What are the main causes of dizziness lasting for days. How can you identify the underlying condition causing prolonged dizziness. What treatment options are available for persistent dizziness symptoms.

Understanding Vertigo: When the World Seems to Spin

Vertigo is a specific type of dizziness characterized by the sensation that you or your surroundings are spinning or moving. This disorienting symptom often worsens with head movements and can significantly impact daily activities. But what exactly causes vertigo?

The most common form of vertigo is benign paroxysmal positional vertigo (BPPV). This condition occurs when tiny calcium crystals in the inner ear become dislodged and move into areas where they don’t belong. As a result, the brain receives incorrect signals about head position and movement, leading to the spinning sensation.

What triggers BPPV?

• Age-related cellular breakdown
• Head injuries
• Sudden head movements

While BPPV can be distressing, it’s generally not serious and often resolves on its own. However, for those seeking relief, a series of specialized head exercises known as the Epley maneuver can help reposition the calcium crystals and alleviate symptoms. Many patients experience improvement after one to three treatments.

Other causes of vertigo

It’s important to note that vertigo can stem from various other conditions, both within and outside the brain. These include:

• Meniere’s disease
• Labyrinthitis
• Acoustic neuroma (a type of brain tumor)
• Vestibular migraine
• Multiple sclerosis
• Stroke affecting the cerebellum

Ear Infections and Inflammation: A Common Culprit for Dizziness

When dizziness is accompanied by ear pain, ringing, or hearing difficulties, an ear infection may be the root cause. Two conditions that frequently lead to vertigo and dizziness are vestibular neuritis and labyrinthitis. Both involve inflammation of the nerves in the inner ear, but they differ slightly in their presentation.

Vestibular neuritis vs. labyrinthitis

Vestibular neuritis affects only the vestibular nerve, responsible for balance. Labyrinthitis, on the other hand, impacts both the vestibular nerve and the cochlear nerve, which is crucial for hearing. Both conditions are typically caused by viral infections, although bacterial infections can also be culprits in some cases.

Symptoms of these conditions often include:

• Sudden onset of dizziness
• Tinnitus (ringing in the ears)
• Hearing loss
• Nausea
• Fever
• Ear pain

These symptoms can persist for several weeks, significantly impacting a person’s quality of life. While viral infections cannot be treated with antibiotics, medications can help manage symptoms as the body fights off the infection.

Meniere’s Disease: Understanding this Chronic Vestibular Disorder

Meniere’s disease is a complex inner ear disorder characterized by episodes of vertigo that can last for hours. This condition can be particularly distressing due to its unpredictable nature and the intensity of its symptoms.

What are the hallmark symptoms of Meniere’s disease?

• Recurring episodes of vertigo
• Fluctuating hearing loss
• Tinnitus (ringing in the ears)
• Aural fullness (feeling of pressure in the ear)

The exact cause of Meniere’s disease remains unknown, but it is believed to be related to an abnormal buildup of fluid in the inner ear. While there is no cure for this condition, various treatment approaches can help manage symptoms and improve quality of life.

Managing Meniere’s disease

Treatment strategies for Meniere’s disease often include:

1. Dietary modifications (particularly a low-sodium diet)
2. Medications to control vertigo and reduce fluid retention
3. Vestibular rehabilitation exercises
4. In severe cases, surgical interventions may be considered

Circulation Issues: When Blood Flow Affects Balance

Dizziness can sometimes be a sign of underlying circulatory problems. The brain requires a constant supply of oxygen-rich blood to function properly. When this supply is compromised, it can lead to lightheadedness, dizziness, and even fainting.

What circulatory conditions can cause dizziness?

• Blood clots
• Atherosclerosis (clogged arteries)
• Heart failure
• Arrhythmias (irregular heartbeats)
• Orthostatic hypotension (sudden drop in blood pressure upon standing)

It’s crucial to seek immediate medical attention if dizziness is accompanied by fainting, loss of consciousness, or other concerning symptoms such as chest pain or difficulty breathing. These could be signs of a serious underlying condition requiring prompt treatment.

Medication-Induced Dizziness: When Treatment Becomes the Problem

Many commonly prescribed medications list dizziness as a potential side effect. If you’re experiencing persistent dizziness and are taking any medications, it’s essential to consider whether they could be contributing to your symptoms.

Which medications commonly cause dizziness?

• Antibiotics (e.g., gentamicin, streptomycin)
• Antidepressants
• Anti-seizure medications
• Blood pressure medications
• Sedatives

If you suspect your medication may be causing dizziness, it’s important to consult with your healthcare provider before making any changes to your treatment regimen. They can assess whether adjusting your dosage or switching to an alternative medication might help alleviate your symptoms while still effectively managing your underlying condition.

Dehydration: A Simple Yet Overlooked Cause of Dizziness

Dehydration is a surprisingly common cause of dizziness, particularly among older adults and individuals with diabetes. Many people don’t consume enough fluids to replace what they lose through daily activities like sweating, breathing, and urination.

How does dehydration lead to dizziness?

When the body becomes severely dehydrated, it can lead to:

• Decreased blood volume
• Lowered blood pressure
• Reduced oxygen supply to the brain

These factors combine to create feelings of lightheadedness and dizziness. In severe cases, dehydration can even cause fainting.

