Can Vertigo Cause Weakness: Understanding the Connection and Symptoms

15.05.197427.09.2021 by alexxlab

What are the main symptoms of vertigo. How does vertigo differ from general dizziness. Can vertigo lead to physical weakness. What are the common causes of vertigo. How is vertigo diagnosed and treated. Are there any home remedies for managing vertigo symptoms. When should you seek medical attention for vertigo.

Содержание

The Nature of Vertigo: More Than Just Dizziness

Vertigo is often misunderstood as simply feeling dizzy, but it’s a specific type of dizziness characterized by a sensation of spinning or movement when there is none. This disorienting condition can significantly impact a person’s daily life and may be accompanied by various other symptoms, including weakness.

Defining Vertigo

Vertigo is the perception that you or your surroundings are moving or spinning when they’re actually stationary. This sensation can be incredibly unsettling and may lead to a range of secondary symptoms.

Key Symptoms of Vertigo

Spinning sensation
Loss of balance
Nausea and vomiting
Headache
Sweating
Abnormal eye movements (nystagmus)
Ringing in the ears (tinnitus)

It’s important to note that vertigo is not a condition itself, but rather a symptom of various underlying conditions affecting the inner ear or brain.

The Link Between Vertigo and Weakness

While vertigo primarily affects balance and spatial orientation, it can indeed lead to physical weakness. This connection is multifaceted and can manifest in several ways.

Direct Effects of Vertigo on Muscle Strength

Vertigo doesn’t directly cause muscle weakness in the same way that a neurological disorder might. However, the intense dizziness and disorientation can lead to a perceived weakness or instability, particularly in the legs and core muscles responsible for maintaining balance.

Indirect Consequences of Vertigo

The weakness associated with vertigo is often a secondary effect of the condition:

Fatigue from constant balance compensation
Muscle tension from trying to maintain stability
Reduced physical activity due to fear of falling
Deconditioning from prolonged bed rest during severe episodes

These factors can contribute to a general sense of weakness or reduced physical capability in individuals suffering from chronic or recurrent vertigo.

Common Causes of Vertigo

Understanding the root causes of vertigo is crucial for proper diagnosis and treatment. While there are numerous potential causes, some are more common than others.

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common cause of vertigo, particularly in older adults. It occurs when tiny calcium crystals in the inner ear become dislodged and move into the semicircular canals, causing a false sense of movement.

Vestibular Neuritis or Labyrinthitis

These conditions involve inflammation of the inner ear or the vestibular nerve, often due to viral infections. They can cause sudden, severe vertigo that may last for days.

Meniere’s Disease

This inner ear disorder is characterized by episodes of vertigo along with fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear.

Migraine-Associated Vertigo

Some people experience vertigo as a symptom of migraine headaches, even without the presence of a headache.

Acoustic Neuroma

This rare, benign tumor on the vestibular nerve can cause gradual hearing loss and balance problems, including vertigo.

Diagnosing Vertigo: A Multifaceted Approach

Accurate diagnosis of vertigo is essential for effective treatment. Healthcare providers use a combination of methods to determine the underlying cause of vertigo symptoms.

Medical History and Physical Examination

The diagnostic process typically begins with a thorough medical history and physical examination. The healthcare provider will ask about the nature and duration of symptoms, any triggers, and associated symptoms like hearing loss or tinnitus.

Specialized Tests for Vertigo

Dix-Hallpike test: To diagnose BPPV
Electronystagmography (ENG) or Videonystagmography (VNG): To evaluate eye movements and inner ear function
Rotary chair testing: To assess the vestibulo-ocular reflex
Posturography: To measure balance and stability
Audiometry: To check for hearing loss

Imaging Studies

In some cases, imaging studies such as MRI or CT scans may be necessary to rule out structural abnormalities in the brain or inner ear.

Treatment Options for Vertigo

The treatment of vertigo depends on its underlying cause and can range from simple home remedies to medical interventions.

Repositioning Maneuvers

For BPPV, canalith repositioning procedures like the Epley maneuver can be highly effective in relocating the displaced calcium crystals in the inner ear.

Medications

Various medications can help manage vertigo symptoms:

Antihistamines: To reduce motion sickness
Anticholinergics: To control nausea and vomiting
Benzodiazepines: For short-term relief of anxiety and vertigo
Diuretics: For Meniere’s disease

Vestibular Rehabilitation Therapy

This specialized form of physical therapy aims to retrain the brain to process balance information more effectively, reducing vertigo symptoms over time.

Lifestyle Modifications

Certain lifestyle changes can help manage vertigo:

Avoiding triggers (e.g., certain head movements)
Staying hydrated
Managing stress
Getting adequate sleep
Avoiding alcohol and tobacco

Surgical Interventions

In rare cases where vertigo is caused by a structural problem or doesn’t respond to other treatments, surgery may be considered.

Home Remedies and Self-Care for Vertigo

While medical treatment is often necessary for vertigo, there are several home remedies and self-care strategies that can help manage symptoms and improve quality of life.

Ginger

Ginger has natural anti-nausea properties and may help alleviate some vertigo symptoms. It can be consumed as tea, supplements, or in its natural form.

Staying Hydrated

Proper hydration is crucial for maintaining the fluid balance in the inner ear, which is essential for proper balance and spatial orientation.

Head Position Exercises

Certain head position exercises, such as the Brandt-Daroff exercise, can be performed at home to help manage BPPV symptoms.

Mindfulness and Relaxation Techniques

Stress can exacerbate vertigo symptoms. Practicing mindfulness, deep breathing, or meditation can help reduce stress and may alleviate some vertigo-related discomfort.

Maintaining a Vertigo Journal

Keeping track of vertigo episodes, including potential triggers and the effectiveness of various treatments, can be helpful for both self-management and discussions with healthcare providers.

When to Seek Medical Attention for Vertigo

While many cases of vertigo can be managed at home or with outpatient treatment, there are situations where immediate medical attention is necessary.

Red Flags for Vertigo

Seek immediate medical care if vertigo is accompanied by:

Sudden, severe headache
Chest pain or shortness of breath
Numbness or weakness in the face, arm, or leg
Difficulty speaking or understanding speech
Loss of consciousness
Sudden hearing loss
Persistent vomiting

These symptoms could indicate a more serious condition, such as stroke or heart attack, requiring urgent medical intervention.

Chronic or Recurrent Vertigo

If vertigo episodes are frequent, severe, or significantly impacting daily life, it’s important to consult a healthcare provider. They can perform a thorough evaluation and develop an appropriate treatment plan.

Living with Vertigo: Coping Strategies and Long-Term Management

For many individuals, vertigo becomes a chronic condition that requires ongoing management. Developing effective coping strategies is crucial for maintaining quality of life.

Adapting the Home Environment

Making certain modifications to the home can help reduce the risk of falls and injuries during vertigo episodes:

Installing handrails in bathrooms and along staircases
Removing tripping hazards like loose rugs
Ensuring adequate lighting, especially at night
Using non-slip mats in showers and bathtubs

Maintaining Physical Activity

Regular, gentle exercise can help improve balance and reduce the impact of vertigo on daily life. Activities like tai chi, yoga, or swimming can be particularly beneficial.

Dietary Considerations

Some individuals find that certain dietary changes can help manage vertigo symptoms:

Reducing salt intake (particularly for Meniere’s disease)
Limiting caffeine and alcohol consumption
Eating regular, balanced meals to maintain stable blood sugar levels

Support Groups and Counseling

Joining a support group for individuals with vertigo or seeking counseling can provide emotional support and practical advice for coping with the condition.

Occupational Considerations

For those whose work is impacted by vertigo, discussing accommodations with employers or considering job modifications may be necessary to ensure safety and productivity.

Living with vertigo can be challenging, but with proper management and support, many individuals are able to lead full and active lives. By understanding the condition, recognizing its symptoms, and working closely with healthcare providers, those affected by vertigo can develop effective strategies for managing their symptoms and maintaining their overall well-being.

Dizziness: Lightheadedness and Vertigo | Michigan Medicine

Is dizziness your main problem?

How old are you?

3 years or younger

4 to 11 years

12 years or older

Are you male or female?

Why do we ask this question?

If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you had a head injury?

Did you pass out completely (lose consciousness)?

If you are answering for someone else: Is the person unconscious now?

(If you are answering this question for yourself, say no. )

Are you back to your normal level of alertness?

After passing out, it’s normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.

Yes

Has returned to normal after loss of consciousness

Did the loss of consciousness occur during the past 24 hours?

Yes

Loss of consciousness in past 24 hours

Have you had any new neurological symptoms other than dizziness?

Yes

Other neurological symptoms

Do you have these symptoms right now?

Yes

Neurological symptoms now present

Is the dizziness severe?

Severe means that you are so dizzy that you need help to stand or walk.

Have you had sudden, severe hearing loss?

Yes

Sudden, severe hearing loss

Is vertigo a new problem?

Are your symptoms getting worse?

Yes

Dizziness is getting worse

Did the symptoms start after a recent injury?

Yes

Symptoms began after recent injury

Have you recently had moments when you felt like you were going to faint?

Yes

Episodes of feeling faint

Have you felt faint or lightheaded for more than 24 hours?

Yes

Has felt faint or lightheaded for more than 24 hours

Are you nauseated or vomiting?

Nauseated means you feel sick to your stomach, like you are going to vomit.

Are you nauseated a lot of the time or vomiting repeatedly?

Yes

Persistent nausea or vomiting

Do you think that a medicine could be causing the dizziness?

Think about whether the dizziness started after you began using a new medicine or a higher dose of a medicine.

Yes

Medicine may be causing dizziness

Have you been feeling dizzy for more than 5 days?

Yes

Dizziness for more than 5 days

Is the problem disrupting your daily activities?

Yes

Dizziness interfering with daily activities

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Vertigo is the feeling that you or your surroundings are moving when there is no actual movement. It may feel like spinning, whirling, or tilting. Vertigo may make you sick to your stomach, and you may have trouble standing, walking, or keeping your balance.

Symptoms of a heart attack may include:

Chest pain or pressure, or a strange feeling in the chest.
Sweating.
Shortness of breath.
Nausea or vomiting.
Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Lightheadedness or sudden weakness.
A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Symptoms of serious illness may include:

A severe headache.
A stiff neck.
Mental changes, such as feeling confused or much less alert.
Extreme fatigue (to the point where it’s hard for you to function).
Shaking chills.

Heartbeat changes can include:

A faster or slower heartbeat than is normal for you. This would include a pulse rate of more than 120 beats per minute (when you are not exercising) or less than 50 beats per minute (unless that is normal for you).
A heart rate that does not have a steady pattern.
Skipped beats.
Extra beats.

Neurological symptoms—which may be signs of a problem with the nervous system—can affect many body functions. Symptoms may include:

Numbness, weakness, or lack of movement in your face, arm, or leg, especially on only one side of your body.
Trouble seeing in one or both eyes.
Trouble speaking.
Confusion or trouble understanding simple statements.
Problems with balance or coordination (for example, falling down or dropping things).
Seizures.

Many prescription and nonprescription medicines can make you feel lightheaded or affect your balance. A few examples are:

Antibiotics.
Blood pressure medicines.
Medicines used to treat depression or anxiety.
Pain medicines.
Medicines used to treat cancer (chemotherapy).

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

Passing out (losing consciousness).
Feeling very dizzy or lightheaded, like you may pass out.
Feeling very weak or having trouble standing.
Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don’t have one, seek care in the next hour.
You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don’t have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

Make an appointment to see your doctor in the next 1 to 2 weeks.
If appropriate, try home treatment while you are waiting for the appointment.
If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Head Injury, Age 4 and Older

Head Injury, Age 3 and Younger

Fall Due To Dizziness, Weakness, Or Loss Of Balance

The symptoms that led to your fall have been evaluated. Your healthcare provider feels it is safe for you to return home.

Many things can cause you to become dizzy. Everyone means a little something different by the word dizzy. People may describe their symptoms using these words:

It doesn’t feel right in my head
It feels like spinning in my head
It seems like the room is spinning
My balance feels off
I feel lightheaded, like I am going to pass out

All these descriptions can have real causes.

Your balance mechanism is in your inner ear. Anything disturbing it can make you feel dizzy, whether it is from a cold, an injury, or many other things. Anything that causes your blood pressure to drop suddenly can make you feel lightheaded, or like you are going to faint. This is because at that moment there might not be enough blood flowing to your brain. Causes include:

Medicines
Dehydration
Standing up or bending over too quickly
Becoming overheated
Taking a hot shower or bath
Straining hard while lifting something or using the toilet
Strokes, heart attack, heart valve disease, very slow or very fast heart rate
Low blood sugar
Ear infection
Hyperventilation
Anemia
Injury
Infection
Panic attack
Pregnancy

You may be at risk of repeat falls. Take precautions described below to prevent another fall.

Home care

If you become lightheaded or dizzy, lie down immediately or sit and lean forward with your head down. It is better to do this than fall and seriously hurt or injure yourself.
Rest today. When changing position, take a moment to be sure any dizziness goes away before standing and walking.
If you have been prescribed a walker, be sure to use it whenever you walk, even if it is a short distance.
If you were injured during the fall, follow the advice from your healthcare provider regarding care of your injury.
Be sure your healthcare provider knows all the medicines, herbs, and supplements you take. Some medicines can cause dizziness.
Cut back on alcohol use.

Follow-up care

Unless given other advice, call your healthcare provider on the next office day to advise of your fall and to schedule an appointment. You may require further treatment for the underlying condition that caused today’s fall.

If X-ray or a CT scan were done, you will be notified of the results, especially if it affects treatment.

Call 911

Call 911 if any of these occur:

Trouble breathing
Confused or trouble arousing
Fainting or loss of consciousness
Rapid or very slow heart rate
Seizure
Trouble with speech or vision, weakness of an arm or leg
Trouble walking or talking, loss of balance
Numbness or weakness in one side of your body, facial droop

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

It’s important to find the cause of dizziness and vertigo

Vertigo can seem to come out of nowhere and feel life-threatening, making it scary to drive or walk down the stairs.

The bad news is there are many causes of dizziness and it can take some sleuthing to figure out which one is affecting you. The good news is functional neurology can help you identify what kind of vertigo you have and help you quickly rehabilitate it.

