What are the main differences between giddiness and dizziness. How can you identify the underlying causes of these sensations. When should you seek medical attention for vertigo or dizziness symptoms. What are the most effective treatments for giddiness and dizziness.

Defining Giddiness and Dizziness: Unraveling the Confusion

Giddiness and dizziness are often used interchangeably, but they actually describe distinct sensations. Understanding the difference between these two experiences is crucial for proper diagnosis and treatment.

Dizziness is generally characterized by:

• A feeling of being off-balance or unsteady
• Difficulty moving or walking
• A sensation of lightheadedness
• Feeling as if you might faint

Giddiness, on the other hand, is more specifically associated with:

• A sensation of whirling or spinning
• Often accompanied by vertigo
• Can be more severe and disruptive than general dizziness

Is giddiness a medical condition? Giddiness itself is not an independent medical condition but rather a symptom of an underlying issue. This underlying cause can range from something as benign as overexertion to more serious conditions like stroke or inner ear disorders.

The Intricate Causes of Dizziness: From Dehydration to Neurological Issues

Dizziness can stem from a variety of factors, ranging from simple lifestyle issues to more complex medical conditions. Here are some common causes:

• Head injuries
• Dehydration
• Low blood sugar (hypoglycemia)
• Low blood pressure (hypotension)
• Motion sickness
• Anxiety
• Alcohol consumption
• Certain medications

Can dizziness be a sign of a more serious condition? While often benign, persistent or severe dizziness can sometimes indicate underlying health issues such as cardiovascular problems, neurological disorders, or inner ear diseases. It’s important to consult a healthcare professional if dizziness is frequent or accompanied by other symptoms.

Vertigo and Giddiness: Exploring the Connection

Vertigo is a specific type of dizziness characterized by the sensation that you or your surroundings are spinning or moving. It’s closely related to giddiness and can be caused by various conditions affecting the central nervous system or inner ear.

What are the primary causes of vertigo? Some common causes include:

• Benign Paroxysmal Positional Vertigo (BPPV)
• Meniere’s disease
• Vestibular neuritis
• Labyrinthitis
• Vestibular migraine
• Cerebellar stroke
• Multiple sclerosis

How does BPPV differ from other causes of vertigo? BPPV is characterized by brief episodes of vertigo triggered by specific changes in head position. It’s caused by displaced calcium crystals in the inner ear and is often treatable with simple maneuvers.

Identifying Red Flags: When to Seek Medical Attention

While occasional mild dizziness or giddiness may not be cause for concern, certain symptoms warrant immediate medical attention. Be alert for:

• Persistent or recurrent episodes of dizziness or vertigo
• Symptoms that interfere with daily activities
• Dizziness accompanied by other symptoms such as:
• Tinnitus (ringing in the ears)
• Severe headaches
• Weakness or numbness
• Blurred vision
• Fainting or loss of consciousness
• Dizziness following a head injury
• Sudden onset of severe vertigo

How quickly should you seek medical help for severe vertigo? If you experience sudden, severe vertigo accompanied by other neurological symptoms, it’s crucial to seek emergency medical care immediately, as this could indicate a stroke or other serious condition.

Diagnostic Approaches: Unraveling the Mystery of Dizziness and Giddiness

Diagnosing the underlying cause of dizziness or giddiness often requires a comprehensive approach. Healthcare providers may employ various methods, including:

• Detailed medical history
• Physical examination
• Neurological tests
• Balance and coordination assessments
• Hearing tests
• Imaging studies (CT scans or MRI)
• Blood tests to check for underlying conditions

What is the Dix-Hallpike test? The Dix-Hallpike test is a specific maneuver used to diagnose BPPV. It involves moving the patient’s head in certain positions to trigger vertigo symptoms and observe eye movements.

Advanced Diagnostic Techniques

For more complex cases, specialized tests may be necessary:

• Electronystagmography (ENG) or videonystagmography (VNG) to assess eye movements and inner ear function
• Rotary chair testing to evaluate the vestibular system
• Posturography to assess balance control
• Vestibular evoked myogenic potentials (VEMP) to test specific parts of the inner ear

Treatment Strategies: Tailoring Solutions to Individual Needs

The treatment for dizziness and giddiness depends on the underlying cause. Some common approaches include:

1. Medications:
   • Antihistamines for motion sickness
   • Anti-emetics for nausea
   • Diuretics for Meniere’s disease
   • Migraine medications for vestibular migraines
2. Vestibular rehabilitation therapy:
   • Exercises to improve balance and reduce dizziness
   • Gaze stabilization exercises
   • Habituation exercises
3. Canalith repositioning procedures for BPPV
4. Lifestyle modifications:
   • Dietary changes
   • Stress reduction techniques
   • Avoiding triggers
5. Surgery (in rare cases)

How effective is vestibular rehabilitation therapy? Vestibular rehabilitation therapy can be highly effective for many patients with chronic dizziness or balance disorders, often leading to significant improvements in symptoms and quality of life.

