would be unlikely to convince most people to have a device implanted unless they had some very good reason, we think this statistic is far too high because of sampling bias. This seems very reasonable. Especially the history, as talking to the patient is often the most important part of an evaluation.
Similarly, Albassem et al stated that "the clinical examination, including the electrocardium as part of multivariable scores, can accurately identify patients with and without cardiac syncope". History should establish the context of the syncope -- i. No pulse? How long did it take for them to recover? Reuber et al used a factor analysis to find questions that were best at discriminating between seizures, pseudoseizures and syncope -- obviously here their definition of syncope was not transient loss of consciousness as recomended above.
Recall that only a small proportion of transient loss of consciousness in the ER are from seizures or "pseudo"-LOC.
Questions reflecting a "catastrophic experience" -- i. So in essence, dramatic answers to questions about what happened are more common in pseudoseizure patients. No big surprise, as pseudoseizures are often just mini-dramas intended to accomplish some purpose.
Moya suggested paraphrased here that one should ask about circumstances position, activity, predisposing factors , Onset of attack especially palpitations , eyewitness inquiry fall, color, duration, breathing, convulsions, tongue biting , End of attack e. Vasovagal syncope is characterized by simple fainting spells. However, these fainting spells can be accompanied by confusion, jerking movements and loss of consciousness much like an epileptic seizure.
If you experience minor fainting episodes caused by suddenly standing up or heat exhaustion, then you may not need to visit an emergency room. An exception is made if falling after fainting has caused damage to your body — including concussions, fractures, or other severe injuries.
Passing out, too, may cause seizures or even permanent brain damage, though Busis is unaware of any instances of that happening on a roller coaster.
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