For instance, benign paroxysmal positional vertigo (BPPV) is one of the most common causes of dizzy spells and is easy to treat. By defining each word in this complex sounding condition, we can see it is not as grave as it sounds:

Benign: Not life-threatening.
Paroxymal: Comes on suddenly and is brief.
Positional: Usually happens in response to a head position or movement.
Vertigo: Dizziness, or a sense of things spinning either inside or outside your head.

BPPV occurs when small crystals in the inner ear become dislodged and travel to areas in the ear canals where they don’t belong. In most cases the Epley maneuver or another similar maneuver can move the crystal back to where it belongs.

Sometimes vertigo can be caused when the individual eye muscles do not work together because one or more of them is weak. This weakness causes the eyes to move abnormally. This abnormal movement sends incorrect visual information to the brain and vestibular system, an area of the inner ear vital for balance. This can cause dizziness and light-headedness.

Although a person usually doesn’t notice this eye muscle weakness, in functional neurology we can spot it during a neurological exam and provide exercises that target areas needing rehabilitation.

The vestibular system plays an important role in balance and the prevention of vertigo. However, it is a fragile system and vestibular dysfunction is more common than people realize. For instance, if you’ve had a mild concussion, whiplash from a car accident, falls or hits from sports, or other impacts to the head or body, you may have damaged your vestibular system.

Inflammation or infection can also affect the vestibular system and provoke vertigo.

The cerebellum, an area at the base of the brain, works with the vestibular system in balance and the prevention of vertigo. If the cerebellum is damaged from a brain injury, stroke, or an autoimmune disease (a disorder in which the immune system attacks and destroys tissue), this can cause dizziness.

Other symptoms of compromised cerebellum function may include poor balance, being unsteady on your feet, poor coordination, and anxiety (because the unsteadiness is a perceived as a constant stressor).

Other brain-related causes of dizziness can include an imbalance between the hemispheres of the brain or neck issues that hinder proper communication between the body and brain — always take whiplash seriously, it could impact your brain health.

If you are having dizzy spells, it’s important to identify the source of your vertigo because it will determine the best course of treatment. You need to know whether your vertigo stems from the vestibular system or the brain because each is rehabilitated differently.

Make note of other symptoms (below) you have in addition to vertigo; they can help your functional neurology doctor customize the right treatment for the cause of your dizziness.

Symptoms and signs often associated with vertigo, dizziness, and imbalance include:

Feel easily overwhelmed in areas with a lot of sensory input (grocery store, walking through a parking lot, movie theater, etc.).
One eye is higher than the other
Migraines
Hearing loss
Disturbances with your vision
Feeling disconnected from your body; confusion
Depression
Anxiety

Schedule a consultation to discuss how Functional Neurology can help with your dizziness and Vertigo.

Dizziness | Causes of Dizziness and How To Get Rid of It

What is dizziness?

Dr Sarah Jarvis MBE

Ah, that is the million dollar question. “Feeling dizzy” means different things to different people. Or even to the same person in different situations. Most commonly it is used to describe one of the following sensations:

Vertigo, which is a feeling of spinning around.
Feeling faint or light-headed, as if about to pass out or collapse.
Loss of normal balance, ie being unsteady but without feeling faint or whirly.

When you go to a doctor saying you feel “dizzy”, you are giving them a real challenge. Because the word “dizzy” describes several symptoms, and a vast number of conditions can cause dizziness. Your doctor should, however, be able to narrow it down, by finding out exactly what you personally mean by dizziness, and asking about other symptoms.

Why do I feel dizzy?

Dizziness is usually a problem of the inner ear or brain. It may be due to infection or nerve problems. Balance issues without dizziness may be due to low blood pressure, anxiety, nerve problems and heart issues. It is important to see your doctor to investigate the problem.

Well, again, it is going to depend on what you personally mean by dizziness. If you have vertigo, ie you feel as if you or the world around you is spinning, then the most common causes are inner ear problems. Other than confusing your inner ear balance system by riding on a playground roundabout or the teacups ride at the fair, or by turning a load of pirouettes, then causes include:

Read more about these conditions and other causes of vertigo.

What are the possible causes of feeling faint?

If, by dizziness, you mean feeling faint or light-headed, then conditions originating anywhere in your body may be the cause. For example:

People who feel faint often say they feel “light-headed” and feel as if they may collapse unless they sit or lie down. This is sometimes described as feeling dizzy. Most of us can remember times when we have felt like this. For example, when we have been ill with a high temperature (fever), very hungry, or very emotional. However, some people have repeated episodes of feeling faint without an obvious explanation such as a fever.

Orthostatic hypotension

This means your blood pressure drops when you sit up from lying, or when you stand up from sitting or lying. In particular, if you jump up out of bed after a night’s sleep. The fall in blood pressure is just for a short time as the blood pressure quickly adjusts to your new posture. However, in some people the fainting feeling can be more severe and last for a few minutes. This problem tends to get more troublesome as you become older.

Anaemia

The main symptom of anaemia is tiredness. However, if you have anaemia you may not get sufficient oxygen to the brain. This can make you feel light-headed.

Arrhythmias and other heart problems

An arrhythmia is an abnormal heart rhythm. It occurs when the heart may suddenly beat too fast, too slowly, or in an abnormal way. There are various causes. One of the symptoms of an arrhythmia is to feel faint or light-headed as there may be a sudden decrease in blood supply to the brain as the arrhythmia develops. See the separate leaflet called Abnormal Heart Rhythms (Arrhythmias) for more details.

Various other heart disorders may cause a reduced flow of blood to the brain and cause you to feel faint or light-headed.

Anxiety

In particular, if you have anxiety with panic attacks you can feel light-headed. This can get worse if you over-breathe (hyperventilate) due to the anxiety or panic attack.

Medication

Feeling faint and/or light-headed is sometimes a side-effect of some medicines. It is always worth reading the information leaflet that comes in the drug packet to check if dizziness is a recognised side-effect.

And if you mean the type of dizziness where you don’t feel you or the room are spinning and you don’t feel faint, but you just feel unbalanced, then there are yet more possible causes. These also can start from problems of various body organs and systems, such as your ear, your brain, your nervous system and your general state of health. Alcohol, street drugs and various medicines can also make you feel off-balance, and affect different people differently.

Should I worry about dizziness?

Dizziness due to a temporary infection is usually not harmful. See your doctor if you have:

Tinnitus (ringing or pulsing in ears)
Hearing or visual loss
Loss of consciousness or memory
Headache, worsening or worse when laying down
Headache, worse when coughing
Numbness, movement or speech problems
Irregular, slow or fast pulse

If you are getting recurring dizzy spells, or a constant dizziness for which there is no obvious cause, then see your doctor. If you have dizziness with other alarming symptoms (such as sudden weakness in your arms, legs or face muscles, or chest pain or feeling very breathless), then call an ambulance or see a doctor urgently.

Do I need to see a doctor?

It is usually best to have an explanation for dizziness. If you have a prolonged episode of dizziness, or recurring episodes of dizziness and are not sure what is causing them, then it is wise to see a doctor. In particular, if you have other symptoms in addition to the dizziness, such as:

Headache, especially if it is severe, or a different kind of headache to ones you usually get.
Hearing or visual loss.
Problems with speech.
Weakness of arms or legs.
Difficulty walking.
Collapse, or periods of unconsciousness.
Numbness in areas of your body.
Chest pain.
An abnormally slow or fast pulse.
An irregular pulse.
Any other symptom that you cannot explain.

If any of these symptoms have come on suddenly, see a doctor immediately.

Causes of dizziness

With this number of possibilities, it isn’t all that surprising that a cause is not always found. Indeed, it is estimated that in one out of every five people who go to the doctor complaining of dizziness, a cause is never found. Fortunately even if the cause hasn’t been found, the symptom of dizziness often settles in time.

How do you normally keep your sense of steadiness and balance?

Your brain constantly receives nerve messages from various parts of the body to tell you where you are and what position you are in. The three main sources of these nerve messages are:

Your eyes – what you look at helps your brain to tell what position you are in and how you are moving.
Nerve messages from your skin, muscles and joints help your brain to tell the positions of your arms, legs and other parts of your body.
Your inner ears. The inner ear includes the cochlea, vestibule and semicircular canals in which there is a system of narrow fluid-filled channels called the labyrinth. The cochlea is concerned with hearing. The three semicircular canals help to control balance and posture. Head movements are sensed because when you move your head, the fluid in the labyrinth within the semicircular canals moves too. The movement of the fluid moves tiny fine hairs that are on the inside lining of the labyrinth. When the hairs move, this triggers messages to be sent to the brain via a nerve called the vestibular nerve. This gives the brain information about the movement and position of your head, even when your eyes are closed.

Cross-section of the ear

Inner ear diagram

To be free of dizziness and to have good balance, it is best to have all of these (eyes, nerve signals from the skin muscles and joints, and inner ears) working normally. However, if you shut your eyes, you will normally still have a good sense of balance and know the position of your head and other body parts. This is because of the nerve messages that are sent to your brain from your inner ears, and other parts of your body.

What is meant by dizziness due to balance problems?

In this type of dizziness you do not have vertigo and are not light-headed or feeling faint. However, you feel unsteady on your feet and feel as if you may fall over when you walk, due to unsteadiness.

What can cause loss of balance?

This can be caused by various conditions. These include the following:

Ear problems

Some inner ear conditions can cause balance problems without the spinning sensation of vertigo – for example, an inner ear injury.

Nerve disorders

Various disorders which cause the nerves in the legs not to work properly can cause unsteadiness. For example, peripheral neuropathy, multiple sclerosis, etc.

Brain disorders

Various problems in the brain, such as a stroke, or a brain tumour, can cause balance problems. These occur if the affected part of the brain is a part that helps to control posture and balance. There will usually be other symptoms too.

General frailty

General frailty and/or being seriously ill with another illness may lead to loss of balance. You will usually have other symptoms in addition to problems with balance.

Alcohol and drugs

Your balance can be affected by drinking too much alcohol or taking some street drugs.

What tests might I have for dizziness?

A doctor is likely to examine you. Sometimes the doctor can tell you the cause of the dizziness from your symptoms and the result of the examination. In some cases, various tests may be organised to find the cause of the dizziness.

Your doctor will firstly need to ask you some questions about the dizziness. Is it constant or in attacks? Is it the world-is-spinning type of dizziness or a loss of balance, or do you feel faint or light-headed? Do you have other symptoms with it, such as being sick, hearing problems, a ringing in the ear (dizziness), headaches, palpitations, etc? Does it come on in certain situations – for example, when you move your head from one side to the other? Are you taking any medicines?

The doctor will then need to examine you. What this involves will depend on the information gleaned from the answers above, but might include:

Taking your temperature.
Examining your ear.
Examining your eyes and their movements.
Checking your pulse and blood pressure.
Checking your balance and co-ordination.
Looking for any weakness in the muscles of your arms, legs or face.
Tests which look for dizziness in certain positions or position changes.

Depending on what has been established from the above, further tests might be relevant. These will differ depending on which diagnosis is suspected, but might include:

Dizziness treatment

The treatment depends on the cause. Your doctor will be able to advise you regarding this. It will entirely depend on the type of dizziness and what has caused it. For example:

Labyrinthitis usually improves on its own over time.
Benign paroxysmal positional vertigo (BPPV) can be cured by a series of manoeuvres tilting your head in certain ways to move debris in the semicircular canals of the inner ear.
Dizziness caused by a problem with the heart rhythm or rate is treated by putting the heart rate right – for example, by medicines, a pacemaker or a procedure done directly on the heart.
Dizziness caused by medication is usually easily solved by reducing the dose of, changing or stopping the medicine in question.
Dizziness due to panic attacks or anxiety is solved by treating these conditions directly with talking treatments or medicines. Examples of possible treatments include cognitive behavioural therapy, beta-blocker medicines or antidepressant medicines.

Is there anything I can take for dizziness?

Sometimes you need a medicine for the symptom of dizziness. This might be while you wait for it to get better (for example, labyrinthitis) or while you are waiting for tests to find out the cause, or because you have a condition which can’t easily be cured. For the vertigo type of dizziness, tablets called prochlorperazine or cinnarizine are often prescribed. These do not cure the underlying problem but they help you feel better until it goes away. These do not work so well for the light-headed/faint type of dizziness or for loss of balance.

Diagnosing Different Types of Dizziness

Dizziness is a very common problem. More often than not, it is caused by a condition or illness that is easily treated or resolves on its own. Sometimes, however, dizziness can be a sign that something serious or even life-threatening.

By identifying the type of dizziness a person is experiencing, healthcare providers can often pinpoint the underlying cause before it becomes more of a problem.

Phynart Studio / Getty Images

Types of Dizziness

Dizziness is a term which can be used to describe several distinct sensations, each of which is linked to different organ systems or illnesses. By describing these sensations, you can provide your healthcare provider with the means to offer a diagnosis and begin investigations.

Dizziness can be described in the following ways:

Presyncope: Feeling Lightheaded

Presyncope is the lightheaded sensation you may experience if standing up too quickly. In some cases, you may turn pale, feel clammy, or even pass out (which is referred to as syncope).

Presyncope happens as a result of the restriction of blood to the brain. It may be caused by something as simple as not drinking enough water or as serious as heart disease.

Disequilibrium: Feeling Off Balance

Disequilibrium is the sensation of not being able to maintain balance, often veering to one side of the other. If it appears suddenly, it may be caused by something as uncomplicated as an ear infection or as serious as a neurological disease.

If the symptoms progress slowly, it may be the result of a degenerative movement disorder such as Parkinson’s disease or a systemic (all-body) infection affecting the nervous system.

Vertigo: When Everything Is Spinning in Circles

Vertigo is the same sensation you have if you’ve been spinning around quickly and suddenly stop. Vertigo can be caused by an inner ear problem, resulting in peripheral vertigo. When it is the result of a problem with the brainstem (which regulates balance and equilibrium) it is called central vertigo.

Causes can include toxins, metabolic disorders (such as kidney failure), multiple sclerosis, and stroke. Double vision, tingling, numbness, weakness, facial drooping, or difficulty swallowing may also accompany vertigo.

Non-Specific Dizziness: Feeling Funny

In this case, the term dizziness may be used to describe a symptom you can’t put your finger on, such as fatigue or disorientation. It may involve an “out of body” sensation you may be having after starting a new medication. In some cases, the sensation may be psychiatric in nature.

