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Dizziness and vertigo are common, often overlooked non-movement symptoms in Parkinson's disease. Recognizing symptoms like these can help you discuss optimal treatments with your care team.
Dizziness can make a person feel faint, weak, or unsteady. Vertigo is dizziness that causes someone to feel as if they, or their surroundings, are spinning or moving.
Dizziness or fainting is an early sign of Parkinson's disease. If you become lightheaded upon standing, report it to your doctor. Addressing dizziness and vertigo can help you live better with Parkinson's. Your doctor will ask questions about your symptoms, perform a checkup, and possibly tests to diagnose the cause of vertigo. Many causes unrelated to Parkinson's can cause dizziness and vertigo, including anxiety, a cold, the flu, dehydration, migraine, heart conditions, and stroke.
The primary causes of dizziness and vertigo in Parkinson's include: 1) orthostatic hypotension; 2) neurogenic orthostatic hypotension; 3) medication-induced dizziness or vertigo; 4) deep brain stimulation, or DBS; and 5) benign paroxysmal positional vertigo.
Orthostatic hypotension, or OH, also called postural low blood pressure, is a drop in blood pressure when a person rises from lying or sitting down. Medications, including those for high blood pressure, as well as dehydration, heart disease, and other health conditions, can increase this risk.
Talk to your doctor about tailoring your medication therapies to minimize dizziness or taking medications that can raise your blood pressure. If you have orthostatic hypotension, these lifestyle tips may help: Move your legs before standing to pump blood into your body. Change positions and/or rise slowly. Pause in between movements. Drink six to eight glasses of water daily. Wear compression stockings. Increase salt in your diet. Eat smaller, more frequent meals if heavy meals increase dizziness.
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Neurogenic orthostatic hypotension, or NOH, is a type of low blood pressure related to nervous system disorders. In Parkinson's and certain other diseases, the body makes less norepinephrine, a chemical that raises blood pressure. This can cause a significant blood pressure drop upon standing.
In early PD, a person might only experience memory problems as a symptom of NOH. Weakness, thinking difficulties, headache, and blurry or dimmed vision can also be NOH symptoms.
Talk to your doctor about adding medications that can raise your blood pressure or adjusting other medications. These tips may help if you experience NOH: Drink two eight-ounce glasses of cold water quickly to increase blood volume and boost blood pressure. The benefits can last hours. Practice regular, gentle exercise. Minimize high-carbohydrate meals and alcoholic beverages.
Anticonvulsants, antihypertensives, antibiotics, antidepressants, antipsychotics, pain medications, and anti-inflammatory drugs are among the medications linked to vertigo.
Discuss your prescription drug regimen with your doctor, who can recommend adjustments to reduce lightheadedness. Dizziness or vertigo symptoms can occur soon after deep brain stimulation, a Parkinson's surgical therapy.
A healthcare professional can power the device off and on and observe whether the device could be the cause of dizziness. If your symptoms improve when the device is off, your healthcare provider might reprogram it and use brain imaging to check the location of the electrodes. If symptoms do not improve, it might be necessary to see an otolaryngologist, or ear, nose, and throat doctor.
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More than 10% of people with PD can experience benign paroxysmal positional vertigo, or BPPV, a sudden, brief dizziness due to head movement.
BPPV is short-lived and often caused by a sudden head movement. It can become more common with age. If BPPV is suspected, your doctor can diagnose it using an in-office test called the Dix-Hallpike maneuver. Your doctor may recommend physical therapy to reduce symptoms.
Abrupt dizziness, often accompanied by other sudden-onset symptoms of the nervous system, could be a stroke or a transient ischemic attack, a brief stroke-like attack. Seek emergency medical attention immediately if you suspect a stroke.
It's important to remember that you are not alone. If you would like more information on Parkinson's disease, dizziness, and vertigo, visit Parkinson.org or call the Parkinson's Foundation Helpline at 1-800-4PD-INFO.