Living with Dizziness and Giddiness: Coping Strategies and Lifestyle Adjustments

Managing chronic dizziness or giddiness often requires a multifaceted approach. Here are some strategies that can help:

• Fall prevention:
  • Remove tripping hazards at home
  • Use assistive devices when necessary
  • Improve lighting in living spaces
• Stress management:
  • Practice relaxation techniques
  • Consider cognitive-behavioral therapy
  • Engage in mindfulness or meditation
• Dietary considerations:
  • Stay hydrated
  • Limit salt intake (especially for Meniere’s disease)
  • Avoid trigger foods
• Physical activity:
  • Engage in regular, gentle exercise
  • Practice balance exercises under supervision
• Sleep hygiene:
  • Maintain a consistent sleep schedule
  • Create a relaxing bedtime routine

How can you safely exercise with chronic dizziness? Start with low-impact activities like walking or swimming. Always exercise with a partner or in a safe environment, and stop immediately if symptoms worsen. Gradually increase intensity as your balance improves.

Emotional and Psychological Support

Living with chronic dizziness or giddiness can take an emotional toll. Consider these support options:

• Join support groups for people with vestibular disorders
• Seek counseling or therapy to address anxiety or depression
• Practice self-compassion and patience during recovery
• Educate friends and family about your condition

Emerging Research and Future Treatments

The field of vestibular research is continuously evolving, offering hope for improved treatments and management strategies. Some areas of current research include:

• Gene therapy for inherited vestibular disorders
• Advanced imaging techniques for more precise diagnosis
• Vestibular implants to restore balance function
• Novel pharmacological treatments targeting specific vestibular pathways
• Virtual reality applications in vestibular rehabilitation

What potential does gene therapy hold for vestibular disorders? Gene therapy shows promise in treating certain inherited vestibular disorders by correcting or replacing faulty genes. While still in early stages, this approach could potentially offer long-term solutions for some patients.

Personalized Medicine Approaches

The future of dizziness and giddiness treatment may lie in personalized medicine. This approach takes into account individual genetic, environmental, and lifestyle factors to tailor treatments more effectively. Some areas of focus include:

• Pharmacogenomics to predict medication responses
• Biomarker identification for more accurate diagnosis
• Customized rehabilitation programs based on individual vestibular function
• Integration of wearable technology for continuous monitoring and adjustment of treatment

As research progresses, patients with dizziness and giddiness can look forward to more targeted and effective treatments, potentially improving outcomes and quality of life for those affected by these challenging symptoms.

Dizziness & Giddiness – Know the Difference

Giddiness and dizziness describe feeling imbalanced, lightheaded, unsteady, as if you are about to faint. But being specific it is important to distinguish between feeling dizzy from experiencing vertigo (or giddiness).

In this article, we’ll explain how to distinguish between dizziness and vertigo.

What’s the key difference between dizziness and giddiness?

Dizziness generally describes a feeling of being off-balance. When you’re dizzy, moving can be difficult. You may stagger while you’re walking or feel like you’re going to fall. Many people with vertigo will report dizziness as a symptom.

While giddiness (a sensation of whirling/spinning) can affect a person severely, it is not an independent medical condition but often a symptom of some other underlying condition. This underlying condition could be something as simple as overexertion or as serious as a stroke. Most often it is caused by neurological or inner ear issues.

What causes dizziness & giddiness?

Dizziness and giddiness can also have different causes. Let’s break them down below.

Dizziness

• head injuries
• dehydration
• low blood sugar
• low blood pressure
• motion sickness
• anxiety
• alcohol consumption
• certain medications

Giddiness (or vertigo)

Vertigo may also be caused by conditions that impact your central nervous system. Potential causes include:

• head injuries
• benign paroxysmal positional vertigo
• Meniere’s disease
• vestibular neuritis
• labyrinthitis
• vestibular migraine
• cerebellar stroke
• multiple sclerosis

When to seek medical attention?