Around 8 million people visit their healthcare providers each year due to unexplained dizziness.

Dizziness as a Symptom of Serious Illness

In most cases, the cause of dizziness will be simple and require little or no medical intervention. At other times, dizziness can serve as an early warning sign of a severe or life-threatening situation. The following are among the most serious conditions associated with dizziness.

Vertebrobasilar Insufficiency

Vertebrobasilar insufficiency is a term used for decreased blood flow to the brainstem. When this happens, a person may experience symptoms of central vertigo which go well beyond lightheadedness.

If blood supply is reduced for a brief period of time, it can cause a transient ischemic attack (sometimes referred to as a “mini-stroke”). If the restriction is longer, it can lead to a stroke and permanent brain damage.

Infections

Infections can also lead to vertigo. One of the more common causes is viral labyrinthitis, a type of infection that leads to inflammation in the inner ear.

Other, more serious infections include Cryptococcus (a fungal infection frequently seen in people with advanced HIV) or communicable bacteria such as tuberculosis or Listeria, all of which can affect the brainstem. Viruses such as herpes zoster can also cause dizziness by attacking the nerves in your face nearest your ear.

Heart Disease

Heart disease is frequently associated with dizziness due to an insufficient blood supply to the brain. Advancing cardiovascular diseases reduce the heart’s ability to pump blood efficiently against the pull of gravity. This is why standing up quickly can cause presyncope in some people.

Cardiac arrhythmias (irregular heartbeats) can often do the same thing.

Endocrine Tumors

Endocrine tumors are rare but are known to secrete hormones that can make you feel dizzy. One type, called pheochromocytoma, secretes hormones that increase blood pressure and may cause nonspecific dizziness.

Another example is an insulinoma, a tumor that secretes the same hormone used by people with diabetes to regulate blood sugar. If too much is released, the person’s blood sugar can become so low as to cause dizziness, weakness, and disorientation.

Guillain-Barré Syndrome

Guillain-Barré sydrome is an autoimmune disorder in which the body’s immune system attacks the peripheral nervous system. Guillain-Barré may be triggered by an acute bacterial or viral infection.

Symptoms typically start as weakness and tingling in the feet and legs which gradually spread to the upper body. Unsteadiness is common as the disease advances. Paralysis can sometimes occur.

Wernicke’s Encephalopathy

Wernicke’s encephalopathy (WE) is caused by a deficiency of thiamine (vitamin B1). People with WE can have problems moving their eyes as well as maintaining steadiness when walking.

Moreover, they can develop memory problems which may become irreversible unless they are provided the vitamin as soon as possible. Most symptoms will improve quickly if thiamine deficiencies are treated early.

A Word From Verywell

When seeing a healthcare provider about symptoms of dizziness, be as specific as possible when describing what you are experiencing. Be sure to disclose information about any and all medications you may be taking, prescribed or otherwise, or any changes you may have made to your diet, lifestyle, alcohol intake, or work schedule.

The more precise you are about the symptoms you are experiencing, the more readily a diagnosis can be made.

Can Vertigo be Caused by Stress?

Stress can have a dramatic impact on our physical health, triggering all sorts of symptoms and making many medical conditions worse. One issue that is often attributed to stress is vertigo, but is it really true that being stressed could cause this symptom?

What is Vertigo?

The term vertigo refers to the sensation that you or your surroundings are spinning or tilting, even though everything is actually stationary. It can make you feel sick, dizzy and unbalanced. The symptoms may only last for a few seconds but can last for days at a time.

Vertigo is a symptom that can happen for many different reasons. Sometimes it can be linked to an underlying condition such as a heart arrhythmia or blood pressure problems. It can also be caused by conditions affecting the balance structures in the inner ear, including infections and Meniere’s disease. However, there isn’t always a physical cause for vertigo. Sometimes it seems to be linked to our emotions instead.

How Can Emotions Trigger Vertigo?

The physical causes of vertigo can trigger this symptom by interfering with the balance organs in the inner ear or by affecting the blood supply to your brain, which can make you feel lightheaded and dizzy. Emotional triggers can cause vertigo in a slightly different way.

You may have heard of the flight or fight response, which is triggered by stressful, worrying or frightening situations. It happens because our adrenaline levels go up in response to these types of situations. Adrenaline activates the autonomic nervous system, which prepares our bodies to run away or fight back if we need to. It speeds up our heartbeat and breathing, dilates our eyes and makes us more alert. It can also cause unpleasant side effects such as unsteadiness, dizziness and vertigo.

You can experience these effects if you’re feeling stressed, anxious or depressed. These emotions can trigger the symptoms of an underlying issue such as an inner ear condition, but they can also cause vertigo by themselves.

What Can You Do?

If you’ve been experiencing vertigo frequently, it’s very severe, or it doesn’t go away then you should see an ENT specialist. The doctor will check for any underlying causes and recommend treatment if necessary.

You can also take steps to reduce and manage your stress. This should help whether the vertigo is entirely stress-induced or if there is an underlying condition that is being triggered by stress.

Try to eliminate sources of stress if you can, for example by taking more time off to relax or asking your family to help out more at home
Make sure that you’re getting plenty of sleep as tiredness can take a big toll on your mental and emotional wellbeing
Eat well and exercise regularly as good health can improve your mood as well as your physical wellbeing
Relieve stress by talking about it, enjoying a warm bath, doing an activity you find fun, or using relaxation techniques such as mindfulness or meditation
See your GP if you’re feeling very stressed, anxious or depressed

Vertigo: Symptoms, causes, and what you should do if you have it

If you’ve ever suddenly felt like you are on a tilt-a-whirl while you’re walking down the street or sitting in your office, then you might have vertigo.

Vertigo is a specific type of dizziness that is characterized by the sudden sensation that you are spinning or that the world around you is spinning. The feeling can come and go or it can last for hours or days. Along with the dizziness, people may also experience nausea or vomiting, headaches, double vision or a racing heartbeat.

“Dizziness is one of the top reasons why elderly people go to the emergency room, but not all of them have vertigo,” Dr. Marlan Hansen, an associate professor of otolaryngology at the University of Iowa Hospitals and Clinics, told CBS News. Hansen has been treating diseases and disorders of the ear, nose and throat for 12 years. “Most people referred to me are misdiagnosed.”

What causes vertigo?

The most common causes of vertigo are inner ear infections or diseases of the ear such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere’s disease.

BPPV can occur when calcium builds up in canals of the inner ear, causing brief dizziness that lasts from 20 seconds to one minute. It is usually brought on by trauma to the head or by moving the head in certain positions.

Vestibular neuritis is brought on by an inner ear infection that causes inflammation around the nerves that help the body sense balance. It results in a severe bout of vertigo that can last a day or more and sometimes includes hearing loss. “A person is dizzy for a day or two and then off balance,” Hansen explained. The Cleveland Clinic says 95 percent of patients make a full recovery and never have it again.

Meniere’s disease is caused by the buildup of fluid and pressure in the inner ear and can cause dizziness along with ringing in the ears and hearing loss.

Less common causes of vertigo can include head or brain injuries or migraines.

How do you treat vertigo?

Hansen said that vertigo can be a once-in-a-lifetime thing that comes and goes quickly, and should not normally be cause for alarm. “It just happens,” he said.

However, if a person does experience repeated bouts of dizziness and hearing loss, Hansen advises seeing an ear, nose and throat specialist to seek appropriate treatment. Dizziness could also be a symptom of of a serious brain problem such as stroke, bleeding in the brain or multiple sclerosis.

Vertigo that is caused by BPPV can be treated by physical therapy where patients learn a series of exercises known as the canalith repositioning procedure — slow maneuvers for positioning your head to shift particles in the inner ear.

Ryan Adams’ self-titled album has been nomina…

03:37

If a person has Meniere’s disease, Hansen said that a doctor might prescribe a low sodium diet and a diuretic to decrease fluid pressure in the inner ear. Musician Ryan Adams, who suffers from Meniere’s disease, told CBS News last year that adjusting his lifestyle and the lighting onstage helped ease his symptoms.

Some vertigo sufferers can also be treated with certain prescription medications including calcium channel blockers, beta blockers and tricyclic antidepressants.

While it can be disorienting, Hansen said vertigo is not a dangerous condition. For people with BPPV, he said it can become hazardous if the person is working on something such as scaffolding when they get a case of vertigo. People with Meniere’s disease are restricted from some jobs including airline pilot and truck or bus driver.

“Most people still drive cars,” Hansen said. “They’re usually safe to get off the road and wait it out.”

Trending News

Download our Free App

For Breaking News & Analysis Download the Free CBS News app

90,000 Causes of weakness, dizziness and fatigue

Weakness, dizziness, fatigue are symptoms that can appear in a number of pathological conditions and diseases, including those requiring prompt medical attention. Some patients tend to consider physical, emotional stress, stress as the cause of the malaise and do not attach much importance to them. This is a mistake, as fatigue can be one of the first symptoms of serious, rare conditions such as Pompe disease.

Pompe disease is a genetic disorder that can manifest itself at any age. It is associated with a hereditary deficiency of the acid maltase enzyme. Due to its deficiency, glycogen accumulates in the muscles, which leads to their damage. The classic symptoms of Pompe disease are progressive muscle weakness, or myopathy. In Pompe disease with a late onset (that is, manifesting at the age of over 1 year), muscle manifestations may be preceded by increased fatigue, weakness, muscle pain ¹.

Along with rare congenital diseases, these symptoms may indicate the development of common conditions and diseases.

Common Causes

More often weakness, dizziness appear due to the following conditions:

Decrease in blood sugar levels (hypoglycemia), more often as a result of the introduction of an incorrect dose of insulin (in diabetes mellitus). Glucose levels can also decrease in healthy people experiencing hunger ².
Decrease in blood pressure (hypotension). It is more common in young people 20-30 years old. In this case, hypotension is considered physiological and is considered a variant of the norm. However, the condition can be associated with various heart problems, trauma, dehydration, certain medications and other causes ³.
Anemia is a condition caused by an insufficient number of red blood cells that carry oxygen to organs and tissues, or by a violation of their function.Dizziness, weakness, fatigue in such situations appear due to hypoxia – oxygen deficiency. The most common cause of the disease is a decrease in the level of iron in the body. About 80% of anemias are associated with it ⁴.
Chronic fatigue syndrome is a condition in which persistent, prolonged fatigue cannot be explained by some organic disease. Usually occurs at the active age of 40-59 years, more often in women ⁵.
Violation of the rhythm of the heart – irregular heartbeat, arrhythmia, in which the heart beats too slowly, too fast, or “skips” beats ⁶.
Taking certain medications, in particular, antidepressants, anticonvulsants, drugs that lower blood pressure, muscle relaxants (drugs that reduce muscle tone), hypnotics, and others.

Additional symptoms

Weakness, dizziness, increased fatigue can be accompanied by a number of other symptoms, depending on what condition or disease they are associated with. So, with hypoglycemia, severe malaise occurs, the pulse rises, there is a feeling of hunger, sweating, irritability, headache ².The decrease in pressure is accompanied by nausea, thirst. A person begins to breathe quickly, shallowly, the skin turns pale, becomes sticky, problems with concentration appear ³.

The typical symptoms of anemia, along with dizziness and weakness, include increased heart rate, shortness of breath even with light exertion, headache, pallor of the skin ⁴.

Chronic fatigue syndrome, even with light exertion, may be accompanied by chills, night sweats, difficulty breathing, coughing, abdominal pain, visual impairments (blurred vision, pain in the eyes), palpitations, psychological problems (depression, persistent irritability), loss of or on the contrary, an increase in body weight, drowsiness.Patients complain of a lack of stimulus to activity, apathy.

The symptoms of chronic fatigue syndrome are extremely nonspecific – they are inherent in many diseases, therefore the doctor should establish the diagnosis after excluding serious pathologies ⁵.

Which doctor should I contact?

In the event of persistent dizziness and weakness, it is important to immediately consult a general practitioner or family doctor. To establish a diagnosis, the doctor may prescribe a comprehensive examination, including both laboratory tests (blood and urine tests) and instrumental (X-ray, ultrasound, sometimes MRI *, CT **). If necessary, the therapist refers the patient to narrow specialists, for example, a cardiologist, neurologist, hematologist and others.

Treatment for weakness, fatigue and dizziness depends on the underlying disease. So, with hypoglycemia, it is enough to eat a candy or sweet fruit, and with low blood pressure – drink a cup of strong coffee. Treatment of iron deficiency anemia is based on the appointment of iron preparations and correction of the diet, arrhythmias – on the intake of antiarrhythmic drugs, and so on.

Alarms

In some cases, weakness, fatigue and dizziness can be signs of an emergency. An ambulance should be called immediately if they are accompanied by the following symptoms:

loss of consciousness, fainting
convulsions
visual impairment or complete loss
severe vomiting
severe chest pain
impaired consciousness
fever
speech impairment.

* MRI – magnetic resonance imaging,

** CT – computed tomography

References

Sukhorukov V.S. et al. Diagnosis of Pompe disease // Russian Bulletin of Perinatology and Pediatrics – 2010. – T. 55. – No. 6.
Starostina E. G. Hypoglycemia and hypoglycemic coma // Medical Council – 2013. – No. 5-6.
Litovchenko T.A., Zinchenko E.K. Arterial hypotension – the initial stage of the formation of chronic cerebrovascular insufficiency (treatment features)
// International neurological journal – 2011.- No. 6.
Dvoretsky L.I.
Vorobieva OV Chronic fatigue syndrome (from symptom to diagnosis) // Difficult patient – 2010. – T. 8. – No. 10.
Shkolnikova M.A.Cardiac arrhythmias and sports-side of risk // Russian Bulletin of Perinatology and Pediatrics – 2010. – V. 55. – No. 2.

GZEA.PD.18.09.0435i

Getting rid of the loss of strength and weakness

Are you just tired? Or is it more serious?

What person has never felt tired and weary at least once in his life? In some cases, lethargy, drowsiness and deterioration in well-being are the norm, but sometimes worsening of the condition is a reason to be wary. How to distinguish normal fatigue from illness?

First, let’s look at the main causes of weakness, loss of strength and poor health.