Preventing dehydration-related dizziness

1. Drink water regularly throughout the day
2. Increase fluid intake during hot weather or physical activity
3. Monitor urine color (pale yellow indicates good hydration)
4. Consume foods with high water content (e.g., fruits, vegetables)
5. Limit alcohol and caffeine intake, as they can contribute to dehydration

Low Blood Sugar: When Glucose Levels Affect Balance

Hypoglycemia, or low blood sugar, is another potential cause of dizziness that is often overlooked. While it’s most common in people with diabetes who are taking insulin or certain oral medications, it can occur in anyone under specific circumstances.

What are the symptoms of hypoglycemia?

• Dizziness or lightheadedness
• Confusion
• Shakiness
• Sweating
• Hunger
• Irritability

If left untreated, severe hypoglycemia can lead to loss of consciousness and even seizures. It’s crucial for individuals with diabetes to monitor their blood sugar levels regularly and be aware of the signs of hypoglycemia.

Managing hypoglycemia-related dizziness

1. Consume fast-acting carbohydrates (e.g., glucose tablets, fruit juice)
2. Follow up with a balanced meal or snack
3. Check blood sugar levels to ensure they’ve returned to normal
4. Consult with a healthcare provider to adjust medication if necessary

Understanding the various causes of persistent dizziness is crucial for effective management and treatment. While some cases may resolve on their own, others may require medical intervention. It’s important to pay attention to accompanying symptoms and seek professional medical advice if dizziness persists or is accompanied by concerning signs such as fainting, severe headaches, or changes in vision or hearing.

By working closely with healthcare providers, individuals experiencing prolonged dizziness can identify the underlying cause and develop an appropriate treatment plan. This may involve lifestyle modifications, medication adjustments, specialized exercises, or other targeted interventions depending on the specific diagnosis.

Remember, persistent dizziness should never be ignored, as it can significantly impact quality of life and may be a sign of a more serious underlying condition. With proper diagnosis and management, many people can find relief from their symptoms and regain their sense of balance and well-being.

Why Am I Dizzy? 7 Possible Causes of Dizziness and How To Treat It

Written by Stephanie Langmaid

• Is It Vertigo?
• Is It an Infection?
• Is It Meniere’s Disease?
• Is It Your Circulation?
• Is It Your Medication?
• Is It Dehydration?
• Is It Low Blood Sugar?
• Is It Something Else?
• More

Many parts of your body — including your eyes, brain, inner ear, and nerves in your feet and spine — work together to keep you balanced. When a part of that system is off, you can feel dizzy. It can be a sign of something serious, and it can be dangerous if it makes you fall.

Your doctor will look at all your symptoms and overall health to figure out what’s going on and how to treat it.

Get medical attention immediately if you’re dizzy and you faint, fall, or can’t walk or have any of the following:

• Chest pain
• Different or really bad headache
• Head injury
• High fever
• Irregular heart rate
• Seizures
• Shortness of breath
• Stiff neck
• Sudden change in speech, vision, or hearing
• Vomiting
• Weakness or numbness in your face
• Weakness in your leg or arm

Does it feel like you’re spinning or the room is moving around you? That’s a classic sign of a particular type of dizziness called vertigo. It’s more than feeling off-kilter and usually gets worse when you move your head. This is a symptom that there is an issue in the inner ear or part of the brainstem governing balance. The most common kind is benign paroxysmal positional vertigo, or BPPV.

Your inner ear is a complicated system of canals filled with fluid. These let your brain know how your head is moving. With BPPV, tiny bits of calcium in part of your inner ear get loose and move to places they don’t belong. The system doesn’t work the way it should and sends your brain the wrong signals.

It’s often caused by the natural breakdown of cells that happens with age. A head injury can cause it, too.

You’ll feel it briefly when you tilt or turn your head, and especially when you roll over in bed or sit up. BPPV isn’t serious and usually goes away on its own. If not — or you’d like to help it along — it can be treated with special head exercises (“particle repositioning exercises”) called the Epley maneuver to get the pieces of calcium back in place. Most people feel better after one to three treatments.

There are other causes of vertigo both in and outside the brain. You can have Meniere disease (described below), labyrinthitis (described below), a tumor called an acoustic neuroma or side effects from some antibiotics. In the brain, it can be caused by a vestibular migraine, multiple sclerosis, malformations of brain structures or a stroke from lack of blood flow or bleed (hemorrhage) in the cerebellum.

Inflammation of the nerves in your ears also can cause vertigo. It can be either vestibular neuritis or labyrinthitis. Vestibular neuritis refers to inflammation of your vestibular nerve only while labyrinthitis involved both your vestibular nerve and your cochlear nerve. Both conditions are caused by an infection. Usually, a virus is to blame. But bacteria from a middle ear infection or meningitis can make their way into your inner ear as well.

In this case, dizziness usually comes on suddenly. Your ears may ring, and it may be hard to hear. You also may be nauseated and have a fever and ear pain. Symptoms can last several weeks. 

If it’s caused by a virus and can’t be treated with antibiotics, medication can help make you feel better as the infection runs its course.

This condition brings on intense periods of vertigo that can last hours. You may feel fullness or pressure in one ear. Other symptoms include ringing in your ears, hearing loss, and nausea. You may feel exhausted after the attack passes.

