A 65-year-old female patient with a history of high blood pressure came to the emergency room experiencing dizziness, followed by double vision and weakness on the right side of her body. She was diagnosed with a cerebral infarction in the brainstem. It was later found that she had previously experienced recurring episodes of dizziness and occasional near-fainting (presyncope).
When experiencing vertigo or dizziness, many people tend to brush it off — when in reality, it can be the body’s warning signal pointing to various underlying conditions. It is important to see a doctor promptly when symptoms occur.
Vertigo vs. Dizziness — What’s the Difference?
Most people assume vertigo and dizziness are the same thing, but doctors distinguish between them for diagnosis:
- Vertigo — a sensation that you or your surroundings are spinning
- Dysequilibrium — a feeling of instability or imbalance
- Presyncope — a near-fainting sensation
- Dizziness — a general lightheaded or woozy feeling
Vertigo is an illusion of movement, typically horizontal and rotational. Nausea and vomiting associated with vertigo often indicate an ear-related cause rather than a brain-related one. Studies show that approximately one-third of patients with dizziness experience vertigo.
Dysequilibrium occurs when the brain receives insufficient information about the body’s position from the sensory and balance systems. It may result from peripheral neuropathy, eye conditions, or balance disorders.
Presyncope is caused by cardiovascular abnormalities that reduce blood flow to the brain, leading to a near-fainting feeling.
What Causes Dizziness & Vertigo?
- Central nervous system disorders, most commonly involving the cerebellum
- Ear-related conditions such as Meniere’s disease or benign paroxysmal positional vertigo (BPPV)
- Neurological conditions such as TIA, stroke, Parkinson’s disease, or certain types of migraine
- Circulatory disorders such as orthostatic hypotension (drop in blood pressure upon standing)
- Side effects from certain medications
- Eye conditions such as cataracts, glaucoma, or retinal degeneration
- Other conditions such as high blood pressure, thyroid disorders, anemia, electrolyte imbalances, or abnormal cholesterol levels
When Should You See a Doctor?
- Dizziness lasting more than 1 week or not improving with medication
- Unsteady walking or inability to maintain balance
- Accompanied by neurological symptoms such as limb weakness, numbness, speech difficulties, or visual disturbances
- Dizziness following an accident or head injury
For any concerns, you can make an appointment or consult with the Neuroscience Center team at Bangkok Hospital Pattaya.