Short daylight hours

According to studies, people often get sick, feel constant lethargy and drowsiness in the autumn-winter period. This is due to the fact that the activity of the body depends on the daylight hours. And in autumn and winter, an ordinary office worker hardly sees the sun: he wakes up when it is still dark, travels most of the way underground, and leaves the office after sunset …

90 120 Solution: chase the sun!

This problem can be easily solved by a couple of weeks of vacation in warm countries.But if this is not possible, you can do with a small vacation without going abroad. Do not spend it at home – try to walk outside more. An organism yearning for the sun’s rays will be grateful to you.

Lack of vitamins and minerals

Improper nutrition can also be the cause of weakness and loss of strength. Fashionable diets, a passion for fast food, a lack of dietary diversity and a lack of fruits and vegetables in the diet can lead to vitamin deficiency and micronutrient deficiencies.

The solution: diversify your diet!

Good food means varied food. Let your menu include dairy products and cereals, vegetables and fruits, meat and fish. Try to include vegetable oils with unsaturated fatty acids in your diet – olive or flaxseed. If your menu cannot boast of variety, take a course of vitamins every six months, vitamins of group B are especially useful for combating increased fatigue.

Busy schedule

If your work is stressful, you work irregularly, you don’t get enough sleep, or you sleep in fits and starts, it’s not surprising that you get tired.Even if at first the body’s reserves are enough to feel healthy and vigorous, over time the tension builds up, and even after the weekend you do not feel rested.

Solution: get some rest!

Treatment of causes such as weakness and loss of strength should begin with rest. If you don’t get enough rest, you cannot be productive. To relieve fatigue, take a few days to rest. Get enough sleep, take a walk, relieve your brain … Take a break from work and do not rush to solve everyday problems.Dedicate these few days to what you have wanted to do for a long time, but have been postponing.

Fatigue for no reason

In some cases, fatigue, weakness and loss of strength appear, it would seem, out of the blue. But it only seems so.

The cause of lethargy and drowsiness can be:

Latent proceeding infection;
Heart disease;
Anemia;
Diabetes;
Diseases of the thyroid gland;
Depression
Hypodynamics.

What to do?

Don’t ignore the warning symptoms. Chronic fatigue is a sign that your body is not coping with the stress you put on it. Listen to yourself. The recipe for well-being is a comfortable work schedule, rest as needed, moderate physical activity, walks in the fresh air, good nutrition and healthy sleep.

If it does not get better, consult a general practitioner. He will collect anamnesis, prescribe additional examinations, take tests, find out what is the reason for the deterioration in well-being, and relieve you of a decline in strength and weakness.

Dizziness | Rinos Clinic

Dizziness is the second most common symptom with which adults consult a neurologist (in the first place are back pain and headaches). The causes of dizziness can be osteochondrosis of the cervical spine, diseases of the inner ear, vestibular apparatus, decreased blood pressure, cerebrovascular accident, psychogenic disorders, etc. Usually attacks of dizziness are accompanied by nausea, vomiting, severe weakness.

A neurologist can help clarify the cause of dizziness. Based on the diagnosis, treatment is prescribed, which includes: the use of drugs for dizziness, the implementation of special exercises designed to train the vestibular apparatus, adherence to a special diet, and in some cases, surgery.

What is vertigo?

True dizziness is a condition in which the patient has a false sensation that the surrounding objects rotate around him or the sensation of his own movement, rotation.

For an example of true dizziness not associated with illness, consider the dizziness that occurs after riding a carousel. If the carousel is stopped abruptly, it seems to the person that the surrounding objects continue to revolve around him, as if the carousel were still in motion.

Most often, the occurrence of true dizziness is a symptom of human diseases associated with the control system of balance and body position in space, which includes the eyes, the vestibular apparatus of the inner ear, sensitive receptors of muscles, joints and human bones.

If dizziness is caused by a disturbance in the balance system, it is often accompanied by nausea and vomiting.

It is possible to define dizziness as a sensation of disturbed orientation of the body in space, which means the sensation of rotation of the patient or objects around him. Often, dizziness is understood as various sensations: slight instability, feeling lightheaded, drunkenness, or the impression of rotation of your body or surrounding objects.

Dizziness occurs when one of the three anatomical systems in the body are stimulated, which are responsible for controlling the balance of the body in space: vestibular, visual, and muscular.This can happen if, for example, you spin quickly on a carousel. But if the occurrence of dizziness is not associated with an apparent cause, it may be a symptom of some kind of disease. It can also appear in connection with damage to the peripheral parts of the vestibular apparatus of the inner ear or the vestibular nerve. In this case, the vertigo is called peripheral. In addition, the cause of dizziness can be diseases of the brain, then it is called central dizziness.

Causes of dizziness

There are many reasons for dizziness. It can occur as a result of damage to the vestibular nerve or inner ear, in which case it will be called peripheral. Also, the causes of dizziness can include diseases of the brain, in this case we are talking about central dizziness. Symptoms accompanying dizziness, the nature of dizziness, the duration and frequency of attacks make it possible to establish the true cause of the disease:

Discharge from the ear and hearing loss may indicate inflammation of the inner ear, in which case conservative treatment may be required.
Dizziness, accompanied by tinnitus, hearing loss, nausea, vomiting, probably indicates the presence of Meniere’s syndrome. In the absence of a disorder of auditory function, dizziness may be a manifestation of vestibular neuritis. Neuritis is characterized by a sudden onset. When trying to stand up and moving the head, the feeling of rotation, severe dizziness and constant vomiting increase. Most often, these symptoms disappear gradually within 2-3 days. After the end of the acute period, in some cases, the illusion of movement with linear accelerations remains, for example, in a lift or a car.
In case of sudden one-sided deafness, tinnitus, vomiting, in half of the cases, patients are diagnosed with perilymphatic fistula. Also, a fistula can manifest itself with varying degrees of dizziness and hearing impairment (hearing loss, noise, ringing in the ears).
Unilateral hearing loss and dizziness exclude a brain tumor. Such dizziness begins gradually, often accompanied by gradually increasing headaches. In certain positions of the body, increased dizziness is characteristic.
Transient cerebrovascular accident and stroke are characterized by an acute onset, a combination of dizziness with impaired coordination of movements, double vision, weakness in the arms and legs, and sensory disorders. As a rule, dizziness is persistent and lasts several days.
Dizziness, accompanied by instability, a feeling of disorientation in space, aggravation of movements in the cervical spine, especially sudden ones (such as flexion, extension, and turning the head to the sides), pain and limited mobility in the cervical spine, most likely due to diseases of the cervical spine. the spine.
Preceding head or spine injury indicates head injury or whiplash.
Vertigo associated with changes in body position in space most likely indicates benign positional vertigo, the presence of which is determined by a simple positional test.
Dizziness preceding a headache attack indicates a basilar migraine. Dizziness can last from a few minutes to an hour and is accompanied by nausea, vomiting, tinnitus, and other neurological symptoms.
Dizziness during flight, travel in a car, train or on the water is most likely the result of motion sickness.
Taking antibiotics can also cause dizziness. In this case, it is necessary to stop taking them or reduce the dose of the drug.

Most common forms and causes of dizziness

According to modern research data, dizziness is most often a symptom of the following diseases:

Benign paroxysmal positional vertigo (BPPV).
Osteochondrosis of the cervical spine and vertebrobasilar insufficiency.
Inflammation of the vestibular nerves (vestibular neuritis).
Brain tumors.
Psychogenic dizziness.
Meniere’s disease.
Basilar migraine.

It should be noted that more than 80% of cases of true dizziness are associated with BPPV.

Below we will consider the main diseases that accompany dizziness, as well as the characteristics of dizziness in each case.

Benign paroxysmal positional vertigo (BPPV)

Benign paroxysmal positional vertigo is one of the most common forms of true vertigo. The name of this disease is deciphered as follows: “benign” means a favorable, not dangerous course of the disease, “paroxysmal” means the appearance of dizziness suddenly, “positional” means the appearance of dizziness at the moment of turning the head in a certain direction.
The reason for the development of benign positional vertigo is irritation by stones of otoliths, which are located in the semicircular canals of the inner ear, receptors of the vestibular apparatus. This disease usually occurs in people over 50-60 years old, after suffering an injury or infection, but it can occur spontaneously in a person of any age.

The main symptoms of benign positional vertigo are:

The appearance of severe dizziness when throwing the head back, when turning the head to the side, when bending over, when turning in bed.
Duration of severe dizziness – from several seconds to several minutes, it may be accompanied by weakness, severe nausea, vomiting.
A series of dizziness attacks may occur, after which they may disappear for a while.

Treatment of benign positional vertigo is performed under the supervision of a neuropathologist using a special exercise, which is partially described below (Complex No. 1). The effectiveness of this exercise reaches 90%, and the duration is only 1-2 minutes.

Psychogenic dizziness

Psychogenic dizziness ranks second after BPPV in prevalence.

Unlike BPPV, psychogenic dizziness is not associated with disturbances in the functioning of the vestibular apparatus, that is, it is not true dizziness.

Basic characteristics of psychogenic dizziness:

Vertigo can be described as a feeling of fog in the head, confusion, fear of losing consciousness, falling, but not as a spinning of objects or the object itself.
Dizziness attacks occur spontaneously, often in stressful situations, in a confined space (transport, elevator), in crowded places.
In addition to the occurrence of dizziness, patients note various other symptoms that resemble some diseases of the internal organs. For example: pain and tension in muscles, in the chest, in the region of the heart, in the abdomen, feeling short of breath, sore throat or a lump in the throat, irritability, anxiety, disturbed sleep, a feeling of inner fear, tension, strong groundless concern about the state of one’s own health and health loved ones, etc.

Psychogenic dizziness can be considered as one of the most common manifestations of vegetative-vascular dystonia (VVD). Attacks of false dizziness are especially common in patients with anxiety disorders and panic attacks. Determining the psychogenic nature of dizziness is important for the correct prescription of treatment. Much more effective in psychogenic dizziness will be treatment that is intended to treat VSD (sedatives, psychotherapy) than treatment with specific drugs, prescribed in all cases of true dizziness.

Dizziness with migraine

Migraine is one of the most common types of headache. During a migraine attack, in some cases, there is a violation of blood circulation in those areas of the brain that control the work of the vestibular apparatus. The result is severe dizziness. Immediately after it, severe headache in the occipital region, imbalance, vomiting, noise and light intolerance may develop. Some migraine patients may experience only severe dizziness and nausea, and headaches may not be present.One of the harbingers of migraine in the future is attacks of severe dizziness, imbalance, nausea and vomiting in children, which eventually turn into typical migraine attacks.

Dizziness with Meniere’s disease

Meniere’s disease is characterized by attacks of severe dizziness, deafness (usually only in one ear), occurring periodically and gradually leading to hearing loss.
At the moment, the cause of Meniere’s disease is not known for certain.It is assumed that in certain cases, the onset of the disease may be due to trauma, viral infection, allergies.

A typical manifestation of Meniere’s disease is an acute attack of severe dizziness, lasting from several hours to several days. It is accompanied by tinnitus, a feeling of pressure inside the ear, hearing loss (in one ear), nausea, and vomiting.

Usually attacks of Meniere’s disease occur within several hours one after another, after which they disappear for a while, but sooner or later reappear.
Dizziness with osteochondrosis, neck and head injuries, vertebrobasilar insufficiency

As mentioned above, for the balance control system to work, sensitive receptors of the bones, ligaments, muscles, joints of the whole body and, first of all, bones, muscles, ligaments of the neck are required.

Degenerative diseases of the cervical spine (including osteochondrosis) are one of the most common causes of dizziness, described by patients as an unstable gait, in very rare cases as a feeling of dizziness.

With osteochondrosis of the spine, not only the normal functioning of the sensitive receptors of the neck is disrupted, but blood circulation in the vertebral arteries located in the brain stem, which supply blood to the parts of the brain that are responsible for the functions of balance and maintaining the position of the body in space, can also be impaired.

Chronic circulatory disorders occurring in the lower parts of the brain (vertebrobasilar basin) is called vertebrobasilar insufficiency.A certain role in the development of vertebrobasilar insufficiency is played by a long-term increase in blood pressure (hypertension) and atherosclerosis of the neck vessels. Most often, vertebrobasilar insufficiency is observed in the elderly. In addition to dizziness, this disease is accompanied by the following symptoms: headache (mainly in the back of the head), tinnitus, memory loss.

Acute circulatory disorders in the vertebrobasilar basin are manifested by severe dizziness, loss of consciousness, vomiting, double vision, weakness.

Injuries to the head and cervical spine (especially from car accidents) can also cause dizziness. Trauma-provoked dizziness is usually most pronounced in the first days after the injury, it gradually decreases as the patient recovers.

Dizziness with brain tumors

In some cases, brain tumors located near the inner ear can cause severe, progressive dizziness.In addition to dizziness, symptoms of a tumor can be:

headache
tinnitus
Hearing impairment (most often in one ear)
nausea
strabismus or paralysis of the muscles of the face

As a symptom of a brain tumor, dizziness is most common in children and young people.

Dizziness with vestibular neuritis

Vestibular neuritis is an inflammation of the vestibular nerve that conducts impulses to the brain from receptors in the inner ear.With inflammation, the vestibular nerve temporarily loses its ability to conduct impulses. This is manifested by severe dizziness, unsteady gait, nausea and vomiting.

The main cause of vestibular neuritis is viral infections. Therefore, the attacks of dizziness associated with it may be accompanied by fever, runny nose, cough, and weakness. Often, true dizziness is combined with psychovegetative disorders, such as: nausea, vomiting, sweating, pallor, anxiety.This is due to the close connection between the vestibular and autonomic systems. Any damage to the vestibular system will immediately lead to autonomic disorders. Despite the feeling of fear that accompanies almost any attack of dizziness, it in itself is not a life-threatening condition. Timely and correct diagnosis of the disease that caused the dizziness is important.

Dizziness during pregnancy

Quite often during pregnancy, there is a false dizziness, which is manifested by a feeling of instability, weakness, near fainting.In pregnant women, dizziness attacks are usually associated with a decrease in blood glucose concentration and with hypotension.

For the treatment of dizziness in pregnant women, the following recipe is effective: 1-2 tbsp. Dissolve tablespoons of sugar in a glass of warm boiled water, drink in the morning after waking up or before leaving the house.