People with Meniere’s disease have too much fluid in their inner ear. Doctors don’t know what causes it, and there’s no cure for it. It’s usually treated with diet changes (a low-salt diet) and medicine to control the dizziness.

Dizziness can be a sign of a problem with your blood flow. Your brain needs a steady supply of oxygen-rich blood. Otherwise, you can become lightheaded and even faint.

Some causes of low blood flow to the brain include blood clots, clogged arteries, heart failure, and an irregular heartbeat. For many older people, standing suddenly can cause a sharp drop in blood pressure.

It’s important to get medical help immediately if you’re dizzy and faint or lose consciousness.

Several drugs list dizziness as a possible side effect. Check with your doctor if you take:

• Antibiotics, including gentamicin and streptomycin
• Anti-depressants
• Anti-seizure medications
• Blood pressure medicine
• Sedatives

Many people don’t drink enough fluids to replace the liquid they lose every day when they sweat, breathe, and pee. It’s particularly a problem for older people and people with diabetes.

When you’re severely dehydrated, your blood pressure can drop, your brain may not get enough oxygen, and you’ll feel dizzy. Other symptoms of dehydration include thirstiness, tiredness, and dark urine.

To help with dehydration, drink plenty of water or diluted fruit juice, and limit coffee, tea, and soda.

People with diabetes need to check the amount of sugar (glucose) in their blood often. You can get dizzy if it drops too low. That also can cause hunger, shakiness, sweating, and confusion. Some people without diabetes also have trouble with low blood sugar, but that’s rare.

A quick fix is to eat or drink something with sugar, like juice or a hard candy.

Dizziness can be a sign of many other illnesses, including:

• Migraines, even if you don’t feel pain
• Stress or anxiety
• Nervous-system problems like peripheral neuropathy and multiple sclerosis
• Tumor in the brain or inner ear

You may have other symptoms besides dizziness with any of these conditions. If your dizziness won’t go away or impacts your ability to function, make sure to discuss it with your doctor to find out the cause and treat it.

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Why Am I Dizzy? 7 Possible Causes of Dizziness and How To Treat It

Written by Stephanie Langmaid

• Is It Vertigo?
• Is It an Infection?
• Is It Meniere’s Disease?
• Is It Your Circulation?
• Is It Your Medication?
• Is It Dehydration?
• Is It Low Blood Sugar?
• Is It Something Else?
• More

Many parts of your body — including your eyes, brain, inner ear, and nerves in your feet and spine — work together to keep you balanced. When a part of that system is off, you can feel dizzy. It can be a sign of something serious, and it can be dangerous if it makes you fall.

Your doctor will look at all your symptoms and overall health to figure out what’s going on and how to treat it.

Get medical attention immediately if you’re dizzy and you faint, fall, or can’t walk or have any of the following:

• Chest pain
• Different or really bad headache
• Head injury
• High fever
• Irregular heart rate
• Seizures
• Shortness of breath
• Stiff neck
• Sudden change in speech, vision, or hearing
• Vomiting
• Weakness or numbness in your face
• Weakness in your leg or arm

Does it feel like you’re spinning or the room is moving around you? That’s a classic sign of a particular type of dizziness called vertigo. It’s more than feeling off-kilter and usually gets worse when you move your head. This is a symptom that there is an issue in the inner ear or part of the brainstem governing balance. The most common kind is benign paroxysmal positional vertigo, or BPPV.

Your inner ear is a complicated system of canals filled with fluid. These let your brain know how your head is moving. With BPPV, tiny bits of calcium in part of your inner ear get loose and move to places they don’t belong. The system doesn’t work the way it should and sends your brain the wrong signals.

It’s often caused by the natural breakdown of cells that happens with age. A head injury can cause it, too.

You’ll feel it briefly when you tilt or turn your head, and especially when you roll over in bed or sit up. BPPV isn’t serious and usually goes away on its own. If not — or you’d like to help it along — it can be treated with special head exercises (“particle repositioning exercises”) called the Epley maneuver to get the pieces of calcium back in place. Most people feel better after one to three treatments.

There are other causes of vertigo both in and outside the brain. You can have Meniere disease (described below), labyrinthitis (described below), a tumor called an acoustic neuroma or side effects from some antibiotics. In the brain, it can be caused by a vestibular migraine, multiple sclerosis, malformations of brain structures or a stroke from lack of blood flow or bleed (hemorrhage) in the cerebellum.

Inflammation of the nerves in your ears also can cause vertigo. It can be either vestibular neuritis or labyrinthitis. Vestibular neuritis refers to inflammation of your vestibular nerve only while labyrinthitis involved both your vestibular nerve and your cochlear nerve. Both conditions are caused by an infection. Usually, a virus is to blame. But bacteria from a middle ear infection or meningitis can make their way into your inner ear as well.

In this case, dizziness usually comes on suddenly. Your ears may ring, and it may be hard to hear. You also may be nauseated and have a fever and ear pain. Symptoms can last several weeks. 

If it’s caused by a virus and can’t be treated with antibiotics, medication can help make you feel better as the infection runs its course.

This condition brings on intense periods of vertigo that can last hours. You may feel fullness or pressure in one ear. Other symptoms include ringing in your ears, hearing loss, and nausea. You may feel exhausted after the attack passes.

