- Dizziness - definitions
- Dizziness - causes
- Dizziness - symptoms and types
- Dizziness - diagnostics
- Dizziness - treatment
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Dizziness can happen for many different reasons. They can be caused by labyrinth diseases, too low blood pressure, migraine or medications taken by the patient. In the case of frequent dizziness, it is necessary to conduct a thorough diagnosis, because before treating dizziness, it is necessary to find out what is causing it. What are the types of vertigo?
Dizzinessbelongs to the group of the most common symptoms in patients. They can be caused by various problems: dizziness can result from labyrinth disorders, and can be caused by too low blood pressure or migraine, it also happens that they are a side effect of medications taken by the patient.
Dizziness belongs to a group of he alth problems that every person will encounter at some point in their life - after all, they can be experienced even when the body position changes too rapidly (especially from lying down to standing) . The incidence of the problem is quite high - according to statistics, long-term dizziness is found in up to 30% of adults and up to 18% of children.
In case of frequent dizziness in a patient, it is necessary to carry out thorough diagnostics - in order to free him of this ailment, it is necessary to detect and then treat the problem that led to them.
Dizziness - definitions
Dizzinesscan be experienced in a variety of ways depending on the person experiencing it. There are, however, two types of vertigo in the medical literature.
The first issystemic dizziness , characterized by the fact that the patient has the impression that he or she is moving (circular or spinning) in relation to the environment or vice versa, that the environment is spinning in relation to him.
The second type isnon-systemic dizziness , described as a vague feeling of uncertainty, instability when walking accompanied by the feeling of imbalance.
Dizziness - causes
Dizzinessmay occur when a person develops some dysfunction of the vestibular system, which is also referred to as the equilibrium system. It includes the labyrinth and the vestibular nerve (constituting the peripheral part of the organ of equilibrium) as wellvestibular nuclei of the brainstem, cerebellum, subcortical nuclei and cortical centers (being the central part of the organ of equilibrium).
It is generally accepted that the above-mentioned systemic dizziness originates from dysfunction of the peripheral part of the equilibrium organ, while non-systemic dizziness may occur in the case of dysfunction of the central part of the equilibrium organ.
Of course, there are many more reasons for vertigo than you might imagine. The problem may occur due to various ENT diseases - they may lead to dizziness:
- diseases of the outer ear (e.g. accumulation of excessive amounts of earwax within the ear)
- perlak
- Eustachian tube inflammation
- Méniere's disease
- labyrinthitis
- toxic damage to the labyrinth
- inner ear injury
- exposure to strong noise
The causes of vertigo include not only diseases in the field of laryngology interest, but also a number of neurological problems, such as:
- vascular diseases of the central nervous system (e.g. transient ischemic attacks)
- inflammation of the vestibular nerve
- head injuries
- multiple sclerosis
- brain tumors (vertigo can be caused primarily by neuromas of the vestibulocochlear nerve)
- epilepsy
- migraine
Dizzinessmay appear in connection with many other he alth problems - their occurrence may be fostered, among others, by such units as:
- depressive disorder
- hypertension
- anxiety disorders
- hypotension
- heart rhythm disturbance
- hypoglycemia
- hypothyroidism
- sleep disturbance
Sometimesdizzinessare not necessarily caused by a disease - sometimes they are a side effect of the patient taking some pharmaceuticals.
The drugs that may have this type of side effect include :
- antidepressants (e.g. serotonin reuptake inhibitors)
- vasodilators
- aminoglycosides
- antiepileptic drugs
- antipsychotics
- sleeping pills
- pain medications
Dizziness - symptoms and types
It would seem thatdizzinessis similar in all people, but in practice this is not the case and the problem manifests itself in different patientsdifferently depending on the exact kind of vertigo they are experiencing.
The most common type of vertigo ispositional vertigo- it is estimated to be responsible for 20 to even 40% of all cases of this problem.
One of their most distinctive features is that they only appear in motion. Their seizures last for a few to several seconds, and may be accompanied by nausea and vomiting.
Patients may also have nystagmus during an attack of positional vertigo. They may occur in the case of dysfunction of both the peripheral and central part of the equilibrium organ.
A slightly different nature of vertigo is experienced by patients who develop labyrinthitis. In this case, patients typically struggle with very strong, systemic dizziness, and the problem is accompanied by ailments such as nystagmus, vomiting and balance disorders. What is characteristic here, however, is that the patients do not have any hearing impairment.
