Ear & Balance
Giddiness, dizziness, “kong kong” and vertigo – Are they the same?
February 1, 2020
Are you confused by these terms used by different people and doctors? Not to worry! Dr Gan will explain what they mean. Giddiness and dizziness are terms often used interchangeably. They have the same meaning – it is a broad term used to describe a feeling that there is a loss of balance in the body. Giddiness may mean different things to different patients. Hence it is important for you to describe what you are feeling as accurately as possible to your doctor when you feel “giddy” or “dizzy”.
In his ENT practice, the types of giddiness commonly encountered by Dr Gan are as follows:
Vertigo is a type of giddiness in which patients feel that the room is spinning or they themselves are spinning. Most patients with vertigo often feel nauseous or vomit during an attack. Fortunately, majority of vertigo are not due to a serious health problem and are often due to a problem of the inner ear balance system.
Some of the common causes of vertigo include:
- · Benign paroxysmal positional vertigo (BPPV) – Due to calcium or “stones” in the inner ear balance system that moves during head movements. This sends the wrong signals to the brain telling the brain that the environment is moving when it actual fact it is not. The vertigo is triggered by head movements and usually last a few seconds or minutes. BPPV can be easily treated with a manoeuvre performed in the clinic to “roll out” the stones.
- · Vestibular neuronitis – This is usually due to a viral infection or inflammation of the nerve that carries information about the body’s sense of balance from the inner ear to the brain. It may occur after a cold or flu. Apart from vertigo, patients may also experience a ringing sound in their ear (tinnitus). This condition usually gets better on its own although there are anti-giddiness tablets that can be taken to make the patient feel better.
- · Acute Labryrinthitis – This is a viral infection or inflammation of the inner ear organ of balance. In addition to vertigo, patients may experience tinnitus and a decreased hearing in one ear. Your doctor may order investigations (blood tests and imaging) to rule out other conditions that may cause similar symptoms. Treatment usually includes anti-giddiness tablets and a course of oral steroids (which may help improve the level of hearing and reduce giddiness).
- · Meniere’s disease – This is a condition in which there is high pressure in the inner ear balance system. The cause is often unknown and multiple hypothesis have been suggested. Patients with classic Meniere’s disease often describe having fullness or a blocked feeling in one ear, followed by a ringing sound in the ear and vertigo. The vertigo may last from minutes to days. The treatment of Meniere’s disease is complex and may include dietary modificaitons (reducing salt intake), medications and even surgery in severe cases.
As vertigo can be distressing and significantly impairs quality of life, patients with frequent vertigo should visit their General Practitioner or an ENT (Ear, Nose & Throat) Specialist for assessment. If in addition to vertigo, you have warning symptoms such as slurring of speech, feeling like passing out or have passed out, having weakness in the arms and legs, you should visit the Accident and Emergency Department to ensure that it is not due to a serious health problem.
2. Feeling faint or lightheaded
Lightheaded or feeling faint is a type of giddiness in which the patient may feel like passing out. This is usually due to a decrease in blood circulation to the brain. There can be numerous causes of lightheadedness including low blood pressure, low blood level (anaemia), dehydration, medications and many more, including serious conditions such as stroke and heart disease. Patients with lightheadedness should visit their General Practitioner first to have a thorough assessment to determine the cause of this type of giddiness. If your General Practitioner is worried of a more serious health concern, he or she may refer you to a Cardiologist (Heart Specialist) or Neurologist (Brain Specialist).
3. Feeling spaced out”, “drowsy” or “kong-kong (commonly used Hokkien term)
It is a type of giddiness that is often due to low blood level (anaemia), low blood sugar level, alcohol, medications, stress and anxiety. Patients should visit their General Practitioner first to have an assessment.
Dysequilibrium is the loss of balance or feeling unsteady when you walk. It is not uncommon amongst elderly patients, when the feedback from the eyes, joints and muscle to the brain on the body’s position has deteriorated. In a Singaporean context, many patients also describe this as a “kong-kong” feeling, making it challenging for the assessing doctor. Dysequilibrium can also be an inner ear problem or a condition in the brain. Hence a General Practitioner should assess such patients first and refer to an ENT Specialist or a Neurologist if necessary.