## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) - [Non-Movement Symptoms](/understanding-parkinsons/non-movement-symptoms) ## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) - [Non-Movement Symptoms](/understanding-parkinsons/non-movement-symptoms) # Vertigo, Dizziness & Low Blood Pressure ## 💡 Quick Summary - Dizziness, vertigo and balance problems are common in Parkinson’s, often caused by neurogenic orthostatic hypotension, [medications](/living-with-parkinsons/treatment/prescription-medications "Prescription Medications"), or age-related vestibular issues. - Managing symptoms includes monitoring blood pressure, staying hydrated, wearing compression garments, eating small meals, [exercising](/living-with-parkinsons/treatment/exercise "Exercise") gently and changing positions slowly. - Other causes should be evaluated by a doctor to ensure proper treatment and safety. ![Man standing with hand on head while feeling dizzy](/sites/default/files/styles/no_sizing/public/images/vertigodizziness_0.jpg?itok=seUL6NQW) **Dizziness** and **vertigo** are commonly reported symptoms in people with Parkinson’s disease (PD). Dizziness is a term used to describe a range of sensations, such as being on the verge of fainting, feeling woozy, weak or unsteady. Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo. All types of dizziness can lead to balance problems. In general, both symptoms are less notable in people in the early [stages of Parkinson’s](/understanding-parkinsons/what-is-parkinsons/stages "Stages of Parkinson's"). It is more common for older people with Parkinson’s to experience dizziness or vertigo. When tested, many people with PD experience vestibular dysfunction (balance issues related to the inner ear) even without having symptoms of vertigo or dizziness. While these [non-movement symptoms](/understanding-parkinsons/non-movement-symptoms "Non-Movement Symptoms") are common, they are often overlooked. To optimize your treatment, know how to identify vertigo and dizziness, so you can address the issue with your care team. ## Causes ### Orthostatic Hypotension (OH) **Postural low blood pressure, also called orthostatic hypotension** **(OH)**, is a drop in blood pressure that happens when you go from a seated position or lying down to standing. Certain medications (including those for high blood pressure), dehydration and conditions such as heart disease increase this risk. When orthostatic hypotension is related to a neurologic disorder like Parkinson’s, it’s called **neurogenic orthostatic hypotension (nOH)**. Damage caused by nervous system disorders, including Parkinson’s, can result in the nervous system not being able to make or release norepinephrine, a chemical that constricts blood vessels and raises blood pressure. This causes dizziness or lightheadedness. Neurogenic orthostatic hypotension tends to be underdiagnosed. It is usually identified because people experience **dizziness** or **lightheadedness** when they stand up. Other nOH symptoms include: - **Weakness** - **Difficulty thinking** - **Headache** - **Blurred or dimmed vision** In early Parkinson's, you might not notice dizziness, but experience foggy thinking or memory problems. ## Managing nOH If you become lightheaded upon standing, report it to your doctor. In general, ask your doctor to screen you for nOH once a year. This is done by taking your blood pressure while lying down and then standing. A drop of 20 points in the top number (systolic) or 10 points in the bottom number (diastolic) indicates nOH. If you receive a diagnosis of nOH, talk to your doctor about reducing or eliminating certain medications (such as antihypertensives, medications that bring down blood pressure, and some dopaminergic medications, those that boost parts of the brain influenced by dopamine). - ### Lifestyle Strategies to Try - Monitor your [**blood pressure**](/library/fact-sheets/blood-pressure "Low Blood Pressure and PD"). - Drink more fluids (water or electrolyte water) to keep hydrated, at least one cup (8 ounces) with meals and two more at other times of the day. If you expect to be standing for a long period of time, quickly drinking two 8-oz glasses of cold water can help increase blood volume and keep blood pressure higher for several hours. - Practice regularly gentle exercise and avoid long periods of inactivity. - Eat small, frequent meals. Avoid hot drinks and hot foods. If your doctor agrees it is safe, increase your salt intake (such as by eating prepared soups or pretzels). Note: people with heart and/or kidney diseases should avoid this strategy unless approved by their physicians. - Wear thigh-high compression stockings and/or abdominal binders. Compression garments such as antigravity stockings can be effective in preventing OH. - Sleep with the head of your bed elevated/tilted up between 10 and 30 degrees. - Do isometric exercises, such as marching your legs slowly in place, before getting up. - Change positions slowly, especially when rising from a seated to a standing position. Pause for several seconds between each move. - ### ​​​​​​​Behaviors and Circumstances to Be Aware Of - Exposure to heat - Fever - Prolonged standing - Vigorous exercise - Drinking alcohol - Straining while going to the bathroom - Meals high in carbohydrates ### Medication-induced Dizziness or Vertigo Other common drugs associated with dizziness or vertigo (a spinning sensation) include anticonvulsants, antihypertensives, antibiotics, antidepressants, antipsychotics, pain medications and anti-inflammatory drugs. With the help of your doctor, this medication-related issue can be treated by weaning the dosage and slowly discontinuing the drug or drugs causing the side effect. ### Deep Brain Stimulation A surgical procedure for PD, [deep brain simulation (DBS)](/living-with-parkinsons/treatment/surgical-treatment-options/deep-brain-stimulation "Deep Brain Stimulation (DBS)") can be associated with dizziness or vertigo. Either symptom can emerge soon after surgery. A health professional can determine if the dizziness is caused by the device by simply powering it on and off. Once the device is turned off, your care partner or medical team should observe you to confirm if the dizziness or vertigo resolves. If it does resolve, your healthcare team may reprogram the device and possibly check the location of the electrodes (usually by brain imaging). When turning the device on and off is not enough, an evaluation by an ENT specialist may be necessary. ### Benign Paroxysmal Positional Vertigo (BPPV) This is a sudden onset of vertigo, lasting only a few seconds, typically after a sudden head movement such as turning in bed. Research reveals BPPV may occur in 11% of people with Parkinson's who experience dizziness and becomes more common with age. It can be diagnosed using an in-office assessment called the [Dix-Hallpike maneuver](https://www.youtube.com/watch?v=wgWOmuB1VFY). Your doctor, or a physical therapist who is an expert in vestibular rehabilitation can offer treatment options or teach you the [Semont maneuvers](https://www.youtube.com/watch?v=pK9qaprUU64), a series of simple movements to self-administer at home. ### Transient Ischemic Attack or Stroke Sudden onset of dizziness, usually in the presence of other sudden onset neurological symptoms, could possibly be a transient ischemic attack “TIA” (a brief stroke-like attack) or stroke. *If a stroke is suspected, you should seek emergency medical attention immediately and undergo appropriate imaging and potentially stroke-related therapies.* ### Other Causes Dizziness and vertigo are not unique to Parkinson’s and can have many other causes. Symptoms can be caused by [anxiety](/understanding-parkinsons/non-movement-symptoms/anxiety "Anxiety"), cold, flu, dehydration, heart conditions, migraine, among others. Tell your doctor if you regularly experience dizziness or vertigo. ### Orthostatic Hypotension Treatments When experiencing lightheadedness due to OH, these treatments can help: - Stay hydrated (drinking 6-8 glasses of water a day) - Wear compression stockings and abdominal binders - Elevate the head of your bed during sleep - Move the legs before standing — this can pump blood into the body, potentially lessening symptoms - Avoid getting up too quickly, especially when first getting out of bed, when you have been seated for a long period, or when getting up from the commode - Increase salt in your diet - Eat smaller meals if lightheadedness is worse after a large meal - Work with your doctor to adjust medications that worsen OH - Consider prescription medications, such as Florinef, Midodrine, Droxidopa, Mestinon or salt tabs that can raise blood pressure *Page reviewed by Dr. Addie Patterson, Movement Disorders Neurologist at the Norman Fixel Institute for Neurological Diseases at the University of Florida, a Parkinson’s Foundation Center of Excellence.* ## Related Materials Fact Sheets ### [ Pain in Parkinson's Disease ](/library/fact-sheets/pain) [Read Now](/library/fact-sheets/pain) Fact Sheets ### [ Nutrition and PD ](/library/fact-sheets/nutrition) [Read Now](/library/fact-sheets/nutrition) Fact Sheets ### [ Medications for Non-motor Symptoms ](/library/fact-sheets/medications-nonmotor-symptoms) [Read Now](/library/fact-sheets/medications-nonmotor-symptoms) ## Related Blog Posts ![Couple filling out survey together](/sites/default/files/styles/500x360/public/images/english-2026-community-survey-blog-hero.jpg?h=ed9ce7df&itok=1n7O60Ql) Raise Awareness ### [ Insights from our 2026 State of the Community Survey ](/blog/awareness/2026-community-survey) READ NOW ![Woman using tablet outside](/sites/default/files/styles/500x360/public/images/mental-wellness-resources-blog-hero.jpg?h=ed9ce7df&itok=sTWEmceG) Raise Awareness ### [ Caring for the Mind: 10 Parkinson’s Mental Wellness Resources ](/blog/awareness/mental-wellness-resources) READ NOW ![Nurse helping senior woman stand](/sites/default/files/styles/500x360/public/images/science-news-oh-preview.jpg?h=9105c3fe&itok=QBWJo9Rk) Science News ### [ Orthostatic Hypotension in Parkinson’s Raises Long-Term Fall Risk ](/blog/science-news/orthostatic-hypotension) READ NOW ### Order a Parkinson’s Hospital Safety Guide The Hospital Safety Guide is a resource for people with Parkinson's and their care partners filled with useful tools and information to prepare for and navigate a hospital stay. 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