It’s usually a good idea to see a doctor for feelings of dizziness, vertigo, or lightheadedness that:

• keeps returning
• affects your daily life
• comes with other symptoms like:
  • ringing of years (tinnitus)
  • headache
  • weakness or numbness
  • blurry vision
  • fainting

Your treatment plan depends on addressing the underlying cause of your symptoms. In many cases, treating the cause of dizziness, vertigo, or lightheadedness can help clear up these symptoms.

Wrapping up…!

Dizziness and giddiness are two similar feeling with an important difference. So, it is important to avoid using them interchangeably.

Dizziness is a general feeling of being off-balance. Giddiness is the feeling that you or your surroundings are moving or spinning. But both can affect your balance and movement. Hence it is important to seek immediate medical attention from your neurologist.

Source/s:
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The Difference between Giddiness and Vertigo: NY Neurology Associates: Neurologists

Giddiness and dizziness describe feeling  imbalanced, lightheaded, unsteady, as if you are about to faint. It is important to distinguish between feeling dizzy from experiencing vertigo. There are different causes for these types of sensations. Dizziness can be a symptom of vertigo. Vertigo is the sensation of your surrounding spinning. Both giddiness and vertigo are often accompanied by nausea or vomiting.

While giddiness can have a severe impact on the persons well-being and ability to go on about their daily lives, it is not a diagnosis, but a symptom of some other underlying condition.

The underlying condition could be just an overexertion or something serious such as stroke. Most often giddiness is caused by either neurological or innerear issues.

Symptoms

Some symptoms of giddiness may include:

• Feeling faint or lightheaded
• Feeling unsteady and imbalanced
• Feeling like the surrounding is moving or spinning
• Feeling woozy or heavy-headed

In addition to balance issues, some symptoms of vertigo may include :

• Motion sickness
• Tinnitus, or ringing in the ear
• Headaches
• Nystagmus, or an uncontrollable eye movement

It is important to note that there are two types of vertigo that can occur : peripheral and central vertigo. Peripheral vertigo is caused by an issue in the inner ear, while central vertigo is caused by a brain damage, including brain injury, stroke, tumors, or infection.

What are the causes ?

Some of the major causes of vertigo include :

• Benign Paroxysmal Positional Vertigo – one of the most frequent condition seen causes for the feeling of giddiness. The patient experiences a spinning sensation with mild to severe giddiness, It is caused by problems with the inner ear.
• Hypotension – or a low blood pressure (lower than 90 mmHg/ 60mmHg).
• Hypoglycemia – or low blood sugar (less than 70 mg/dL).
• Inner ear problems due to irritation or inflammation of the inner ear can cause balance problems and giddiness.
• Circulatory problems leading to a reduction in blood supply and, therefore, oxygen supply to all parts of the body.
• Motion sickness
• Dehydration .
• Overexertion or excessive exercise
• Migraines
• Head Injury – can be very serious, if the person is experiencing dizziness after a head injury they should go to the emergency room as soon as possible.
• Stroke is caused when the blood supply to the brain is disrupted.
• Neurological Problems, such as  Multiple Sclerosis or Parkinson’s can manifest as giddiness
• Vestibular Neuritis and Labyrinthitis are the conditions of inflammation of nerves. Vestibular neuritis involves the vestibular nerve, while labyrinthitisis involves the inflammation of both the vestibular nerve and the cochlear nerve.
• Anxiety Disorders can elevate stress hormone called cortisol, and can impact the vestibular system function that controls imbalance
• Heatstroke
• Side Effect of Certain Medications a lot of allergy and pain medications can cause dizziness

When you should consult a doctor ?

Dizziness is not a problem in itself, but can be a symptom of an underlying health problem. When it occurs  frequently or for prolonged periods of time, it is important to consult a neurologist.

Vertigo accompanied by the following symptoms prompts an appointment with a medical professional

• ChestPain
• Drooping of the Eyes or a Mouth
• Headache
• Head Injury
• Hearing Loss
• Blurred Vision
• High Fever
• Loss of Consciousness
• Numbness or Tingling
• Ongoing Vomiting
• Speech Difficulties

Treatment Options

Usually a  physical exam is first performed to determine the cause of the giddiness or dizziness.

Dizziness can often resolve on its own within a couple weeks, however, if it does not our neurologists can help find the root cause and develop a custom treatment plan that would address  the symptoms as well as the underlying issue. Treatment can include medication or medical techniques.

Epley maneuver can be used for Benign Paroxysmal Positional Vertigo (BPPV). As BPPV is caused by the inner ear issue, this technique involves canaliths repositioning.  Canaliths are calcium crystals that help detect motion, when the crystals detach in the semicircular canals, they may send incorrect signals to the brain causing vertigo. This technique is a series of movements that cause the crystals in the ear to be dislodged from the ear canals thus resolving vertigo. It can be done by a neurologist, an audiologist or a physical therapist.