Pregnant women (especially in the first half of pregnancy) should always carry water with them. When the first signs of dizziness appear, you should try to drink as much as possible.

What symptoms are not diagnosed as dizziness?

As it becomes clear from the above, the term dizziness has a rather narrow medical interpretation: a false sensation about one’s own rotation or about the rotation of the surrounding world. A number of other symptoms that are not actually dizziness are often mistaken for dizziness:

Weakness, feeling unsteady, confusion in the legs, nausea
Feeling of unstable gait, imbalance
Darkening of the eyes as a result of a sudden rise to the feet from a lying or sitting position
Feeling of nearness fainting, loss of consciousness
Veil before the eyes.

A patient suffering from dizziness at the doctor’s appointment should tell as accurately as possible about his health, try to describe his condition, the symptoms observed, and not just tell the doctor that he is suffering from “dizziness”. The plan for further examination and treatment depends on the accuracy of the patient’s description of the symptoms he has.

In contrast to true dizziness, as it was said, which is a consequence of a disturbance in the activity of the balance system, false dizziness, described by patients as a feeling of instability, darkening in the eyes, weakness and veil before the eyes, can be a sign of vascular dystonia, anemia, chronic fatigue, hypotension ( low blood pressure), hypovitaminosis.Also, dizziness can be confused with episodes of lipotimia (a sharp decrease in muscle tone with strong physical exertion), fainting, short-term seizures of epilepsy.

Special attention should be paid to the sudden attacks of weakness and dizziness in patients with diabetes mellitus. For this category of patients, weakness and dizziness can be a sign of a dangerous decrease in blood glucose levels.

How does the human balance system work?

True (central, systemic) dizziness is most often a manifestation of various diseases of the system that provides balance and control over the position of the human body in space.

The components of this system are:

The vestibular apparatus, which is located in the thickness of the skull, where there are sensory receptors that respond to the linear or angular acceleration of the human body in space.
Eyes that provide visual information about the location of the human body, as well as its individual parts in space in relation to other objects.
Proprioceptors (sensory receptors), which are located in the bones, joints, muscles, ligaments of a person, providing accurate information about the position of individual parts of the human body in space, as well as relative to each other.

Simultaneously, all three components of the system (vestibular apparatus, eyes, proprioceptors) send data to the brain. In certain areas of the brain, this information is analyzed, after which it is processed into a person’s ideas about how his body is located in space and in relation to surrounding objects.

When data that comes from one of the sources (for example, irritation of the receptors of the vestibular apparatus at rest) is distorted for any reason, an incorrect idea of the position of the body in space and its movement is formed in the brain.In this case, an illusory feeling arises that the body moves and rotates at the moment when in fact it is motionless.

The reasons that lead to the disruption of the balance system are different. Today, there are more than 80 diseases, the symptoms of which are dizziness. This article will cover only the most common ones.

When should I see a doctor immediately if I feel dizzy?

In all cases of dizziness accompanied by the following symptoms, see a doctor as soon as possible:

Severe headache and muscle weakness in the arms or legs.
Severe dizziness that lasts more than an hour.
Severe dizziness arising in a patient with hypertension or diabetes mellitus.
The patient fell and was injured as a result of dizziness.
The patient lost consciousness as a result of dizziness.
Elevated temperature.
Persistent vomiting.

What to do if you feel dizzy?

If dizziness occurs, it is recommended to consult a neurologist.Establishing the exact cause of dizziness and prescribing the correct treatment requires a comprehensive examination of a therapist, neuropathologist, endocrinologist, and otolaryngologist.

If dizziness develops acutely and there is speech impairment, weakness or awkwardness in the limbs, double vision, numbness or other sensory disorders, you should immediately call a doctor. It will be most correct to lie down before the doctor arrives and measure your blood pressure. If the pressure is increased, no measures should be taken to reduce it abruptly.Remember: in most cases, lowering blood pressure below normal is more dangerous than raising it. Do not take medications without talking to your doctor.

Tests that help establish the diagnosis

Neuropathologists, otolaryngologists, ophthalmologists are engaged in the diagnosis and treatment of diseases associated with dizziness. In order to clarify the cause of dizziness and prescribe the correct treatment, the patient undergoes a number of examinations:

examination by an ophthalmologist,
X-ray of the skull and cervical spine,
Doppler ultrasound of the main arteries of the head,
computed tomography (CT) or nuclear magnetic resonance (NMR),
audiographic examination.

Diet in the treatment of vertigo

Due to the fact that in some diseases that are accompanied by dizziness, there is an excess of fluid filling it in the inner ear (for example, hydrops of the inner ear, Meniere’s disease), it is recommended to observe a number of dietary restrictions to remove excess fluid from the body for these patients:

Restriction in the consumption of salty foods and table salt (no more than 2 g per day).
Restriction in fluid consumption (no more than 1.5 liters per day).
Exclusion of tobacco and alcohol.
Restriction of consumption of chocolate, tea, coffee.

Rules for the arrangement of the life of a patient prone to dizziness

Except for those cases when dizziness is a sign of a dangerous disease (for example, a brain tumor), it does not pose a particular danger to human life. But its consequences can be very dangerous, for example, injuries as a result of falls.Patients suffering from chronic forms of dizziness are advised to secure their place of work and home according to the following principles:

Cover the floors with soft carpets that do not have folds or kinks to trip over.
In the bathroom, install the shelf with accessories in an easily accessible place, which you can reach without getting up, glue special non-slip rubber pads to the bottom of the bathroom.
In the shower cubicle, install handrails and a chair where you can shower while seated.
Equip existing staircases in the house with double-sided handrails. When climbing stairs, always hold on to them, even if at this moment your head is not dizzy.
Place the night light on your bedside table so that you can turn it on without getting out of bed.
If possible, place the phone near the bed so that you can reach it without getting up.
Getting out of bed, take your time, get up with caution, sit on the bed for 1-2 minutes and only when you feel normal, get up completely.
Avoid activities requiring balance and precise control of body position in space (active sports games, cycling).

Exercises to treat vertigo

Certain types of vertigo (eg, benign positional vertigo) are successfully treated with specific exercises.

Complex No. 1.

Sit on the floor with your legs extended and look in front of you.
Lie quickly on your back, quickly turn onto your left side, continuing to look in front of you.
Quickly roll over onto your right side, then just as quickly roll over onto your back, and then return to a sitting position.

Fast execution of the exercise is very important in this case. This is necessary to maintain the healing effect. Before doing the exercise at a fast pace, do it several times, slowly, slowly, memorizing the order of movements.

Complex No. 2.

Standing position, look in front of you. Turn to the left (around the left heel), turn to the right (around the right heel).

Complex No. 3.

Sitting in a chair, lean forward quickly and look at the floor. You also quickly straighten, turning your head to the left.
Repeat the exercise once more, while turning the head to the right.
Quickly turn your head to the left, then to the right. Repeat three times.
Bend over quickly while looking at the floor. Then quickly straighten up, keep your head straight.
Quickly nod your head three times, bringing your chin to your chest.

It is necessary to repeat these exercises 2-3 times a day for 3-4 months in the safest calm environment, having previously agreed on the possibility of their performance with the attending physician.

In the first time after the start of exercise, an increase in dizziness may occur, but continuation of regular exercise it decreases very quickly and gradually disappears.

Vertigo

Olga Beklemishcheva: Today we will consider a symptom called dizziness. This is not quite the usual formulation of the question for our program. As you know, we mainly talk about the treatment of a specific disease or group of diseases.And this time we decided to tell in more detail about the symptom that accompanies many diseases of various origins. The fact is that dizziness is a very common complaint of patients. Every tenth person at a therapist’s office complains about them. And at a neurologist’s appointment – every third. Statistics, of course, are selective, but quite reliable. The danger of dizziness is that we quickly get used to it, and after all, very dangerous diseases can hide behind them, which no longer manifest themselves until it is too late.This, of course, is an extreme case, but everyone should know some things about dizziness. Therefore, today in our studio is Professor of the Department of Neurology of the Russian State Medical University Alexei Alekseevich Nikonov. And Professor Daniil Borisovich Golubev, our permanent American expert, who will talk about the tactics of American family doctors in case of complaints of dizziness, will take part in the conversation. And we start.

Alexey Alekseevich, there are well-known symptoms of diseases – fever, nausea and vomiting.The Russians know better than the prayer “Our Father” when to take aspirin and when to call an ambulance. And with dizziness, the situation is completely different: people complain about it, but they cannot imagine how to treat it at home. What is dizziness?

Alexey Nikonov: Dizziness is the same general cerebral symptom. But unlike the headache we talked about in the previous show, it has a double meaning. Dizziness can be a manifestation of some disorder, some kind of disease of the nervous system, but at the same time it can be a manifestation of a disease of the ear, throat, nose, that is, those organs that are within the competence of ENT doctors.Dizziness can be the onset of such formidable diseases as bleeding with anemia (unfortunately, it occurs when the bleeding has already taken place). This may be the first manifestation of myocardial infarction, stroke, meningitis, hypertensive crisis, vegetative dystonia. I can practically list the table of contents of a textbook on medicine for senior courses. And therefore, it is probably significant to understand: what do we mean by dizziness? Oddly enough, a person who complains of dizziness means basically four types of it.The first is the movement of objects in front of the eyes in a certain direction (left, right, up, it doesn’t matter). The second is the so-called non-systemic dizziness, that is, a person feels that everything is spinning inside his head, but he cannot describe it accurately. Third, very often patients complaining of dizziness say “I’m about to lose consciousness” when you ask them the question “what do you mean by dizziness?” That is, the feeling of an impending loss of consciousness, fainting. And finally, the person says: I don’t know what dizziness is, but something is wrong with me.

Olga Beklemishcheva: He staggers.

Alexey Nikonov: Also option. And I can say that dizziness differs from all other symptoms in classical neurology in that there are so-called physiological dizziness, that is, dizziness in healthy people.

Olga Beklemishcheva: Is this not what athletes mean by being dizzy with success?

Alexey Nikonov: Well, you understand, dizziness from success is more a metaphor, and dizziness is dizziness, dizziness is spinning.And if my head is spinning, a person can say: I am unstable when walking, I am unstable when standing, I have an unpleasant sensation when I change the position of my head, I cannot walk for sure. Well, and what is familiar to the entire population of the earth, remember the state of slight intoxication, which causes uncertainty in gait, uncertainty in movements, this is noticeable to others, this can also be objectified, like a complaint of dizziness.

Olga Beklemishcheva: We will not consider such pleasant conditions for a part of our population.

Alexey Nikonov: By the way, intoxication, manifested by dizziness, latent intoxication, is not the intoxication that a person objectifies …

Olga Beklemishcheva: He knows what he has taken.

Alexey Nikonov: Yes, he knows what he took, but just like that – dizziness can be a sign of any intoxication, that’s the trick.

Olga Beklemishcheva: And this, probably, should be borne in mind, because we do not always realize that we have poisoned ourselves with something.

Alexey Nikonov: Well, in order to say “poisoned” or “something happened to me”, let us first tell our listeners what a normal state of dizziness is in healthy people. This is not defeat, this is annoyance. This is an inconsistency between the three main functional systems of the brain. After all, dizziness is not only the vestibular apparatus. Three systems are involved in the realization of vertigo. This, of course, is the vestibular apparatus, but this is also the visual system, and this is a system of general sensitivity, in fact the entire brain.And what is interesting, remember, normal dizziness, if a person was simply put on new glasses, and they were just a little wrong, he went out into the street in them and he said: my head was spinning. Is this a pathology or a norm?

Olga Beklemishcheva: This is just a glitch in the system for evaluating external information.

Alexey Nikonov: That is, this is over-irritation, this is an inadequate integral reaction, summing up all these three functional systems.

Olga Beklemishcheva: Is this physiological dizziness?

Alexey Nikonov: Of course. This is not a defeat, but simply inconsistency, multidirectionality of those complex neurophysiological mechanisms that ensure upright walking, excellent well-being, which ensure the absence of dizziness. Dizziness is still a manifestation of some kind of inconsistency in this situation.

Olga Beklemishcheva: In this sense, it is the same symptom that indicates some disorder, as the same temperature, which doctors constantly talk about, is a signal.

Alexey Nikonov: This is a signal. Therefore, our task today is to remember that a person who is spinning on a carousel and dizzy is not a pathology, this is the norm.

Olga Beklemishcheva: He is spinning for this.

Alexey Nikonov: He got out of the carousel, maybe for a minute, maybe two heads, and then everything came fine in a good state. The next point is also important. Panoramic cinemas are in fashion now. And when you watch chase scenes there, and I came across this, when the first videos with chase scenes appeared, and the kids looked directly at them, stared at the TV, they also got dizzy. That is, I explain that people do not care about these dizziness, agree with me.

Olga Beklemishcheva: But there are dizziness accompanied by a feeling of fear and insecurity. That is, a person already subconsciously knows that something is wrong with him, that this is an abnormal reaction to some change in the external environment. This can already be called the painful symptom that should be discussed.

Alexey Nikonov: Of course. And here you quite rightly said that dizziness itself, if it can be explained, will never cause fear, anxiety, or anxiety.But if a person, on the whole healthy, suddenly begins to spin objects in front of his eyes, this is a lack of information: why did this happen? And the lack of information causes fear, anxiety, anxiety and a whole chain of those reactions that accompany it – up to a rise in pressure, increased heart rate, a sense of fear of death, panic.

Olga Beklemishcheva: The so-called “panic attacks”.

Alexey Nikonov: In general, yes.But, you see, everything is reciprocal here. Dizziness can cause a panic attack, but this is quite rare, but the panic attack itself includes, as one of the many symptoms of its manifestation, non-systemic dizziness.

Olga Beklemishcheva: I will explain a little what this is about. A panic attack is a condition of a person, mainly women of a fairly young age, which is accompanied by the fear of death.

Alexey Nikonov: In general, yes.Fear of death is a typical symptom of a panic attack. Panic attack is a more Western term. Our fellow citizens are more accustomed to the term vegetative dystonia with such and such or other vegetative crises. The late Academician Aleksandr Moiseevich Vein was engaged in this all his life, and now his school continues his work.

Olga Beklemishcheva: Bright memory, a great man.

