Brief Answer:
Symptoms can reflect a benign process or something more serious

Detailed Answer:
I'm sorry that your wife is feeling ill but on the simple description of awakening with dizziness, nausea, and vomiting in a 64 year old woman (who I'm assuming is otherwise healthy)- the differential can be anything as simple as mild viral illness to include affectation of the inner ear (viral labrynthitis) to something she had to eat last night that was not agreeable to her stomach to more complicated and urgent problems such as cardiovascular or cerebrovascular problems including heart attack or stroke. Typically, with the latter 2 entities there would be expected other symptoms such as chest pain with radiation to the shoulders and/or jaw, shortness of breathing, and cold clammy sweating. If it were stroke or aneurysmal bleed in the brain usually the nausea and vomiting are quite severe and noticeable changes in her neurological condition would be noted such as weakness over one side of the body, speech/language difficulties, and in the worst case scenario her mental status would be deteriorated or deteriorating.

Since I am answering your question from a remote location and have no idea what your wife's prior health status actually is or what she is being controlled for by medication or anything else I would advise that you (and your wife if she's able) make a decision whether or not 911 should be called to at least get a set of vital signs and get another pair of eyes, ears, and hands into the situation quickly to assess whether in fact, there is a need to transport your wife to an Emergency Facility for further workup. They will likely get some O2 on her, get an EKG, measure vital signs, and check her level of mentation and mental status. They will transport if they think anything is looking like it needs higher level service or evaluation by a specialty physician.

Again, this is a decision only you and your wife can make. I usually tell people that making an overcall in situations like this almost never gets the patient in trouble while thinking it's nothing and letting it go..certainly can lead to urgent complications for which you WILL BE SCRAMBLING to get emergency services at a time when it will be obvious that they should've been called before.

As a neurologist, I always treat patients with your wife's symptoms as potential emergencies until I can know that it is otherwise.

My hope is that your wife quickly and completely recovers without incident.

If I've satisfactorily addressed your questions could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback on your opinion as to our transaction?

Many thanks for posing your question to our attention on this network and do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 12 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

---