Vascular diseases of the nervous system may also lead to the patient havingdizziness.Symptoms - e.g. in the case of transient ischemic attacks - are not only severe dizziness, but also other neurological disorders, such as transient paresis, double vision, sensory disturbances (e.g. in the form of paraesthesia) and dysarthria.
One of the conditions that are most associated with vertigo is Méniere's disease. In her case, patients experience systemic attacks of vertigo, which may be accompanied by tinnitus, a feeling of fullness in the ear, as well as nausea and vomiting.
In addition to those listed, patients with Méniere's disease may also experience hearing impairment, which worsens with each subsequent attack of vertigo and which gradually leads to hearing loss.
Patients suffering from epilepsy and people experiencing migraines can also struggle with dizziness. In the case of the first of these conditions, dizziness may be the basic symptom of epileptic seizures - this type of problem is called vestibular epilepsy.
It also happens that you experience severe dizziness before the seizure occurs (this is called the pre-seizure aura).
And in the case of migraine patients,dizzinesscan take the form of both systemic and non-systemic dizziness, and can last from several minutes to several hours.
Presbyastasis, on the other hand, is a problem that is a possible cause of vertigoin the elderly. It causes dizziness, but also balance disorders, gait disturbances and increased fear of falling. Presbyasty occurs due to disturbances in deep sensation and age-related involutional changes in the organ of balance, hearing and eyesight.
Dizziness - diagnostics
Considering how different the causes of vertigo can be, you can quickly come to the conclusion that it is not easy to determine its source. A patient with this type of problem often has to undergo a number of different diagnostic tests.
An initial medical interview is conducted with him - to come up with a guess what the etiology of the vertigo may be, it is important to know in what situations this symptom appears, how long it lasts, and whether it is accompanied by any other ailments.
The patient needs to perform basic tests - blood pressure measurement, pulse measurement on both upper limbs, and also the assessment of the carotid pulse.
In vertigo diagnostics, it is also necessary to perform a neurological examination (with particular attention to possible imbalances), as well as a basic hearing test, it is also recommended to perform an ophthalmological examination. Later - depending on the suspected cause of the problem - various tests may be ordered, such as:
- caloric tests (which are used to assess the functioning of the labyrinth)
- imaging tests (such as computed tomography or magnetic resonance imaging of the head)
- electroencephalography
- ultrasound of the carotid arteries
- laboratory tests (especially important in the case of suspicion that the cause of vertigo may be vascular diseases of the nervous system - in this case, the determination of parameters whose incorrect results suggest an increased risk of vascular incidents)
- EKG, echocardiography (ordered in patients whose dizziness may be related to e.g. arrhythmias)
- electronystagmography (a test to accurately assess nystagmus)
Dizziness - treatment
In the treatment of vertigo, there are three types of impacts that are important - there are measures to quickly stop dizziness, therapies based on the elimination of their causes, and methods to minimize the effects of damage to the labyrinth.
Preparations recommended for patients to stop a vertigo attack are characterized by various mechanisms of action andthey belong to different drug groups - there is no one ideal drug that would help all patients, so sometimes choosing an effective pharmaceutical for a given patient may take some time.
Drugs that can be used as an ad hoc treatment in the treatment of vertigo include:
- antihistamines (such as clemastine and promethazine)
- betahistine
- preparations from the group of calcium antagonists (e.g. verapamil, nimodipine)
- benzodiazepines (e.g. midazolam, clonazepam)
- hydroxyzine
- neuroleptics (e.g. haloperidol, promazine)
Accurate diagnosis of vertigo is crucial because in order to eliminate it, it is necessary to try to fix the problem that led to it. For this reason, the treatment of vertigo can be very different.
For example, in patients with Méniere's disease, patients are sometimes recommended to limit fluids and sodium intake, as well as take diuretics or drugs that block histamine receptors, and if conservative treatment is ineffective, they are sometimes subject to surgery.
In the case of vestibular neuritis, patients are mainly recommended to use emergency measuresdizziness , and they can also be given preparations from the group of glucocorticosteroids. In turn, when the cause of dizziness is epilepsy, cardiac arrhythmias, hypothyroidism or arterial hypertension, the most important thing is to strive for the best possible equalization of their course.
It has been mentioned above that in patients struggling with vertigo, the actions aimed at reducing the effects of damage to their vestibular system are also important.
In this case, the most important role is played by kinesiotherapy, which may result in the displacement of otoliths located in the semicircular ducts (changing their location may have beneficial effects due to the fact that these structures will not stimulate certain receptors during movement, which could result in dizziness). Regular rehabilitation can also help patients - especially the elderly.
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