Alexey Nikonov: Yes.You know him too, we knew him and loved him and worked with him for many years. I want to say that vegetative dystonia, unfortunately, is not only the prerogative of young women, as we would like, but also adult men in their prime, formally healthy … Sometimes these panic attacks are an inexplicable, sudden feeling of fear of death – so their invalidate that they simply cannot work. This is a topic for our separate conversation.

Olga Beklemishcheva: Now I would like to ask our American expert Professor Golubev, how will an American general practitioner (as you call it, “family doctor”) react to the initial visit of a patient with a dizziness symptom?

Daniil Golubev: In general, I believe, just like the Russian one, that is, realizing that this symptom can be a manifestation of a variety of conditions – from the most harmless to deadly and can be caused by diseases of various organs and systems, again relatively easy to heal, and very formidable in their consequences.But there is one peculiarity that catches the eye when comparing the treatment tactics of American doctors and doctors of European countries. This feature is associated with the special attention of the American medical school to the role of the vestibular apparatus in the genesis of vertigo. In other words, in the absence of a clearly expressed connection between the first case of dizziness with certain diseases of the internal organs, the American doctor will certainly send the patient for an initial consultation with an otolaryngologist. This direction can be combined with the involvement of other specialists – neuropathologists and therapists, but he will definitely refer him to an otolaryngologist. Only after the vestibular component in the genesis of vertigo is rejected, an in-depth search for other causes of this condition will begin. Once again, I want to emphasize that if there is an obvious connection between the symptom of dizziness and pathology of the brain or cardiovascular system, appropriate treatment will begin immediately, but in unclear cases, especially during the initial treatment, consultation with an otolaryngologist will play a primary role.A reflection of this attitude to the symptom is that in medical encyclopedias and reference books, the list of the causes of dizziness begins with the syndrome of “vertigo”, that is, a violation of the circulation of fluid in the canals of the inner ear or a violation of the innervation of this area. This is followed by the labyrinthitis of infectious etiology, Meniere’s disease Meniere’s, neuroma of the vestibular nerve, meningitis, and only then – vertebrobasilar insufficiency, arthritis of the cervical spine, an increase or sharp decrease in blood pressure, impaired blood supply to the brain, stroke.

Olga Beklemishcheva: What methods of differential diagnosis and treatment of vertigo are most often used in America?

Daniil Golubev: In addition to the generally accepted methods of instrumental analysis, an important role in the differential diagnosis of the causes of dizziness is played by the method of nuclear magnetic resonance (MRI), and in otolaryngological practice, a special especially accurate type of MRI, which makes it possible to identify neuromas with a diameter of a few millimeters.

If, as a result of the diagnosis, a causal effect is revealed connection between dizziness and this or that disease – impaired blood supply to the brain, meningitis, infectious labyrinthitis, lesions of the cardiovascular and endocrine systems, hypotonic vascular dystonia, blood disease, head trauma and neck, then the treatment will naturally focus on the underlying disease.

In case of functional disorders of the vestibular apparatus, complicated by dizziness, anti-cholenergic and antihistamines are used, and very effective special exercises can be used to stimulate the stability of the vestibular apparatus.

Olga Beklemishcheva: Thank you, Daniil Borisovich. Aleksey Alekseevich, what does Russian tactics imply in the first place – namely, the patient’s referral to an otolaryngologist, after, of course, a district therapist, or, first of all, to a neurologist or neurologist, as they say now?

Alexey Nikonov: This is a matter of the competence of the local therapist. I do not see the difference between European, American, Russian schools.There is either a doctor, or he is not, and it does not matter where he works – in America, in Russia, in Europe or Africa, in Latin America. All specialists are identical. Indeed, in terms of the frequency of pathologies encountered, it was considered and is believed that most often this is associated with damage to the middle inner ear, but that is the task of the one who in America is called a family doctor, we have a district doctor, to find out what the person is. means dizziness.

Olga Beklemishcheva: This is what you said earlier, there can be as many as four types.

Alexey Nikonov: Of course. And then, indeed, in a number of cases and most often, consultation with an earworm is needed.

Olga Beklemishcheva: And what type of vertigo is this?

Alexey Nikonov: This is systemic dizziness, when all objects circle in front of the eyes in one direction – either to the left, or to the right, or up, or down. But this is the art of a therapist to understand: what is the reason for this dizziness? If there is no violation of the heart rhythm, there are no other symptoms, the patient himself actively complains that he has a runny nose, that he has a fever, that his ear hurts and shoots, of course, a direction to the ear is necessary.But if dizziness is accompanied by nausea, vomiting, weakness in the limbs, double vision, inability to stand upright, and the general condition is severe, then this is already a question of the emergency room doctor, you will agree with me. And at the same time, we talked about physiological dizziness, with which a person can also come and say: you know, I went for a ride on the merry-go-round, and my head started spinning. They will tell him: calm down, train your vestibular apparatus. It will not make a person easier when you explain to him why he is dizzy, you don’t have to scare the patient at the appointment: you know, let us do a lot of research, what if you need an operation, what if you have a brain tumor … By the way Running a little ahead, perhaps I can say that, like the findings, with the introduction and general availability of magnetic resonance imaging in Russia now, small benign tumors of the eighth pair of nerves (this is the auditory nerve) are found – 1-3 millimeters.And if this tumor is, was, is observed once a year, and it does not grow, does not manifest itself in any other way, does not create difficulties in the mechanism of brain activity, then people live with it, I observe such patients. Neurosurgeons are quite calm about this and do not call for surgery, everything should be reasonable.

Olga Beklemishcheva: That is, in principle, a mole can be on the auditory nerve.

Alexey Nikonov: I can only agree with you.I want to say again that the tactics are the same throughout the world, there is no difference between the European and American schools. Yes, there are standards of care that provide for consultation with an earworm, followed by a therapist, third by a neurologist, and so on and so forth. But, in general, I do not see any discrepancies here.

Olga Beklemishcheva: Well, in Russia standards are not yet so strongly introduced into medical practice …

Alexey Nikonov: Why? They are absolutely implemented in practice, and every neurologist, every therapist has a standard: what complaints what examinations need to be done, to which specialists you need to refer in the first place, in the second, in the third.It’s a long time ago.

Olga Beklemishcheva: Alexey Alekseevich, are you sure that these standards are on their tables, not only when you come to check them, teach them?

Alexey Nikonov: Yes, yes. I have already told you that I visit quite different cities in Russia, and rural medical centers, and district neurologists in some small regional hospital, where he is alone for both the clinic and the hospital, and one for everything about everything … he is also perfectly knowledgeable.

Olga Beklemishcheva: This pleases me.

Alexey Nikonov: At least I haven’t come across others. The issue of the intellectual development of doctors is, you know, a very special issue, and the number of smart and other people in each specialty is absolutely the same, the range differs all over the world – in America, in Russia, in Africa.

Olga Beklemishcheva: Everything is distributed according to Gauss.

Alexey Nikonov: Of course.

Olga Beklemishcheva: Returning to the symptoms of dizziness, what is associated with otolaryngological pathology, we probably should not consider now, because it is clear that here the ENT doctor – he has cards in his hands, and various diagnostic and other survey methods. But what should dizziness look like without other symptoms in order for a person to still better go to a neurologist?

Alexey Nikonov: I have already spoken about the non-systemic nature of vertigo, something that belongs to the competence of a neurologist.If dizziness appears with a sharp turn of the head, if the ear does not suffer, if there is no runny nose, if there are no fluctuations in blood pressure, if there are no other formidable symptoms, dizziness, as a manifestation of hypertension, is a fairly frequent symptom. Dizziness, as a manifestation of heart rhythm disturbances, is also an equally frequent symptom. But, of course, the frequency of damage to the ear, throat, nose, runny nose, some kind of otitis media, as a complication of chronic, there, pharyngitis, laryngitis, acute inflammation of the ear, throat, nose, is in the competence of the ear throat.But if this is combined with something and is not directly related to the ear, throat and nose, then you need to contact the local doctor, and he will decide whether this is the competence of the therapist, or whether it is the competence of a neurologist. For this, the local therapist is sufficiently armed with knowledge. I can say that there is this in the system of training in the basics of neurology for district doctors, which we are engaged in.

Olga Beklemishcheva: Nevertheless, why do so many people complain of dizziness just in everyday conversations? If everyone is well enough armed?

Alexey Nikonov: I can say that when we hear complaints of dizziness, about two-thirds of women over 65 and about 40% of men at the same age experience dizziness.

Olga Beklemishcheva: Is this physiological?

Alexey Nikonov: No, these are age-related things. The brain, unfortunately, also ages in a certain way with age, not only because of some vascular lesions, the structure of the brain itself is somewhat simplified, that complex integrating system of interconnections of the vestibular, visual and sensory analyzers is simplified, and when it is simplified, there is what there is a lack of information, and it can be realized in non-systemic dizziness.

Olga Beklemishcheva: That is, we can say that it takes more time to bring into the system, to integrate all the signals that a person receives from the look, from the ear, from his general muscular feeling, and if they are a little the slower they tend to this synthetic picture, then their dizziness will be less.

Alexey Nikonov: Dizziness that occurs slowly, inconsistently, gradually, a person sometimes adapts to it, sometimes not.You will notice that they complain, but they don’t go to the doctors.

Olga Beklemishcheva: So this is a sign that this is, in principle, a tolerable malaise?

Alexey Nikonov: If a person gets used to it, then he knows that it is unlikely that he will go to a therapist: the therapist will say that this is not mine, I understand that you have a change in pressure, go to a neurologist, go to the earworm, and everyone says it’s not mine.But for this there is an even more subtle specialist, this is the so-called otoneurologist, who, in the most difficult cases, will deal with dizziness. And one more very important nuance. Some of our elderly fellow citizens are very fond of eating pills.

Olga Beklemishcheva: And as a general intoxication syndrome, including … effect, rare, insignificant, dizziness would not be described.And I once again urge that each medicine should be monitored by medical prescriptions and its effectiveness, appropriateness, duration, and so on, should be assessed.

Olga Beklemishcheva: Take note of this, dear listeners. Let’s still single out those dizziness that are signs of neurological diseases, neurological disorders, those that should first of all force a person to take a careful look at their health and start looking for a suitable doctor.

Alexey Nikonov: Probably these are the dizziness that does not appear quickly on its own and go away on its own, although this is also a reason for a neurological examination, but these are dizziness that is combined with other symptoms of damage to the nervous system … If dizziness not only causes fear, but is accompanied by nausea, vomiting, inability to raise your head, loss of consciousness, numbness, double vision, weakness in the limbs – in the arms, legs, speech impairments, then this is a reason to dial “03”, not thinking.

Olga Beklemishcheva: But even here the leading syndrome is not dizziness as such, but what you said – nausea, weakness.

Aleksey Nikonov: I am talking about the fact that dizziness may be the first sign, and in the next minutes or hours such symptoms are added, from the point of view of a person, not always significant. Dizziness is unpleasant, it is disabling, it causes nausea, in some cases – vomiting.But if suddenly my cheek, lip, half of my tongue become numb (due to the severity of dizziness, a person is not inclined to pay attention to this), this may already be a stroke. Or there are pains behind the breastbone, shortness of breath – these are also formidable symptoms.

Olga Beklemishcheva: Well, I think our listeners will take note of this.

And now news from Evgeny Muslin.

Skin patches coated with a culture of bacteria E. coli, which causes diarrhea, enhance the body’s immune response and can dramatically reduce the need for influenza vaccine in the event of a global pandemic.This was stated by Dr. Gregory Glenn, scientific director of the American company “Yomai” .

Experiments on mice and guinea pigs have confirmed that patches with bacterial culture allow obtaining the necessary immune response to vaccines against common and avian influenza when their doses are reduced by 100 or even 10 thousand times.

For humans, as Dr. Glenn said at a conference on infectious diseases in Baltimore, the required doses will probably be reduced by 10-50 times, and the bacterial patches can be glued to the skin immediately after vaccination, instead of the usual hygienic patches.Clinical trials of the efficacy of bacterial patches are planned at the National Institute of Allergy and Infectious Diseases in the process of testing a vaccine against the H5N1 avian influenza virus.

“Hundreds of millions of our patches,” said Dr. Glenn, “can be stocked and distributed in advance, even before a massive pandemic begins, especially since they are universal and suitable for any influenza virus.”

Experts fear that in the event of a pandemic, there will be an acute shortage of vaccine necessary to protect the entire population, since influenza viruses are extremely variable, and it is not known in advance which virus will have to be dealt with.

“This is a great new technology,” said Dr. Bruce Wagner of the Center for Disease Prevention and Control of America of Yomai’s development, “it’s simple, effective, and addresses the lack of factory vaccine capacity around the world.”

Two million children in developing countries die each year on their birthday only because of a shortage of skilled midwives and mothers not getting tetanus shots.This was stated by the head of the international charitable organization “Save the Children” Jasmine Whitbread. Its 2006 World Motherhood report found that of the more than 10 million children who die each year in poor countries under the age of 5, one in five children dies in the first 24 hours of their lives.

“The first hours, days and weeks are critical to the lives of children, but few newborns in poor countries receive the care they need,” the report says.”Simple and cheap measures can reduce infant mortality by 70%.”

Newborn mortality in developing countries is so common that parents do not give them names until the baby is at least a week old. “This is one of the most pressing global health problems, one that is overlooked and urgently needed by governments,” the report says.

Tests for AIDS virus infection, according to American health officials, should become as routine in the United States as testing blood for cholesterol.According to a proposal from the US Centers for Disease Prevention and Control, such voluntary tests will be done to all Americans between the ages of 13 and 64 years old and when visiting doctors for ambulance and general examinations.

The fact is that one in four of a million Americans infected with the immunodeficiency virus does not even know about it, and it is this group that is most responsible for the spread of the AIDS epidemic.

Olga Beklemishcheva : And now we must answer the first caller.Tamara Mikhailovna was the first to call us from St. Petersburg.

Listener: I’ll try to be short. I have no dizziness. I know what dizziness is. I have instability. I lie, it seems to me, I will get up and go, but I get up and … I have instability, I only walk with a stick. I found a certain analogy when talking about people working in America on very high buildings, on high-rise buildings. When they descend to the ground, they do not have dizziness, but there is instability, they need to somehow settle in place.

