Content

Introduction

Introduction

Dizziness is a symptom rather than a pathological condition. Generally, they are caused by problems with balance that involve the functioning of the inner ear, but they can also be caused by problems that arise in some parts of the brain.

Dizziness causes the sensation that the person, or the surrounding environment, is moving or rotating. This perception can be mild, or so strong that it does not allow you to maintain balance and carry out daily activities.

Depending on the triggering cause of dizziness, other disturbances (symptoms) may appear, such as, for example, high temperature, ringing in the ears (tinnitus or tinnitus), hearing loss.

Attacks of vertigo can come on suddenly and last from a few seconds to a few hours; more severe dizziness can last for days or months. The constant presence of dizziness can make everyday life very difficult.

In most cases, the dizziness improves and disappears without treatment. If you repeat episodes of dizziness affecting daily life, it is advisable to contact your GP to ascertain the cause.

Causes

Causes

Vertigo is a sign (symptom) of various diseases or conditions. There are two types of vertigo, known as peripherals Andcentral depending on the cause.

Peripheral vertigo

Peripheral vertigo is the most common type and is caused by an alteration of the inner ear (vestibule) which is the organ of balance. The most common causes include:

    • changes in head position (benign paroxysmal positional vertigo)
    • head injuries
    • inner ear infection (labyrinthitis)
    • inflammation of the vestibular nerve (vestibular neuronitis)
    • Ménière's disease
    • taking certain medications

Benign paroxysmal positional vertigo

It is one of the most common causes of dizziness and is characterized by short episodes of dizziness lasting about 15-30 seconds, caused by changes in the position of the head (for example, getting up, bending over, or turning over in bed). It is believed to occur when calcium oxalate crystals (otoliths), which are contained in the inner ear and control head movements, move to the back and inside of the ear canal (semicircular canals).

Attacks of vertigo can be repeated and are often accompanied by nausea, although vomiting is rare. During this type of vertigo the eyes move in a rhythmic and uncontrollable way (nystagmus).

Head injuries

Vertigo can sometimes develop after a head injury.

Labyrinthitis

Labyrinthitis is an "inflammation of part of" the inner ear (the labyrinth). When this happens, the information reaching the brain is different from that sent by healthy ears and eyes; disturbed signals cause dizziness and dizziness.

Labyrinthitis is usually caused by a "viral infection, such as the common cold or the flu, which spreads through the labyrinth. More rarely, it is caused by a" bacterial infection.

The dizziness caused by labyrinthitis can be accompanied by nausea, vomiting, hearing loss, tinnitus (tinnitus), and sometimes a high fever and ear pain.

Vestibular neuronitis

Vestibular neuronitis, also known as vestibular neuritis, is caused by inflammation of the vestibular nerve (one of the nerves in the ear responsible for balance). In some cases, the labyrinth can also be inflamed. It is believed to be caused by a viral infection. It usually goes wild suddenly and can cause other ailments, such as unsteadiness, nausea, and vomiting. Generally, there is no hearing problem. It can last a few hours or days, but it can take several weeks to fully recover.

Ménière's disease

It is a rare disease that affects the inner ear. A typical episode may begin with a feeling of pressure in the ear, with perception of ringing (tinnitus) and decreased hearing, followed by severe dizziness, often accompanied by nausea and Vomiting Episodes of vertigo can last two or three hours and recur over time, interspersed with long periods of well-being.

Dressings

Dizziness can occur as an undesirable effect (side effect) of some types of medications. For this it is advisable to consult the leaflet provided with the drug to see if dizziness is listed as possible side effects. However, it is advisable to consult your doctor.

Central vertigo

Central vertigo is caused by problems in one part of the brain, such as the cerebellum (located behind and below the brain) or the brainstem (located between the brain and spinal cord). Causes of central vertigo include:

  • migrainea severe headache that is usually felt as a throbbing pain in the front or side of the head, especially common in young people
  • multiple sclerosis,a disease affecting the central nervous system (the brain and spinal cord)
  • acoustic neuroma, rare benign brain tumor involving the auditory nerve, the nerve responsible for auditory perception and balance
  • brain tumor or metastasis
  • transient ischemic attack (TIA) or stroke - which causes part of the blood flow to the brain to be cut off
  • taking certain types of medications
Diagnosis

Diagnosis

To ascertain dizziness, the attending physician will carry out some checks and ask for information about:

  • disturbances (symptoms) associated with the first episode of dizzinessfor example, the sensation of being lightheaded or that the surrounding environment is spinning
  • presence of other disturbances, such as hearing loss, ringing in the ear (tinnitus), nausea, vomiting or a feeling of pressure in the ear
  • frequency and duration of vertigo
  • influence of vertigo on daily activities, for example whether or not you are able to walk during a dizzy episode
  • factors that trigger or make them worse, like moving your head in a particular direction
  • elements that improve ailments

The primary care physician may also perform a medical examination to check for any diseases that may be causing dizziness. You may be able to control your balance or try to make you feel dizzy by asking you to move quickly from a sitting position to a lying position.
Depending on the type of disorder that has appeared, you may recommend that you go to a specialist for further tests. In the event of tinnitus (ringing in the ears) and hearing loss, your general practitioner may prescribe a visit to the otolaryngologist, a doctor who specializes in diseases affecting the ear, nose or throat. a neurologist, a medical specialist in the treatment of diseases affecting the nervous system.