People with Meniere’s disease have too much fluid in their inner ear. Doctors don’t know what causes it, and there’s no cure for it. It’s usually treated with diet changes (a low-salt diet) and medicine to control the dizziness.

Dizziness can be a sign of a problem with your blood flow. Your brain needs a steady supply of oxygen-rich blood. Otherwise, you can become lightheaded and even faint.

Some causes of low blood flow to the brain include blood clots, clogged arteries, heart failure, and an irregular heartbeat. For many older people, standing suddenly can cause a sharp drop in blood pressure.

It’s important to get medical help immediately if you’re dizzy and faint or lose consciousness.

Several drugs list dizziness as a possible side effect. Check with your doctor if you take:

• Antibiotics, including gentamicin and streptomycin
• Anti-depressants
• Anti-seizure medications
• Blood pressure medicine
• Sedatives

Many people don’t drink enough fluids to replace the liquid they lose every day when they sweat, breathe, and pee. It’s particularly a problem for older people and people with diabetes.

When you’re severely dehydrated, your blood pressure can drop, your brain may not get enough oxygen, and you’ll feel dizzy. Other symptoms of dehydration include thirstiness, tiredness, and dark urine.

To help with dehydration, drink plenty of water or diluted fruit juice, and limit coffee, tea, and soda.

People with diabetes need to check the amount of sugar (glucose) in their blood often. You can get dizzy if it drops too low. That also can cause hunger, shakiness, sweating, and confusion. Some people without diabetes also have trouble with low blood sugar, but that’s rare.

A quick fix is to eat or drink something with sugar, like juice or a hard candy.

Dizziness can be a sign of many other illnesses, including:

• Migraines, even if you don’t feel pain
• Stress or anxiety
• Nervous-system problems like peripheral neuropathy and multiple sclerosis
• Tumor in the brain or inner ear

You may have other symptoms besides dizziness with any of these conditions. If your dizziness won’t go away or impacts your ability to function, make sure to discuss it with your doctor to find out the cause and treat it.

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Causes, symptoms and treatment of vertigo

Vertigo is a misperception of one’s body in space. This is a fairly common symptom of both neurological and mental, somatic diseases. An average of 15-35% of the population experiences dizziness in their lifetime. Most often these are people after 60 years – 20%, after 70 – 30% and after 80 – 50%.

Regular bouts of dizziness when standing up markedly impair quality of life and can lead to injury due to falling. This is especially dangerous for the elderly. For people of working age, such manifestations in the body often cause a temporary loss of the opportunity to work fully.

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Conditionally there are 5 main types of vertigo:

• vestibular;
• lipothymic;
• postural;
• cervicogenic;
• psychogenic.

Vestibular vertigo develops due to damage or physiological stimulation of the peripheral vestibular apparatus and central autonomic structures. As a rule, difficulties with orientation in space arise when the head is rotated. All this passes with loss of balance, periodic falls, nausea and other unpleasant manifestations.

Lipothymic vertigo occurs in pre-syncope after excessive use of insulin or insulinoma. A characteristic symptom is “fog” in the head. A similar condition can occur after taking drugs that depress the central nervous system. For example, tranquilizers.

Postural vertigo is due to various gait disorders.

Cervicogenic dizziness is provoked by diseases of the cervical spine. Dizziness in this pathology is the result of pain and limited mobility of the neck.

Psychogenic dizziness is characteristic of people with neuroses and personality disorders. Such attacks are manifested due to feelings of anxiety, panic attacks in various situations. This type is usually described as a feeling of unsteadiness, the presence of heaviness in the head, a feeling of intoxication. Oscillatory eye movements in this case are absent, but, unlike other varieties, depression may occur afterwards. Treatment of vertigo in women and men includes psychotherapy, vestibular exercises, and antidepressants.

SYMPTOMS OF VERTIGO AND BALANCE

People who experience dizziness more often describe their condition as follows:

• sensation of body movement;
• loss of balance and body tilt to one side;
• feeling of tension, constriction in the head;
• fall for no reason;
• unsteady gait or loss of her confidence.

Symptoms may only get worse with changes in body position or head rotation. Dizziness can come on suddenly and be so severe that you have to sit up or lie down abruptly. It can last a day or even several, although it is often limited to a few minutes.

CAUSES OF Dizziness

There are many causes of dizziness, from diseases of the inner ear to taking certain medications. The most serious are determined by pathologies of blood circulation in the brain, as well as tumors or brain damage after falls or strong blows.

In many situations, acute vertigo is caused by diseases of the inner ear, benign paroxysmal positional vertigo, Meniere’s disease. Also often the basis is infectious diseases of the ear.

Less common causes are vertebrobasilar insufficiency, stroke or intracerebral hemorrhage, multiple sclerosis, vestibular migraine, acoustic neuroma, orthostatic hypotension, hypoglycemia (low blood sugar), anemia (low iron), medication.

Inner ear infections

Vestibular neuritis and labyrinthitis are disorders that result from infections. They cause inflammation of the inner ear, or the nerve that connects the inner ear to the brain. After that, the transmission of sensory information from the ear to the brain is disrupted. The result is hearing loss and balance problems.

Inner ear infections are caused by viruses or bacteria. You can find out about the presence of viruses in the body by the symptoms of an infection of the internal respiratory tract. Its manifestations are noted a few weeks before the onset of dizziness. You can get an infection at any age.