Alexey Nikonov: First of all, of course, the issue of age is important, and if a person looks down from a height, he reflexively develops dizziness. And what can you advise Tamara Mikhailovna here? This is primarily the selection of glasses. Go to the optometrist. This is not dizziness. Shakiness of walking, violation of posture, if this is an age, let’s say, not the youngest, then this is very often associated with insufficient blood supply to the posterior parts of the brain and with insufficient blood supply to the occipital, temporal lobes, that is, where the main centers are located that ensure stability when walking …She walks with a stick. Unfortunately, the call fell through, I can only speculate. If Tamara Mikhailovna hears us, I can advise that in St. Petersburg there are excellent neurologists, in particular, there are clinics of the First Medical Institute, and the Military Medical Academy, and the Society of Neurologists of St. Petersburg is headed by Academician Skoromets Alexander Anisimovich. I have been to St. Petersburg, I do not think that you will be denied help, but do not really turn to an earworm, but to a neurologist.

Olga Beklemishcheva: And the next call is Elena from St. Petersburg.

Listener: I didn’t hear the beginning, I’m sorry, I only heard my symptoms later. I want to explain briefly. When I get very nervous (well, before, up to 50 years old, it was very rare for me), my head dizzy and it hurts, I close my eyes, lie down, vomit, vomit, I can’t look, everything flies around me, and I fly down, and the ceiling falls on me, I feel very bad. And they tell me that I am becoming completely green, the pupils are slightly dilated.

Alexey Nikonov: Elena, excuse me, I’ll interrupt you. Did you measure your blood pressure at that time?

Listener: You know, I generally don’t like going to the clinic, I didn’t measure. Now I am already 70 years old. So, I am a very energetic person, and my thyroid gland has been removed. Recently I was examined by a stump, it seems that it works there a little hyper. Now these attacks have become more frequent. What I told you is repeated about once a month.In addition, pain in the chest, under the scapula, under the neck and teeth. And my pulse is like a thread then. Jumped to 70, nothing.

Alexey Nikonov: I can only advise you on one thing. Well, in the end, all intelligent people, why don’t you like going to clinics, don’t measure your pressure and have to endure and reduce your own quality of life? Perhaps they will certainly help you, I can name the specialists. This, of course, is an endocrinologist, first of all, and the neuropathologist to whom your thyroiditologist-endocrinologist will send you.

Olga Beklemishcheva: In addition, you should still have a home apparatus for measuring blood pressure, because the first thing Professor Nikonov started with is that dizziness can accompany a sharp change in pressure.

Alexey Nikonov: Both rise and fall.

Olga Beklemishcheva: I personally, as a hypotonic person, periodically encounter a sharp change in posture … Of course, it is clear that with age it will be more serious.

Alexei Nikonov: I absolutely agree with Professor Golubev, go to the therapist, let them take an elementary cardiogram. If these are rhythm disturbances, and they are stopped for you, then you have all these manifestations that you are complaining about – with nausea, with vomiting, they will simply pass.

Olga Beklemishcheva: I see that, judging by the story, the mechanism is as follows: stress … Surely, there is an increase in pressure.

Alexey Nikonov: Dizziness appeared, then nausea, vomiting, inability to tear off the head and a threadlike pulse.Threaded pulse – most likely this is a decrease in pressure. Are there any interruptions in the heart, are there pains in the heart … With ischemic heart disease, with a pre-infarction state, there may also be dizziness and nausea, and vomiting.

Olga Beklemishcheva: And the next listener is Sergey Lvovich from Moscow.

Listener: I worked as a radiologist in the seventh city hospital. How does ionizing radiation affect a person? I can’t explain to myself, but it was clearly dizzy.And second, do blind people experience dizziness?

Alexey Nikonov: Answering your first question about the effect of ionizing radiation, I think it’s a question of dose. Radiologists who work … You also walked around with a dosimeter, it is very tough in the health care system – both Russian and Soviet – it has always been dosed. The doses you received could not cause dizziness. This is an evidence base, absolutely clear and specific, the answer is no.Another question is that with age, dizziness becomes more frequent. The answer here is yes. And the next question that you put before us, about blind people, is a very good question. Blind people most often do not experience dizziness.

Olga Beklemishcheva: Because it is connected with the activity of the visual analyzer as well.

Alexey Nikonov: Paradoxically, when the vestibular analyzer is damaged, the vertigo decreases sharply.

Olga Beklemishcheva: That is, if we have something wrong with the vestibular apparatus, we will not get dizzy?

Alexey Nikonov: No, not in order – this is a partial defeat, a partial irritation. I have already said that vertigo is provided by three analyzers – visual, vestibular and sensitive. And if the vestibular or visual switches off, the other two analyze its function.And if pathological impulses do not come from there, it means that the dizziness also significantly decreases or disappears altogether, this is such a paradoxical fact noted in many monographs, even in the ear.

Olga Beklemishcheva: I then had the following question. Is it possible to train your vestibular apparatus in such a way as to reduce dizziness?

Alexey Nikonov: There is a medical and physical dispensary.I can give a mini-lecture for our doctors, four stages, each with 2-3 exercises on how to train the vestibular apparatus. If the vestibular apparatus suffers moderately, like in the elderly, then these trainings give a fantastic effect, and you don’t even need to drink pills.

Olga Beklemishcheva: Why did I ask this question? I had a very good scientific advisor who once told me that due to the fact that he traveled a lot in his youth, in particular, on camels, of course, it was terribly nauseous and nauseous there, the Russian person is not well adapted to the camel.He came up with his own gymnastics, he just twisted his head – three times to the right, three times to the left, and after a while all the symptoms of seasickness from riding camels disappeared. I thought, maybe there is some simple exercise or is it still dangerous?

Alexey Nikonov: Let’s do this, if the nature of the dizziness is clarified, if the cause is eliminated, and the dizziness remains as a trace reaction, then the first exercise: lying on your back, follow the instructor’s finger only with your eyes.He will bring your finger closer to your nose from one meter to 30 centimeters, both left and right. The second phase is when he sits you down. The third phase is to stand. And the fourth phase is to exchange a ball or some other objects, and perform highly coordinated movements.

Olga Beklemishcheva: But is it better not to do this without an instructor?

Alexey Nikonov: It is better not to study without an instructor, without a medical appointment.The system of medical physical education in dispensaries is still in effect. And one moment. I would like to say that, of course, you do not need to endure, you do not need to endure dizziness. If not accompanied by any symptoms, you just need to take a pill.

Olga Beklemishcheva: Which one?

Alexey Nikonov: Drug treatment for vertigo is so diverse. Let us recall the aeron and belladonna preparations known in Soviet times.If the dizziness is moderate and not accompanied by gag reflexes, which do not allow taking the pill, today the drug of choice is betaserc, betahistine. It is now in all pharmacies, but before you decide to take it for yourself, you need to go to the doctor so that he can determine the duration, dose, appropriateness, and so on and so forth. Still, there are no harmless drugs – this is my point of view.

Olga Beklemishcheva: Betaserc can be taken by those elderly people who suffer from dizziness and nothing else?

Alexey Nikonov: A lot of reliable studies have been carried out, betaserc has a very good effect on the prevention of dizziness in the elderly.This is known for certain. It is considered the drug of choice today. But I want to emphasize once again so that you do not run to the pharmacy and do not take it yourself, but go to an appointment either to a therapist, or to a neurologist, or just to your friend’s doctor, who will competently explain to you the expediency and duration of this admission.

Olga Beklemishcheva: And the next person to call us is Galina Sergeevna from Moscow.

Listener: Alexey Alekseevich, it is very difficult to get advice from you, because listening to you, I realized that all these symptoms of dizziness in different positions you still attribute to age-related costs.And to what etiology can my dizziness be attributed? If I go to the clinic, it stops for me. If I am in a relative’s apartment, it also stops. As soon as I come to my apartment … I conducted several examinations – both the ear throat and the neurologist, therapists do not do this at all, and I came to the conclusion that really ionized radiation is coming, then people are put on a neurocomputer. People do not understand why their ear is blocked, this betaserc does not help, no matter how many times they have not taken it.

Olga Beklemishcheva: Galina Sergeevna, the fact is that part of the dizziness is carried out by the department of psychiatry and you shouldn’t be afraid or ashamed of it. As Professor Nikonov told me, in Europe up to 40% of people calmly take antidepressants and this is not considered some kind of vice, it is just a way to help a person.

Alexey Nikonov: Galina Sergeevna, I think that the therapists you went to really do not do this, this is not their specialty, but they probably performed such a primitive examination for you as taking an electrocardiogram to rule out pathology heart rate, to exclude a violation of the blood supply to the myocardium.Everything related to the effects of radiation has already been proven that this does not affect this situation. And once again I want to say, if you cannot clearly characterize your dizziness completely, and it occurs in your situationally in your apartment, and not in relatives or friends, and when you go to the clinic, it also appears partially on the street , I think that the most optimal thing is to go to a neurologist and explain to him what I said: what do you actually perceive under dizziness and what complaints still accompany your suffering?

Olga Beklemishcheva: The next question is from Andrey from the Moscow region.

Listener: My mother is 60 years old, she sleeps very badly. Her therapist prescribed nitrazepam. She has dizziness in the morning and cannot get up for 15 minutes. Is this the effect of the medicine? How can this be explained? And she drinks strong tea and she immediately gets better.

Alexey Nikonov: Andrey, measure your mother’s blood pressure. Nitrazepam is a good sleeping pill. If it helps, you probably need to ask the doctor if the individual dose of this medicine is related to that dizziness.But most likely, if mom is feeling dizzy in the morning, take your blood pressure. If it is normal, then ask your doctor about changing the sleeping pill. I said that almost absolutely the use of all drugs – from the most well-known (aspirin, which is more than 160 years old) to the most modern – in single people or in a group of people can be accompanied by dizziness. Maybe it just doesn’t suit your mom.

Olga Beklemishcheva: And there are other sleeping pills.

Alexey Nikonov: Of course.

Olga Beklemishcheva: The next listener is Irina from St. Petersburg.

Listener: I am 64 years old. Last year I went outside, it was very cold. I am a person who never visits doctors, but God has mercy on me. I went outside, frost, and suddenly I had pain behind my breastbone and it was so strong that I even had to return home.But the day passed, it all went away from me. The next day is the same. I called the ambulance. They told me: take nitroglycerin and valocordin urgently. I did it. Finally, I went to the doctor. So what? The doctor looked at me, made a cardiogram, prescribed medicine. But it absolutely did not help. These attacks occurred last year and in the summer I literally every half hour at the dacha, until I lie down for 5-7 minutes … That is, these attacks passed without any medication. I could take nitroglycerin, I could not take it, all the same, the attacks came.Thank God, this year all this has passed for me. That’s what it was, I can’t figure it out.

Alexey Nikonov: Are these attacks of chest pain?

Listener: Behind the breastbone. The state is such – a person is running, in a hurry and such a state of pain after a strong run.

Alexey Nikonov: This is outside the topic of our program. I can say the following thing: you need to go to the doctor again, explain your observations to him in more detail, and, perhaps, after the examination, the therapeutic examination, the doctor can connect this with something.I do not exclude that they will not be able to explain this to you. Thank God it’s all gone. But, excuse me, the culture of our people, the culture of modern society consists in the fact that any person must undergo a preventive examination at least once a year. Moreover, now it is becoming mandatory for many workers. And for people over 60, perhaps these visits to the doctor should be more frequent. And then all of our listeners, Olya, the question begins with this: I don’t go to the doctor, I am treated myself …

Olga Beklemishcheva: Yes, and this is considered as a matter of pride.Although, dear listeners, I understand that often a visit to the clinic is not the right time, I don’t want to be too lazy to force myself, but you need to take care of your health a little, you need to be more attentive to it and not assume that you can feel good just by listening let’s say our program. You see, you need to make some personal efforts. I really want you to do this, so that you have enough strength and patience, because then you will certainly live better, the quality of your life will increase. Now there are a lot of very good techniques, medicines, you just need patience and some effort to apply them.

I would like to ask one more question to Professor Nikonov. All the callers say that the diagnosis was not made … And what kind of diagnostic manipulations should a neurologist apply when he is approached with complaints of dizziness, and the ENT doctor has already looked, ruled out his pathology, the cardiologist looked, ruled out his pathology? Here you, as a neuropathologist, what will you look at and on what diagnostics?

Alexey Nikonov: I have already listed the widest range of diseases of the nervous system, which can debut with dizziness, be accompanied by dizziness, or be where dizziness is the main complaint.I think that each of these neurological forms, of these diseases, has its own clear-cut examination algorithm, which includes the electroencephalogram, and according to the indications of the Doppler examination of the vessels of the main arteries of the head, and, if necessary, magnetic resonance imaging, but this is already the competence of the doctor and in each specific situation there is no single standard that everyone with dizziness should be sent to some …

Olga Beklemishcheva: At NMR.

Alexey Nikonov: At NMR. Well, it’s just not necessary in some cases, it’s unnecessary. Nevertheless, I think that here it is especially important for a neurologist, first of all, to stop this dizziness in this particular patient. And what we start with is that we examine the neurological status and look at the conclusion of the therapist – whether there is arrhythmia, whether there is high or low blood pressure.

Olga Beklemishcheva: And if this is not all, then you can prescribe the same drug and lead the person further, having already removed this symptom.

Alexey Nikonov: Of course. These drugs are selected individually, but I want to say again that today, maybe tomorrow there will be something different, this is the drug that we talked about, this is Betaserc, which can be bought at the pharmacy, it is available, and the main thing is that it will be clearly and completely tracked under medical supervision.

Olga Beklemishcheva: The next listener is Irana Alexandrovna from St. Petersburg.

Listener: Alexey Alekseevich, I am 66 years old. I have always led an active lifestyle. In the past, she was once an athlete. Recently, I noticed that if I lead a sedentary lifestyle, for example, I watch a movie for a long time or sew something, bending over a little, then after a few hours a slight dizziness may begin. Do you think this is due to ostechondrosis or what? Which doctor should I go to?

Alexey Nikonov: I think you need to go to a therapist, take a cardiogram, measure your blood pressure.But what I said, if this dizziness is due to the fact that you are in one position for a long time, and then you get up abruptly and your head starts spinning, then … You led a reasonable lifestyle and lead it, probably. Reasonable physical activity is needed, those exercises that I talked about – gaze concentration, turning the eyes left and right, soft, very smooth turns of the neck in the morning, after sleep, at rest, when you are relaxed, turned your head to the left, hold it in the extreme abduction, return to the center, count to yourself to ten, turn right.In this way, three exercises – and you are already training your vessels. I think you will part with dizziness.

