Dizzness and Motion
Each year more than two million people visit a doctor for dizziness, and an
untold number suffer with motion sickness, which is the most common medical
problem associated with travel.
What Is Dizziness? Some people describe a balance problem by saying they feel
dizzy, lightheaded, unsteady, or giddy. This feeling of imbalance or dysequilibrium,
without a sensation of turning or spinning, is sometimes due to an inner ear
What Is Vertigo? A few people describe their balance problem by using
the word vertigo, which comes from the Latin verb "to turn". They
often say that they or their surroundings are turning or spinning. Vertigo
due to an inner ear problem.
What Is Motion Sickness and Sea Sickness? Some people experience nausea and
even vomiting when riding in an airplane, automobile, or amusement park ride,
and this is called motion sickness. Many people experience motion sickness
when riding on a boat or ship, and this is called seasickness even though
it is the same disorder.
Motion sickness or seasickness is usually just a minor annoyance and does
not signify any serious medical illness, but some travelers are incapacitated
by it, and a few even suffer symptoms for a few days after the trip
The Anatomy of Balance Dizziness, vertigo, and motion sickness all relate
to the sense of balance and equilibrium. Researchers in space and aeronautical
medicine call this sense spatial orientation, because it tells the brain where
the body is "in space:" what direction it is pointing, what direction
it is moving, and if it is turning or standing still.
Your sense of balance is maintained by a complex interaction of the following
parts of the nervous system:
The inner ears (also called the labyrinth), which monitor the directions of
motion, such as turning, or forward-backward, side-to-side, and up-and-down
The eyes, which monitor where the body is in space (i.e. upside down, rightside
up, etc.) and also directions of motion.
The skin pressure receptors such as in the joints and spine, which tell what
part of the body is down and touching the ground.
The muscle and joint sensory receptors, which tell what parts of the body are
The central nervous system (the brain and spinal cord), which processes all
the bits of information from the four other systems to make some coordinated
sense out of it all.
The symptoms of motion sickness and dizziness appear when the central nervous
system receives conflicting messages from the other four systems.
For example, suppose you are riding through a storm, and your airplane is
being tossed about by air turbulence. But your eyes do not detect all this
motion because all you see is the inside of the airplane. Then your brain receives
messages that do not match with each other. You might become "air sick."
Or suppose you are sitting in the back seat of a moving car reading a book.
Your inner ears and skin receptors will detect the motion of your travel, but
your eyes see only the pages of your book. You could become "car sick."
Or, to use a true medical condition as an example, suppose you suffer inner
ear damage on only one side from a head injury or an infection. The damaged
inner ear does not send the same signals as the healthy ear. This gives conflicting
signals to the brain about the sensation of rotation, and you could suffer
a sense of spinning, vertigo, and nausea.
What Medical Conditions Cause Dizziness? Circulation: If your brain does not
get enough blood flow, you feel light headed. Almost everyone has experienced
this on occasion when standing up quickly from a lying down position. But some
people have light headedness from poor circulation on a frequent or chronic
basis. This could be caused by arteriosclerosis or hardening of the arteries,
and it is commonly seen in patients who have high blood pressure, diabetes,
or high levels of blood fats (cholesterol). It is sometimes seen in patients
with inadequate cardiac (heart) function or with anemia.
Certain drugs also decrease the blood flow to the brain, especially stimulants
such as nicotine and caffeine. Excess salt in the diet also leads to poor circulation.
Sometimes circulation is impaired by spasms in the arteries caused by emotional
stress, anxiety, and tension.
If the inner ear falls to receive enough blood flow, the more specific type
of dizziness occurs-that is-vertigo. The inner ear is very sensitive to minor
alterations of blood flow and all of the causes mentioned for poor circulation
to the brain also apply specifically to the inner ear.
Injury: A skull fracture that damages the inner ear produces a profound and
incapacitating vertigo with nausea and hearing loss. The dizziness will last
for several weeks, then slowly improve as the normal (other) side takes over
Infection: Viruses, such as those causing the common "cold" or "flu," can
attack the inner ear and its nerve connections to the brain. This can result
in severe vertigo, but hearing is usually spared. However, a bacterial infection
such as mastoiditis that extends into the inner ear will completely destroy
both the hearing and the equilibrium function of that ear. The severity of
dizziness and recovery time will be similar to that of skull fracture.
Allergy: Some people experience dizziness and/or vertigo attacks when they
are exposed to foods or airborne particles (such as dust, molds, pollens, danders,
etc.) to which they are allergic.
Neurological diseases: A number of diseases of the nerves can affect balance,
such as multiple sclerosis, syphilis, tumors, etc. These are uncommon causes,
but your physician will think about them during the examination.
What Will the Physician Do for My Dizziness? The doctor will ask you to describe
your dizziness, whether it is light headedness or a sensation of motion, how
long and how often the dizziness has troubled you, how long a dizzy episode
lasts, and whether it is associated with hearing loss or nausea and vomiting.
You might be asked for circumstances that might bring on a dizzy spell. You
will need to answer questions about your general health, any medicines, you
are taking, head injuries, recent infections, and other questions about your
ear and neurological system.
Your physician will examine your ears, nose, and throat and do tests of nerve
and balance function. Because the inner ear controls both balance and hearing,
disorders of balance often affect hearing and vice versa. Therefore, your physician
will probably recommend hearing tests (audiograms). The physician might order
skull X rays, a CT or MRI scan of your head, or special tests of eye motion
after warm or cold water is used to stimulate the inner ear (ENG - electronystagmography).
In some cases, blood tests or a cardiology (heart) evaluation might be recommended
Not every patient will require every test. The physician's judgement will
be based on each particular patient. Similarly, the treatments recommended
your physician will depend on the diagnosis.
What Can I Do to Reduce Dizziness?
Avoid rapid changes in position, especially from lying down to standing up
or turning around from one side to the other.
Avoid extremes of head motion (especially looking up) or rapid head motion
(especially turning or twisting).
Eliminate or decrease use of products that impair circulation, e.g. nicotine,
caffeine, and salt.
Minimize your exposure to circumstances that precipitate your dizziness, such
as stress and anxiety or substances to which you are allergic.
Avoid hazardous activities when you are dizzy, such as driving an automobile
or operating dangerous equipment, or climbing a step ladder, etc
What Can I Do for Motion Sickness? Always ride where your eyes will see the
same motion that your body and inner ears feel, e.g. sit in the front seat
of the car and look at the distant scenery; go up on the deck of the ship
and watch the horizon; sit by the window of the airplane and look outside.
In an airplane choose a seat over the wings where the motion is the least.
1. Do not read while traveling if you are subject to motion sickness, and
do not sit in a seat facing backward.
2. Do not watch or talk to another traveler who is having motion sickness.
3. Avoid strong odors and spicy or greasy foods immediately before and during
your travel. Medical research has not yet investigated the effectiveness of
popular folk remedies such as soda crackers and & Seven Up® or cola
syrup over ice.
4. Take one of the varieties of motion sickness medicines before your travel
begins, as recommended by your physician.
Some of these medications can be purchased without a prescription (i.e., Dramamine®,
Bonine®, Marezine®, etc.) Stronger medicines such as tranquilizers
and nervous system depressants will require a prescription from your physician.
Some are used in pill or suppository form.
Remember: Most cases of dizziness and motion sickness are mild and self-treatable
disorders. But, severe cases and those that become progressively worse, deserve
the attention of a physician with specialized skills in diseases of the ear,
nose, throat, equilibrium, and neurological systems.
If you have further questions about Dizzness and Motion Sickness, please feel
free to contact our office.
& Motion Sickness
Altitude & Airplanes