Anatomy of the ear

The inner ear includes a system of tubes and sacs that are filled with fluid. All this is called a labyrinth, the functions of which are hearing and balance. Sound signals from the labyrinth are transmitted to the brain via the vestibulo-cochlear nerve with two branches. One transmits messages from the organ of hearing, and the other from the organs of balance.

The brain processes balance signals sent through the vestibular nerve from the right and left ear. When one side is infected, it sends false signals. This is how information is presented that does not correspond to reality, which leads to dizziness.

Vestibular neuritis (inflammation of the nerve) affects the balance branch. This leads to dizziness, a disturbed sense of oneself in space, a sharp movement of the eyeballs with a fast phase, but there is no transformation with hearing. It may seem to a person that objects are moving around, and when performing coordination exercises, he will usually be mistaken.

Experts also use the term “vestibular neuronitis” (damage to the sensory neurons of the vestibular ganglion). Its symptom is severe, rapidly developing, paroxysmal dizziness. It is often characterized by vomiting, imbalance. Often, the development of symptoms of dizziness is preceded by SARS. Sometimes, a few weeks before the developed clinical picture, patients may notice short bouts of loss of balance.

Labyrinthitis (inflammation of the labyrinth) occurs when an infection affects both branches of the cochleo-vestibular nerve. Then the hearing changes, attacks of dizziness occur. Even with small turns of the head, the symptoms become more pronounced. Therefore, some people are forced to support their heads with their hands.

Benign paroxysmal positional vertigo (BPPV)

BPPV is one of the most common causes of vertigo, manifested by sudden movements and head waving. The duration of the state is limited to a few seconds or minutes. It occurs when calcium crystals (otoliths) in the inner ear begin to move. Because of this, there is a sensation of rotation of the body.

The causes of BPPV are a history of traumatic brain injury, as well as otitis media. Often, the cause of the disease cannot be identified. Then the diagnosis is confirmed by taking a Dix-Hallpike sample. To do this, the patient quickly lies down from a sitting position and slightly lowers his head, turned 45 degrees. The test is positive if, a couple of seconds later, an attack of dizziness and nystagmus occurs.

Between 20% and 28% of patients with BPPV report symptomatic relief on their own up to a month after the onset of vertigo. The disease is benign and recurs within the first 12 months in only 15% of cases.

Treatment of BPPV

Treatment includes the Epley maneuver. It allows, with the help of head manipulations, to shift the otolith (crystal) into an insensitive zone – the vestibule of the inner ear.

If the effectiveness of such treatment is low, the patient is additionally prescribed a set of exercises to perform at home. This is Brandt-Deroff gymnastics, according to the method of which you need to practice 2-3 times a day from 1 to 3 weeks. Taking medication in this case usually does not give positive dynamics.

Operations are performed when repositioning techniques fail. Surgical interventions carry the risk of complications in the form of injuries of the facial nerve and hearing loss.

Among the possible operations:

• obstruction of the posterior semicircular canal;
• removal of the vestibular nerve;
• labyrinthectomy;
• selective neurectomy.

Meniere’s disease

A disease characterized by repeated attacks of rotational vertigo. They last several hours and are not without noise in the ears, their congestion or bursting, as well as hearing impairment. It occurs in about 0.2% of the population, usually in people from 40 to 60 years old. The disease is based on the expansion of the endolymphatic system in the inner ear, which leads to the degeneration of the labyrinth receptors.

The disease has the following manifestations:

• dizziness;
• unsteady gait;
• hearing impairment;
• problems with perception of sounds;
• nausea and vomiting;
• ringing in the ears.

Treatment of Meniere’s disease

The treatment of an attack is by taking vestibulosuppressive agents. Prevention of the disease necessarily includes a low-salt diet, avoidance of alcohol and caffeine, the use of betahistine and diuretics.

If the chosen therapy does not lead to positive dynamics, more serious treatment is required. These can be injections of drugs directly into the ear or surgery.

Diagnosis of dizziness

Patients with dizziness undergo Halmagi tests to determine the level of the vestibulo-ocular reflex. Its violation speaks of central and peripheral lesions.

The Halmagi test does not require the use of additional equipment and lengthy preparation. The patient needs to stop looking at the bridge of the nose of a specialist who sits opposite. At the same time, the doctor holds the patient’s head with both hands and turns it from side to side by 15 degrees. With a normal vestibulo-ocular reflex, the eyes remain looking at a given point. If there is a violation, then the gaze turns along with the turn of the head.

Severe dizziness with repeated bouts of vomiting lasts up to 3-4 days, after which the patient improves. Recovery can take up to several months. In older people, it is usually delayed and often incomplete. If positive dynamics is not observed within a month, then an MRI of the brain and audiometry should be performed to rule out Meniere’s disease.

WHEN SHOULD YOU SEE A DOCTOR?

The alarm should be sounded if dizziness becomes regular or prolonged. Immediate help is needed if you experience severe dizziness and unsteadiness in combination with the following symptoms:

• sudden headache;
• pain in the retrosternal region;
• labored breathing;
• numbness or weakness of limbs;
• fainting;
• rapid or intermittent heartbeat;
• slow or slurred speech;
• problems with coordination;
• ongoing vomiting;
• convulsions;
• sudden hearing loss;
• numbness or asymmetry of the face.