Therapy

Therapy

Treatment of vertigo depends on the cause and severity of the complaints. There are specific treatments for some types of vertigo. For example, a series of simple head movements (known as the Epley maneuver) is used to treat benign paroxysmal positional vertigo.

Medicines can help in the early stages and in most cases of dizziness.

Many people with vertigo benefit from vestibular rehabilitation, which consists of a series of exercises designed for people with dizziness and balance problems.

To relieve dizziness and reduce the number of attacks, there are a few things to do:

  • relax in a lying position, in a quiet, dark room to reduce the sensation of rotation
  • sleep with your head raised slightly, on two or more pillows
  • get out of bed slowly, sit on the edge of the bed for about a minute before standing up
  • sit down immediately when you feel dizzy
  • avoid bending over to pick up items
  • avoid stretching the neck, for example when you want to reach a high shelf
  • move your head slowly and carefully, during daily activities
  • use a walking stick, if you are at risk of falling
  • try to avoid stressful situations, as anxiety can make dizziness worse

Labyrinthitis

Labyrinthitis is usually caused by a "viral infection and clears up on its own without treatment. In the rare cases where labyrinthitis is caused by a" bacterial infection, antibiotics may be prescribed. Labyrinthitis can also be cured with vestibular rehabilitation.

Vestibular neuronitis

Vestibular neuronitis disorders (symptoms) often improve without treatment after several weeks. However, you may need to rest in bed if your complaints are severe. It is recommended that you go to your doctor if your complaints worsen or do not improve after a week. Vestibular neuronitis can also be treated with vestibular rehabilitation and medication.

Benign paroxysmal positional vertigo

Like vestibular neuronitis, benign paroxysmal positional vertigo often resolves on its own after several weeks or months.
It can be cured using a procedure called Epley maneuver. It consists in performing four separate movements of the head to reposition the crystals (otoliths) that cause dizziness to a point where they can no longer cause disturbances. Dizziness may occur during the movements. Shortly after the execution of the Epley maneuver the disturbances they should improve, although it can sometimes take up to two weeks for complete recovery.

Ménière's disease

There are several treatment options for vertigo and other ailments caused by this disease. They include:

  • diet, especially a low-salt diet to reduce the pressure of the inner ear fluids
  • medications (antihistamines, antiemetics)
  • therapies for the treatment of tinnitus (ringing in the ears)
  • use of hearing aids for hearing loss
  • physiotherapy for balance problems
  • treatment of disorders induced by Ménière's disease, such as stress, anxiety and depression

Central vertigo

If your primary care physician suspects central vertigo, they may recommend that you see a neurologist or otolaryngologist. If the vertigo is caused by migraines, proper treatment could alleviate the pain.

Vestibular rehabilitation

Vestibular rehabilitation aims to abolish or reduce balance disorders. It is aimed, according to the diseases in progress, to reprogram the "equilibrium apparatus" so that the brain can use not the vestibular system (malfunctioning) but, in its place, other sensory systems. It consists in the execution of a particular program of exercises with which the brain is taught to use the sight and perception of the position of the body in space (proprioceptivity) to maintain balance. By relying on other signals, the brain minimizes dizziness and helps maintain balance. The vestibular rehabilitation program is managed by the physiotherapist who uses a variety of exercises, conditioning and behaviors to replace the malfunctioning vestibular system.

Medicines

Medicines can be used to treat episodes of dizziness caused by vestibular neuronitis or Ménière's disease. They can also be used for central vertigo or vertigo with an unknown cause.
The two types of drugs that are prescribed most frequently are:

  • antiemetics, used to relieve nausea and vomiting
  • antihistamines, used to reduce the pressure build-up in the inner ear

Safety

If you suffer from vertigo, there are some safety concerns to consider. For instance:

  • inform the employer if you engage in any activity that involves the use of machinery or requires you to go up / down stairs
  • be aware that you are at greater risk of falls

Dizziness can also affect driving ability. Driving should be avoided if recent episodes of dizziness have occurred and there is a possibility of recurrence.

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