Sometimes BPPV requires medication to be resolved. This would include anticholinergics, antihistamines or sleep aids.

Balance therapy. You may learn specific exercises to help make your balance system less sensitive to motion.  This physical therapy technique called vestibular rehabilitation. It is used for people with dizziness from inner ear conditions such as vestibularneuritis.

When dizziness is caused by circulatory issues, the treatment can involve medications or procedures that help regulate heart rate. In case of tachycardia-bradycardia syndrome, when the heart rate vacillates between beating too quickly or too slowly, ablation or pacemaker implantation can resolve the giddiness.

Dizziness caused by medication requires an adjustment in the dosage or in severe cases, a change of medication altogether. This would have to be done in consultation with the treating doctor.

Simple measures such as healthyt diet and hydration are a good start for addressing giddiness.

Psychiatric and neurological conditions, such as anxiety or migraines can be addressed with medication and lifestyle changes. Stress relief and balance improvement practices such as yoga and meditation, as well as Tai Chi can also help.  It is advised to avoid salt, caffeine, tobacco and alcohol as these may exacerbate dizziness symptoms.  

 

Michael Gudleski,PA was interviewed for this article.

 

More posts on this and other related topics can be found below :

 

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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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Conventionally, there are 5 main types of dizziness:

• 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 walking 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 party 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 DIAGNOSTICS 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.

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Natan Rashbilovich

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Work experience: 10 years

Published: 07/12/2023

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Admission fee: from 6500 ₽

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Work experience: 6 years

Reviews:

Appointment fee: from 9000 ₽

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Podgurskaya
Maria Gennadievna

Neurologist, functional diagnostician

Work experience: 5 years

Reviews :

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All doctors

Prices for neurology services

Neurology

90 348

Primary appointment (examination, consultation) with a neurologist	6,500 ₽
Repeated appointment (examination, consultation) with a neurologist	5,500 ₽
Preventive appointment (examination, consultation) with a neurologist	2,500 ₽
Preventive appointment (examination, consultation) with a neurologist in medical examination	3 500 ₽

903 49 9 000 ₽

9034 9 Remote consultation of a neurologist, Ph. D. , repeated

Appointment (examination, consultation) with a neurologist, PhD, primary
Appointment (examination, consultation) with a neurologist, candidate of medical sciences, repeated	7 500 ₽ neurologist primary	6 500 ₽
Remote consultation of a neurologist repeated	5 500 ₽
Remote consultation of a neurologist, PhD, primary	9 000 ₽
7 500 ₽

Botulinum toxin type A injection, 1 vial (without drug cost)	8 600 ₽
Injection of botulinum toxin type A, 2 bottles (without the cost of the drug)	14 300 ₽

903 48

Remote consultation of a neurologist, rehabilitologist, head of the neuro-rehabilitation unit of the Multiple Sclerosis Center of the Khaim Medical Center Sheba (Tel Hashomer) Doleva Mark	82 500 ₽
Remote consultation of a neurologist, a leading specialist in the Department of Pediatric Neurology at the Edmond and Lily Safra Children’s Hospital of the Chaim Sheba Medical Center (Tel Hashomer) Michal Zadok	60 500 ₽
Remote consultation Neurologist, Professor, Head of the Department of Pediatric Neurology at the Edmond and Lily Safra Children’s Hospital of the Chaim Sheba Medical Center (Tel Hashomer) Bruria Ben-Zeev	83 500 ₽
Remote consultation of a neurologist, professor, head of the Department of Movement Disorders of the Institute of Neurology at the Sourasky Medical Center (Ichilov, Tel Aviv) Tatyana Gurevich	90 000 ₽
Remote consultation of a neurologist, professor , Head of the Institute of Electromyography and Neurophysiology, Department of Neurology, Sourasky Medical Center (Ichilov, Tel Aviv) Vivienne Drori	112,000 ₽
Remote consultation of neurologist, epileptologist at Chaim Sheba Medical Center (Tel Hashomer) Naum Margolin	72 500 ₽

903 47

9037 2

Appointment (examination, consultation) with a neurologist at home within 10 km from the Skolkovo Innovation Center	14,000 ₽
Reception (examination, consultation) of a neurologist with home visits within 20 km from the Skolkovo Innovation Center	16,000 ₽
Reception (examination, consultation) of a neurologist with home visit within 30 km from the Skolkovo Innovation Center	24,500 ₽