TREATMENT OF VERTIGO

• Treatment of vestibular neuronitis When diagnosed, the patient is hospitalized, but sometimes outpatient treatment is acceptable. In either case, treatment should be aimed at reducing the degree of dizziness, stopping vomiting, and accelerating vestibular compensation. Symptomatic therapy includes the use of vestibular suppressants. When vomiting, injectable forms of drugs are used. The duration of treatment is determined by the complexity of the manifestations of dizziness. However, in most cases they are taken no longer than 3 days. An additional effect is given by a course of corticosteroids and antiviral drugs for middle ear infections. The vestibular apparatus is best stabilized through special gymnastics. At first, it can negatively affect the well-being, but after 2-3 days, therapy should stabilize the condition. You need to repeat gymnastics at least twice a day.
• Tumors of the cerebellopontine angle (acoustic neuroma) Quite a rare cause of vertigo. It manifests itself as a slowly progressive hearing loss and tinnitus. Rotational vertigo is rare, but unsteadiness is often noted. For some time, vestibular disorders may be the only symptom of the disease. After that, hearing disorders begin to be observed. People with a similar problem should have an MRI of the brain with IV contrast. This will help check the patient for the presence of a tumor in the posterior cranial fossa. When a tumor is found, patients need to consult a neurosurgeon for referral for surgery.
• Vertebrobasilar insufficiency and cerebrovascular diseases It is distinguished by the development of a reversible dysfunction of the brain stem, cerebellum and other structures that receive blood through the main and vertebral arteries. Ischemic attacks may occur due to violations of their patency. The reason is atherosclerotic changes, vascular hypoplasia. A little less often, inflammation, extravasal compression of the vertebral artery (with a neck injury) or dissection of the artery become a prerequisite. A key cause of loss of coordination during dizziness is a malfunction in the work of small arteries with high blood pressure, diabetes, or two diseases together. According to statistics, cerebrovascular accidents account for about 6%. The cause of dizziness at normal pressure can be a malfunction in the functioning of both the labyrinth itself due to problems with blood circulation, and a violation in the area of ​​​​various brain systems. Most patients with vertebrobasilar insufficiency are diagnosed with other neurological symptoms. Separately, dizziness with problems with blood vessels is very rare. In such situations, further diagnosis is required to remove other concomitant factors. You should not associate bouts of dizziness when changing the position of the head with compression of the vertebral arteries. Often, the rapid development of severe dizziness, along with nausea, vomiting and increased pressure, can be perceived as a signal of the development of a cerebrovascular disease. But usually it rises due to severe dizziness and stress. If a stroke is suspected, a person must be urgently hospitalized for examination and immediate treatment. The hospital performs an MRI of the brain, which in a stroke will show a focal lesion of the cerebellum or brain stem.
• Vestibular migraine Vestibular migraine is rarely diagnosed, although it is regarded as a common cause of recurrent non-positional vestibular vertigo. Its manifestations are dizziness of varying severity, combined with migraine and weakness. It can occur both during the migraine attacks themselves, and in the intervals between them. The duration of such attacks – from 3-5 minutes to 2-3 hours, sometimes days. They are not accompanied by noise or ringing in the ears, as well as hearing loss. Such attacks usually recur. The diagnosis of vestibular migraine is made on the basis of the typical clinical picture, as well as in the presence of migraine and after the exclusion of other possible causes of dizziness in women and men. Treatment of the disease, as with ordinary migraine, includes 3 stages: elimination of provoking factors, relief of an attack and preventive measures. Anti-migraine drugs or analgesics, as well as vestibular suppressants, are taken to eliminate vestibular migraine. Prevention is necessary for regular and severe attacks of vestibular migraine. Then specialists prescribe β-blockers and tricyclic antidepressants.
• Treatment of multiple sclerosis The most important thing in the treatment of this diagnosis is the elimination of life-spoiling sensations and related disorders: difficulties with coordination, hearing or vision. Treatment is determined by the cause of dizziness in men and women and the mechanisms of its development. It is important to guarantee the almost complete independence of the patient in everyday life, try to avoid sources of stress and minimize the risks of falls and injuries. Relief of symptoms includes the use of vestibulolytics. The time of their intake should be short and discussed with the doctor, because the inhibition of nerve formations does not allow compensatory changes to develop. The effectiveness of treatment increases with regular gymnastics, as well as exercises to restore the stable functioning of the vestibular apparatus. Therapy is also important to improve coordination, stabilize gait, and develop skills in a person to avoid balance problems in the future. Usually, physiotherapy exercises are used for this, which not only reduces discomfort, but also gives independence when moving.

Demyelinating disorders (multiple sclerosis)

People with demyelinating lesions of the CNS, especially those with multiple sclerosis, may be diagnosed with vertigo. Diagnostic difficulties may occur when dizziness develops at the onset of the disease without other manifestations or with their moderate severity. Dizziness in this case can be of a mixed nature, and also be characterized by a persistent course. To confirm the diagnosis, the patient needs to undergo an MRI of the brain with intravenous contrast.