Olga Beklemishcheva: That is, it is possible to train cerebral vessels at any age?

Alexey Nikonov: Well, this is with a certain tolerance – to train the vessels. It is necessary, of course, it is necessary. And then, our patient, conditionally, what did she say? I led an active lifestyle and did not turn to anyone, I walked.Now what? Sitting position, prolonged forced position of the head, eye strain. Maybe here the glasses need to be picked up, changed.

Olga Beklemishcheva: I want to say goodbye to our listeners. All the best! Try not to get sick!

Loss of strength: causes and symptoms, what to do

It so happens that a person begins to feel constant fatigue, it is difficult for him to force himself to do something, his appetite and interest in life disappear.This condition has received the definition of “loss of strength”, and this is an alarming bell of the body, which must be paid attention to. Neglected cases can develop into chronic fatigue syndrome and cause depression. In addition, lack of energy can be a symptom of a number of dangerous diseases such as diabetes, arthritis, anemia, thyroid or cardiovascular problems. In this case, timely diagnosis and medical assistance can cure the disease and save lives. Fatigue is dangerous for the body, so you should not neglect rest, proper sleep and physical activity.

What are the symptoms of a breakdown

Scientists have concluded that about two-thirds of the world’s population suffers from constant fatigue. Regardless of the place of work and the nature of the activity, people begin to feel a lack of energy. Physical activity is no longer an indicator of fatigue. Intellectual activity and constant psychological stress provoke serious health problems.

Symptoms of loss of strength may vary from case to case, but there are several main points that can be highlighted:

Drowsiness.The constant desire to lie down and the inhibited state of the body negatively affect not only the person’s performance, but also the psychological state. In contrast to this symptom, some people suffer from insomnia.
Dizziness. General weakness, nausea, feeling unwell are common companions of a loss of strength and the first signs of chronic fatigue.
Irritability. An aggressive reaction to external stimuli often happens as a result of overworking the nervous system.
Decreased appetite. The body’s resources are aimed at eliminating fatigue, the brain is overloaded and does not send a signal in time about the need to eat.
Decrease or increase in pressure. The cardiovascular system actively responds to stress. A sharp increase in heart rate is often observed.

A combination of several symptoms reduces performance, mood deteriorates, depression may occur, and in some particularly severe cases, suicidal tendencies may occur.If a person is in a similar state for a long time, his health can be significantly affected.

Reasons for the loss of strength

A breakdown can occur regardless of age, social status, profession, level of employment. By the way, fatigue is especially dangerous for children, as it can develop into asthenia, that is, a loss of taste for life. Fatigue can arise from both excessive physical exertion and psychological stress.In modern society, the nervous system suffers more often than the muscular one.

The reasons for the loss of strength can be different:

Physiological causes

Lack of sunlight. Short daylight hours provoke drowsiness, apathy and reduce immunity.
Lack of vitamins and minerals. A poor diet, fast food, foods with a high content of harmful components do not provide the body with enough substances for normal functioning.
Hormonal disruption in the body. Immune system disorders can be triggered by a lack of hormones. To identify the problem, they pass a special analysis.

Psychological causes

Busy work schedule. Constant mental activity, irregular working hours, lack of days off, a fast pace of life – all this significantly depletes the nervous system and provokes a breakdown.
Conflicts.Problematic situations between family members and colleagues deplete the body’s resource. The time that can be used for relaxation and rest is spent on aggression, self-destruction, negative emotions.
Multitasking. Sometimes people push themselves into too rigid frames, forcing themselves to do a lot of things. The nervous system ceases to cope with the number of tasks – and a breakdown sets in.

There can be many more psychological reasons: failures in personal life, the impossibility of realizing any desires, envy and others.Most often, we are not talking about one problem, but about several, layered one on top of the other. In this case, the consultation of a qualified psychologist can help.

Fatigue can be one of the signs of a dangerous illness. There are a number of ailments associated with fatigue:

diabetes;
anemia;
an infection that occurs latently in the body;
diseases of the thyroid gland;
problems of the cardiovascular system;
physical inactivity;
depression.

Consultation with a therapist will help you understand the cause of the loss of strength. If the disease is identified at the initial stage, it will be much easier to overcome.

What to do in case of loss of strength

A breakdown is a serious reason to reconsider your approach to life in general and pay attention to health. Often, following a few simple steps can prevent serious fatigue consequences.

So, what to do in case of a breakdown:

Revise the power system

Proper nutrition has a positive effect on both physical and psychological health of a person.A varied diet will help replenish the loss of vitamins and minerals, give the body energy. Many foods improve mood and have a positive effect on well-being, help to get rid of fatigue. From drinks, you should lean on water, as it is the safest and removes toxins from the body. Diets, hunger strikes, and similar experiments are best left to a more favorable time.

Lead an active lifestyle

Daily stay in the fresh air solves the issue of vitamin D and oxygen supply to the body.Unventilated rooms and sedentary lifestyles make people feel weak and tired. For good health, it is enough to take a leisurely walk in the fresh air for half an hour a day.

Learn to relax

Upon returning from work, you need to be able to throw off the burden of responsibilities. Constant nervous tension provokes a breakdown. For relaxation, you can use any convenient and individual way: taking a bath, reading, massage, watching a movie, hobbies, listening to music, meeting friends, etc.d.

Fall out

Drowsiness does not just interfere with the productive functioning of the body. It is harmful to health, which means you need to get enough sleep. It is better to remove gadgets away from the bed, and instead use a book, music or soothing tea. During sleep, melatonin is produced, which effectively regenerates the body.

If none of the above methods helps, and the feeling of loss of strength only increases, it is necessary to urgently seek medical help.The therapist will examine and identify the disease that provokes fatigue. This will help restore health and re-experience the zest for life. And if you constantly adhere to the above simple rules, you can avoid a breakdown. It is always easier to prevent an illness than to get rid of it.

Read also: How to understand which vitamins the body lacks

See also: Burnout: Symptoms and How to Fight

See also: Herbs adaptogens: for strength, endurance and stress management

Dizziness with menopause.Vertigo treatment

Female sex hormones play a much larger role in the body than is commonly believed. In addition to their main purpose – to help in the conception and bearing of a child, estrogens also affect most systems, including the central and peripheral nervous, cardiovascular systems. That is why, with a deficiency of estrogen, unpleasant symptoms can develop: hot flashes, a feeling of heat, malaise, dizziness with menopause and cerebrovascular accident.

Causes of dizziness with menopause

Against the background of a decrease in the level of estrogen, the tone of the vessels is disturbed, the pressure fluctuates and the uniform constant flow of blood to the brain is disturbed. Deficiency of blood, which forms during active brain activity, can lead to hypoxia (lack of oxygen), which forms attacks of dizziness during menopause , manifested in the form of seizures. There are episodes when objects and people are felt around the body against the background of the appearance of dark spots and flashes of light, changes in the pictures of the surrounding world.

Against the background of such attacks, and can form:

coordination disorder,
movement disorders,
Problems with movement in space due to floating objects or ground underfoot.

With such attacks of dizziness with a climax of , stops are required to wait out the attack. There may be light-headedness against the background of a sensation of objects rotating, malaise, heart rhythm disturbances and nausea.Changes in position can aggravate the malaise, even fainting.

Examination by a neurologist

In addition to dizziness, you may experience:

Feeling sick,
hot flashes,
redness of the face and neck,
headache and nausea,
pressure and pulse surges.

Similar symptoms and any other ailments that occur during the climacteric period become the reason for seeking medical attention.

To identify the causes of dizziness and eliminate them, it is necessary examination by a neurologist
to exclude all possible causes of neurological disorders. All this is due to the fact that menopause can lead to an exacerbation of some pathologies that were previously available, but proceeded imperceptibly. These can be neuritis of the cranial nerves, osteochondrosis of the cervical spine, Meniere’s disease or hypertension, endocrine disorders, neoplasms (tumors).

Often, attacks of dizziness are aggravated by constant stress, overstrain and bad habits, and inappropriate nutrition.

Complete examination by a neurologist
allows you to identify all the factors and determine exactly why your head is spinning. The specialist can prescribe some studies and instrumental diagnostics, as well as recommend the consultation of an ENT doctor, ophthalmologist or cardiologist in order to exclude combined pathologies.

Based on all the results obtained, the data of the hormonal study and the patient’s complaints during the examination, the neurologist of the neurologist is diagnosed, the treatment tactics and methods of dizziness prevention are determined.

Treatment of dizziness with menopause

If all other reasons are excluded and the confidence that attacks of lightheadedness are associated precisely with menopause, then the approach to treatment of dizziness at menopause should be complex.All drugs and non-drug methods of treatment must be selected individually with a doctor, depending on the additional manifestations and the degree of violation of the general condition. So, if the symptoms are pronounced, and depend on a sharp deficiency of sex hormones, replacement therapy with estrogen preparations in strictly selected dosages and under tolerance control may be indicated. Non-hormonal drugs that improve the general condition, drugs with a sedative, sedative effect and anti-stress protection can also be used in the treatment of dizziness with menopause .A course of multivitamins with minerals is shown to replenish the body’s reserves, to prevent anemia and osteoporosis.

Additionally, treatment of dizziness with menopause implies the use of herbal medicine – soothing, fortifying herbal teas (with mint, valerian, fennel or sage), as well as non-drug measures that increase the general tone of the body and normalize blood circulation, including in the brain.

Patients do not always understand that all these unpleasant phenomena are temporary and do not indicate severe pathologies, but are associated with fluctuations in the hormonal background, and will gradually be eliminated as the level of hormones stabilizes at a new basic level.

How to help with dizziness during menopause

In addition to all the drugs that will be prescribed by the doctor, it is also important to reconsider your attitude to everyday life, giving up bad habits, the influence of stress and physical overwork.

Non-drug measures, if they are performed in combination, significantly help to alleviate dizziness, menopause
can flow more comfortably. Contrast water procedures, dosed physical activity and a revision of nutrition in favor of a dairy-vegetable diet with a complete protein subsidy help to maintain blood vessels in good shape, to be more alert and more active, to keep pressure under control.

It is important to control weight and salt intake in order to avoid unnecessary stress on blood vessels and an increase in pressure, leading to dizziness menopause .

Physiotherapy procedures can be shown that normalize the tone of the autonomic nervous system and relieve unpleasant manifestations. Also shown are physiotherapy exercises, a set of exercises for weight correction and maintaining muscle tone. It is important to monitor the daily routine – constant lack of sleep, chronic fatigue lead to an increase in the manifestations of dizziness of menopause .It is necessary to stay in the fresh air more and more often, to lead an active lifestyle.

Doctors of TN-Clinic are the authors of numerous scientific papers and articles on menopause. During their many years of practice, they have helped thousands of women to remove unpleasant manifestations. In the treatment, they successfully use both traditional therapeutic methods – hormone therapy, vitamin therapy, homeopathy, dietology, etc., as well as their own author’s methods.

For more than 20 years of work, TN-Clinic doctors have helped tens of thousands of women return to normal life.They will find the true cause of dizziness and develop an individual treatment program for you, select alternative methods of therapy if, for some reason, traditional methods do not help.

Questions still

You can always make an appointment and get detailed information from the specialists of our advisory department by phones:

+7 (495) 210-02-48 +7 (495) 799-02-06

Make an appointment
90,000 Dizziness – causes, prevention and treatment

Dizziness.A condition in which it seems to a person that the objects around him and / or his own body are moving or rotating in a certain direction (systemic dizziness). But often a person cannot say for sure in which direction he and everything around him are moving (non-systemic dizziness). It happens that a person only notes his instability and instability (staggering, trembling) of the space around him, the feeling of throwing the head back, the movement of the legs and body in one direction (more often up), and the head in the other (more often downward in the supine position), feeling falling into the abyss.Dizziness occurs when there is an inconsistency in the work of the organs of vision and the central nervous system, which is responsible for the sense of the position of the body in space (kinesthetic) and the sense of balance (vestibular).

Symptoms and course

There are many reasons for dizziness. Absolutely healthy people may also experience treatment for vertigo, for example, when looking down from a great height or when looking at clouds, if you stand near a high-rise building – then there is a feeling that the clouds are not moving, but the building is leaning.Dizziness occurs if you spin around for a long time and then stop.

Dizziness as a manifestation of the disease can be caused by a disease of the inner ear, when an inflammatory or tumor process affects the vestibular (equilibrium) apparatus. Such patients usually suffer from inflammation of the inner ear (otitis media) for a long time, at first their hearing decreases, and then dizziness appears. With a tumor lesion, attacks occur against the background of hearing loss, ringing in the ear, and dizziness attacks gradually increase and intensify.

Dizziness is very common with a sharp turn of the head to the side, when getting out of bed in the morning, throwing the head backward (while pasting wallpaper, hanging linen, removing a book from the top shelf), with prolonged tilting of the head to the side or to the front (weeding, car repair, long sleep in a train or bus), sometimes when walking “throws to the side.” Such vertigo is caused by a spasm or constriction of the vertebral artery, which supplies blood to the regions of the brain responsible for balance.Dizziness can occur with high or low blood pressure, poisoning, fluid loss (vomiting, diarrhea), or blood loss (bleeding). It is accompanied by dizziness and anemia (lack of erythrocytes – red blood cells in the blood), high temperature.

Recognition of dizziness is simple, based on the patient’s complaints, typical treatment of dizziness symptoms (drunken gait, patient attempts to grab onto surrounding objects, inability to stand or sit, frequent rhythmic twitching of the eyes (when looking to the side or up).

Treatment and first aid

In case of dizziness, lay the patient on his back so that his head, neck and shoulders lie on the pillow, because in this position bending of the vertebral arteries is excluded. You should avoid turning your head to the side, you need to open the windows, ventilate the room, put a cold bandage on your forehead, you can slightly moisten it with vinegar. Having measured the pressure and temperature, take measures to normalize them, with a heart rate of more than 100 beats per minute or an irregular heartbeat that appears, and also, if nausea and repeated (more than 3 times) vomiting have joined the dizziness, you need to call an ambulance.