9 0353

Nerve trunk block	5 100 ₽
Trigger point block, zone 1	5 100 ₽
Unilateral paravertebral block, cervical level	3,700 RUB
Unilateral paravertebral block, thoracic level	RUB 3,700
Bilateral paravertebral block, cervical level
Paravertebral block bilateral, thoracic level	5 100 ₽
Paravertebral bilateral blockade, lumbar level	5 900 ₽
Paravertebral blockade, including the cost of drugs ₽

Reflexology session for diseases of the central nervous system (45 minutes)	7 200 ₽
Reflexology session for diseases of the peripheral nervous system (45 minutes)	7 200 ₽
Reflexology session for diseases of the musculoskeletal system (45 minutes)	7 200 RUB x spine (60 minutes)	8000 ₽
therapy for diseases of the joints (60 minutes)	8 000 ₽
Vertebral therapy session for diseases of the central nervous system (60 minutes)	8 000 ₽
Vertebral therapy session for diseases of the peripheral nervous system (60 minutes)	8 000 ₽

9034 6

Treatment of migraine with Irinex 70 mg/ml 24400 ₽ Treatment with the drug Xeomin, 50 units. 10 100 ₽ Treatment with the drug Xeomin, 100 units. Rs. 3

Focused shock wave therapy (up to 2000 shocks)	$100
Focused shock wave (up to 4500 shocks)	$9
Focused shock wave (over 4500 strokes)	10 100 ₽
Focused shock wave therapy for myofascial pain syndrome, spine (up to 4500 shocks)	11 500 ₽
Focused shock wave therapy for myofascial pain syndrome, spine (over 4500 shocks)	12 900 ₽
Focused shock wave therapy in the treatment of diseases of the shoulder joint treatment of diseases of the hip joint	11 500 ₽
Focused shock wave therapy in the treatment of diseases of the elbow joint (epicondylitis)	10 100 ₽
Focused shock wave therapy in the treatment of diseases of the knee joint	10 100 ₽
Focused shock wave therapy for plantar fasciitis	10 100 ₽
Focused shock wave therapy for bilateral plantar fasciitis	14,300 RUB
Focused shockwave therapy for the treatment of Achilles tendon disease	10,100 RUB
Focused shockwave therapy therapy for delayed healing of bone fractures and stress fractures	10 100 ₽
Focused shock-wave therapy for loading periosteopathy, aseptic necrosis (up to 3,000 strokes)	10 100 ₽
Focused shock-wave therapy for postoperative restoration (removal of edema, pain, up to 3000 shots)	10 100 ₽
Focused shock wave therapy for postoperative recovery (removal of edema, pain, over 3000 strokes)	11 500 ₽
Focused shock wave therapy in the treatment of trophic skin lesions (one segment)	10 100 ₽
Focused shock wave therapy in the treatment of trophic skin lesions (two segments)	12 900 ₽

9000 3

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Dizziness – causes, prevention and treatment

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

Symptoms and course

There are many reasons for dizziness. Treatment of dizziness in people can also occur in absolutely healthy people, 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 it is not the clouds that are moving, but the building tilts. Dizziness occurs if you spin for a long time around its axis, and then stop.

Dizziness as a manifestation of the disease can be caused by a disease of the inner ear, when the vestibular (balance) apparatus is affected by an inflammatory or tumor process. Such patients usually suffer from inflammation of the inner ear (otitis media) for a long time, first they have hearing loss, and then dizziness appears. With a tumor lesion, seizures occur against the background of hearing loss, ringing in the ear, and attacks of dizziness gradually become more frequent and intensify.

Dizziness is very common with a sharp turn of the head to the side, when getting out of bed in the morning, tilting the head back (during wallpapering, hanging clothes, removing a book from the top shelf), with a long tilt of the head to the side or anteriorly (weeding, car repair, long sleep in the train or bus), sometimes when walking “throws to the side.” Such dizziness is caused by spasm or clamping of the vertebral artery, which supplies blood to the parts of the brain responsible for balance. Dizziness can occur with high or low blood pressure, poisoning, fluid loss (vomiting, diarrhea) or blood loss (bleeding). Accompanied by dizziness and anemia (lack of erythrocytes in the blood – red blood cells), high fever.

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

Treatment and first aid

If the patient is dizzy, lay him on his back so that his head, neck and shoulders lie on the pillow, because in this position the kink 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. After measuring the pressure and temperature, take measures to normalize them, if the heart rate is more than 100 beats per minute or an irregular heartbeat has appeared, and if nausea and repeated (more than 3 times) vomiting have joined dizziness, you need to call an ambulance.