I have been suffering with lightheadedness without vertigo for 9 months. It lasts only a second or two, but comes in waves. It normally doesn't start until I have been awake for several hours, but seems to be connected to motion and is accompanied by a buzzing sound. It was diagnosed as severe cervical spinal stenosis and surgery was performed 3 weeks ago. The dizziness (without vertigo) has now returned! Are there any other causes of this type of dizziness?

Question

I have been suffering with lightheadedness without vertigo for 9 months. It lasts only a second or two, but comes in waves. It normally doesn't start until I have been awake for several hours, but seems to be connected to motion and is accompanied by a buzzing sound. It was diagnosed as severe cervical spinal stenosis and surgery was performed 3 weeks ago. The dizziness (without vertigo) has now returned! Are there any other causes of this type of dizziness?

Answer

We can divide dizziness into three categories: vertigo, disequilibrium, and lightheadedness. Vertigo is the sensation of spinning, often associated with nausea and vomiting; either you are spinning or the world is spinning around you. Disequilibrium is the feeling of being off balance; you feel that you can't walk a straight line, but you're not spinning. Lightheadedness is everything else; your head is floating or even heavy, but you don't fit into the other two categories. When you have a problem with dizziness, you can fit into one category, two of the categories, or all three, at different times during the episode.

A normal MRI eliminates many nasty things that can cause dizziness; these include an acoustic neuroma, stroke, brain cancer, and multiple sclerosis. An electronystagmogram (ENG), if it has not already been done as part of your ENT evaluation, can help rule-in or -out the inner ear as the source of your problem.

There is a little understood problem where spasms of the muscles of the neck can cause dizziness. We call this cervical vertigo. With the neck problems and surgery you describe, it is likely there is an associated muscle spasm. You should discuss this with your neurosurgeon and an ENT physician. A combination of medication and physical therapy (rehabilitation) is often very helpful.