HADASSAH MEDICAL MOSCOW PERFORMS DIAGNOSIS AND TREATMENT OF VERTIGO

• CT of the temporal bones and MRI of the brain;

• Ultrasound of neck vessels;

• Audiometry;

• Neurologist appointment;

• ENT doctor’s appointment;

• General practitioner appointment;

• Diagnostic tests to verify BPPV and vestibular neuronitis.

Sources

• Diagnosis and treatment of balance disorders in diseases of the nervous system. Clinical guidelines, Moscow, 2017.
• Jahn K, Kressig RW, Bridenbaugh SA, Brandt T, Schniepp R. Dizziness and Unstable Gait in Old Age: Etiology, Diagnosis and Treatment. Dtsch Arztebl Int. 2015 Jun 5;112(23):387-93. doi: 10.3238/arztebl.2015.0387.
• Neurology: A practitioner’s guide / D.R. Shtulman, O.S. Levin. – 6th ed., add. and perab. — M.: MEDpress-inform, 2008. —— 1024 p.
• Brandt T., Dieterich M., Strupp M. Vertigo: per. from English. // M.: Practice, 2009.
• Parfenov V.A., Zamergrad M.V., Melnikov O.A. Dizziness: Diagnosis and Treatment, Common Diagnostic Mistakes: A Study Guide. // M.: MIA, 2009.
• V. Parfenov, N. Bestuzheva. Diagnosis and treatment of dizziness in outpatient practice // Vrach, 2012
• Neurology. National leadership. Brief edition / ed. E. I. Guseva, A. N. Konovalova, A. B. Gekht. — M.: GEOTAR-Media, 2018 — 688 p.

Published: 07/28/2022

Updated: 07/28/2022

The information provided on the site is for reference only and cannot serve as a basis for making a diagnosis or prescribing treatment. Internal consultation of the expert is necessary.

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Vertigo | Rinos Clinic

Dizziness is the second most common symptom with which adults turn to a neurologist (back pain and headaches come first). The causes of dizziness can be osteochondrosis of the cervical spine, diseases of the inner ear, vestibular apparatus, lowering 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, performing special exercises designed to train the vestibular apparatus, following a special diet, and in some cases, surgery.

What is dizziness?

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

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

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

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, this implies a sensation of rotation of the patient or objects surrounding him. Often, dizziness means various sensations: slight unsteadiness, a feeling of dizziness, intoxication, or the impression of rotation of one’s body or surrounding objects.

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

Causes of dizziness

There are many causes of dizziness. It can occur due to damage to the vestibular nerve or inner ear, in which case it will be called peripheral. Also, the causes of dizziness may 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 is likely to indicate 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 increases, severe dizziness and constant vomiting. Most often, within 2-3 days, these symptoms gradually disappear. After the end of the acute period, in some cases, the illusion of movement remains with linear accelerations, for example, in a lift or a car.
• In the event of sudden unilateral deafness, tinnitus, vomiting, in half of the cases, patients are diagnosed with perilymphatic fistula. Also, the fistula can manifest itself with varying degrees of dizziness and hearing impairment (hearing loss, noise, ringing in the ears).
• Unilateral hearing loss and vertigo rule out 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 sensitivity disorders. As a rule, dizziness is persistent and lasts for several days.
• Vertigo accompanied by unsteadiness, a sense of disorientation in space, worsening with movements in the cervical spine, especially sudden (such as flexion, extension and turning of the head to the side), pain and limitation of mobility in the cervical spine, most likely due to diseases of the cervical spine section.
• An injury to the head or spine that precedes vertigo is indicative of a traumatic brain or whiplash injury.
• Vertigo associated with a change 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 is indicative of basilar migraine. Dizziness can last from a few minutes to an hour, accompanied by nausea, vomiting, tinnitus, and other neurological symptoms.
• Dizziness that occurs during flight, car, train or water travel is most likely due to 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.

The most common forms and causes of dizziness

According to modern research, 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).
• Tumors of the brain.
• Psychogenic dizziness.
• Meniere’s disease.
• Basilar migraine.

It should be noted that more than 80% of cases of true vertigo are due to BPPV.

Below we will discuss 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 the head is turned in a certain direction.
The reason for the development of benign positional vertigo is irritation of otolith stones, 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 of age, after an injury or infection, but can occur spontaneously in a person of any age.

The main symptoms of benign positional vertigo are:

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

Treatment of benign positional vertigo is performed under the supervision of a neurologist 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 is the second most common after BPPV.

Unlike BPPV, psychogenic vertigo is not associated with disorders of the vestibular apparatus, that is, it is not true vertigo.

The main characteristics of psychogenic vertigo:

• Dizziness can be described as a feeling of fog in the head, confusion, fear of losing consciousness, falling, but not as a whirling of objects or the object itself.
• Attacks of dizziness occur spontaneously, often in stressful situations, in a closed limited 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 the muscles, in the chest, in the region of the heart, in the abdomen, feeling short of breath, sore or lump in the throat, irritability, anxiety, disturbed sleep, feeling of inner fear, tension, strong unreasonable 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 vegetovascular 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 proper treatment. Much more effective for psychogenic dizziness will be treatment that is intended for the treatment of VVD (sedatives, psychotherapy) than treatment with specific drugs prescribed in all cases of true dizziness.

Migraine dizziness

Migraine is one of the most common types of headaches. During a migraine attack, in some cases, there is a violation of blood circulation in those areas of the brain that control the functioning of the vestibular apparatus. The result is severe dizziness. Immediately after it, a severe headache in the occipital region, imbalance, vomiting, intolerance to noise and light can develop. Some migraine patients may experience only severe dizziness and nausea, and may not have headache attacks. 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.

Vertigo due to Meniere’s disease

Meniere’s disease is characterized by bouts of severe dizziness, deafness (usually only in one ear), occurring intermittently and gradually leading to hearing loss.
The cause of Meniere’s disease is currently unknown. Presumably, in certain cases, the onset of the disease may be due to trauma, viral infection, or allergies.

The 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.

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

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

Degenerative diseases of the cervical spine (including osteochondrosis) is one of the common causes of dizziness, described by patients as unsteady gait, in very rare cases as a feeling of whirling.

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

Chronic circulatory disorders that occur 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 prolonged increase in blood pressure (hypertension) and atherosclerosis of the vessels of the neck. Most often, vertebrobasilar insufficiency occurs 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. Usually, trauma-induced dizziness is most pronounced in the first days after the injury, it gradually decreases as the patient recovers.

Vertigo due to brain tumors

In some cases, brain tumors that are located near the inner ear can cause severe, progressive dizziness. In addition to dizziness, tumor symptoms may include:

• headache
• tinnitus
• hearing impairment (most often in one ear)
• nausea
• Strabismus or paralysis of facial muscles

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

Vertigo due to 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, attacks of dizziness that are associated with it may be accompanied by fever, runny nose, cough, weakness. Often, true dizziness is combined with psychovegetative disorders, such as: nausea, vomiting, sweating, pallor, anxiety. This is due to the close relationship 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. It is important to timely and correctly diagnose the disease that caused dizziness.

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, vertigo attacks are usually associated with a decrease in blood glucose concentration and hypotension.

For the treatment of dizziness in pregnant women, the following prescription is effective: 1-2 tbsp. Dissolve spoons 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, unsteadiness, confusion in the legs, nausea
• Feeling of unsteady gait, imbalance
• Darkening of the eyes as a result of getting up abruptly from a lying or sitting position
• Feeling close to fainting, loss of consciousness
• Veil before the eyes.

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

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

Special attention should be paid to acute attacks of weakness and dizziness in patients with diabetes mellitus. For this category of patients, weakness and dizziness may 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 sensitive receptors that respond to 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 relative to other objects.
• Proprioreceptors (sensitive 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, and then processed into a person’s ideas about how his body is located in space and relative to surrounding objects.

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

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

In which case should I immediately consult a doctor in case of dizziness?

In all cases of dizziness accompanied by the following symptoms, seek medical attention as soon as possible:

• Severe headache and weakness in the muscles of the arms or legs.
• Severe dizziness that does not go away for more than an hour.
• Severe dizziness in a patient with hypertension or diabetes mellitus.
• The patient fell and injured himself as a result of dizziness.
• The patient lost consciousness as a result of dizziness.
• Fever.
• Persistent vomiting.

What should I do if I 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 the therapist, neuropathologist, endocrinologist, otolaryngologist.

If dizziness develops acutely and there are speech disorders, weakness or awkwardness in the limbs, double vision, numbness or other sensory disturbances, a doctor should be called immediately. It would be best to lie down before the arrival of the doctor, measure blood pressure. If the pressure is elevated, no measures should be taken to reduce it sharply. Remember: in most cases, a decrease in blood pressure below normal is more dangerous than its increase. Do not take medication without consulting your doctor.

Examinations that help to establish the diagnosis

Diagnosis and treatment of dizziness diseases are carried out by neuropathologists, otolaryngologists, ophthalmologists. In order to clarify the cause of dizziness and prescribe the correct treatment, the patient undergoes a series of examinations:

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

Diet in the treatment of dizziness

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

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

Rules for organizing the life of a patient prone to dizziness

Excluding those cases where 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 recommended to secure their place of work and home according to the following principles:

• Cover the floors with soft carpets that are free of folds and folds that could be tripped over.
• In the bathroom, install a shelf with accessories in an easily accessible place that you can reach without getting up, stick special non-slip rubber pads on the bottom of the bathroom.
• Install handrails in the shower cubicle and place a chair on which you can take a shower while sitting.
• Equip existing stairs in the house with double-sided railings. When climbing stairs, always hold on to them, even if at that moment your head is not spinning.
• Place a night light on your bedside table so that you can turn it on without getting out of bed.
• If possible, place your phone near your bed so that you can reach it without getting up.
• When getting out of bed, take your time, get up with care, sit on the bed for 1-2 minutes and only get up completely when you feel normal.
• Avoid activities that require balance and precise control of body position in space (active sports games, cycling).

Exercises to treat vertigo

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

Complex №1.

• Sit on the floor with your legs extended and looking straight ahead.
• Quickly lie on your back, quickly turn to your left side, continuing to look ahead.
• Quickly roll over onto your right side, then quickly roll over onto your back, then return to the sitting position.

It is very important in this case to do the exercise quickly. This is necessary to maintain the therapeutic effect. Before performing the exercise at a fast pace, do it several times, slowly, slowly, remembering the order of movements.

Complex №2.

Standing position, look straight ahead. Turn left (around the left heel), turn right (around the right heel).