Vertigo: Frequently asked questions | University of Iowa Hospitals & Clinics

Vertigo is a subjective sensation. Nobody other than the patient can experience what that person is experiencing. Many people with this disorder are inadequately evaluated.

Since most forms of vertigo are readily treated, we recommend anyone with this condition to seek further attention despite the fact that prior visits to one’s physician may not have resulted in alleviation of this condition.

What is vertigo?

The precise definition of vertigo is an illusion of motion. But it also refers not just to illusions of motions, but chronic or intermittent sensation of loss of balance.

What are common causes of vertigo?

There are a large number of causes of vertigo, but the three most common causes are:

• Cold viruses
• Head trauma
• Meniere’s disease

How are causes of vertigo related?

These are all conditions that affect the inner ear. The inner ear is responsible for our sense of balance and also our sense of position in space. When the inner ear dysfunctions, we lose our sense of balance and frequently suffer symptoms such as vertigo, nausea, vomiting, and loss of balance.

Can vertigo be treated?

Most causes of vertigo are readily treatable with physical therapy, medication, surgery, and time. By time, I mean, waiting because many causes of vertigo resolve spontaneously. Because of the many causes of vertigo, the critical issue in choosing a physician is their experience with vertigo.

Who should I see for vertigo treatment?

There are two types of physicians whose specialties include dizziness:

• Neurologists, who would deal in treating chronic forms of vertigo.
• Otolaryngologists, who are neurologists that specialize in ear disease.

Since many types of vertigo go away without treatment, initial evaluation by a general practitioner or family doctor is appropriate early on, reserving specialty care for chronic cases.

At what age is vertigo most common?

It is extremely rare, but not impossible, for young children to have vertigo. It becomes more common in the early 20s and affects all ages commonly after that. Its consequences however become more substantial as you get older because loss of balance in the elderly commonly leads to major fractures.

Can someone get vertigo from playing a video game that simulates movement?

Three-dimensional video games can cause a brief sensation of vertigo, but it would not persist.

Can stress cause vertigo?

Mental stress can make many forms of vertigo worse, but will not, by itself, produce vertigo.

What is positional vertigo?

Positional vertigo refers to a variety of conditions where a change in the position of your head produces a sense of vertigo.

Benign paroxysmal positional vertigo (BPPV)

The most common form is a condition called benign paroxysmal positional vertigo or BPPV for short. In BPPV when one lies down with the affected ear toward the floor, one gets a brief but very intense feeling of the world spinning around.

Is ataxia related to vertigo?

Ataxia refers to clumsiness. Disease of the inner ear does not produce ataxia per se but can be confused with ataxia. Ataxia is produced by disease of the cerebellum, a part of the brain that works with the inner ears to help maintain balance and also fine motor control.

Can the symptoms of vertigo be confused with the symptoms of other diseases or conditions?

Yes, this is a common occurrence. Usually they are mistaken because of use of the word dizziness. Dizziness can refer to lightheadedness, which is not vertigo and is commonly produced by vascular problems. Dizziness also can mean vertigo, and there are very few causes of vertigo that do not come from the inner ear. Occasionally, rare types of strokes can cause vertigo, but these are usually associated with other neurological symptoms as well.

Are there any surgical procedures to correct vertigo?

There are surgical procedures to correct certain types of vertigo. If the vertigo is caused by a disease such as Meniere’s disease, where the function of the involved ear changes over time, and these changes do not respond to medical therapy, then surgical intervention may eliminate the vertigo.

How does physical therapy help vertigo?

In forms of vertigo, where the inner ear has suffered damage and the function of that ear is fixed, not changing over time, physical therapy can be quite helpful. When the inner ear is damaged, people commonly experience severe spinning for several days. If after several weeks the person still has a loss of balance, then physical therapy can help restore this balance. The reason physical therapy is helpful is that it helps train the brain to compensate for the loss of function in the ear. Just as you can make a muscle stronger by exercising it, you can make the balance system in the brain work better by exercising it.

What kind of physical therapy works to reduce vertigo?

It’s called vestibular rehabilitation, and it is a relatively new form of physical therapy. Not all physical therapists are trained in the practice. Typically the exercises consist of movements that initially make the vertigo worse and balance tasks that are quite difficult. By doing these repetitively, the balance system in the brain learns to function better. Common exercises include moving the eyes from side to side, rotating the head from side to side, rotating the head from side to side while walking down a corridor, and things like this.

Can vertigo be associated with the onset of a menstrual period?

Some women with Meniere’s disease have worse symptoms during their menstrual period. This is not an uncommon symptom because Meniere’s disease is exacerbated by salt retention, and menstrual periods are associated with salt retention.

Is anxiety associated with vertigo?

Yes, vertigo causes extreme anxiety in most people. Anxiety, by itself, does not produce vertigo. However, in association with conditions that do produce vertigo, anxiety can make the vertigo much worse. People with certain anxiety disorders such as panic attacks can sometimes also experience vertigo.

What is particle repositioning maneuver?

Particle positioning maneuvers are a treatment for benign paroxysmal positional vertigo (BPPV).

What causes BPPV?

BPPV is caused by loose otoconia within the inner ear. Otoconia are small calcium carbonate crystals that are part of the balance mechanism. In BPPV, these crystals break loose from their normal attachments and are free to tumble around the inner ear. When the involved ear is suddenly put in a downward position, the otoconia stimulate part of the inner ear abnormally. This results in a brief but intense whirling vertigo.

Eliminating symptoms of BPPV

Particle position maneuvers are a series of body turns that maneuver the otoconia into a different part of the inner ear where they will not cause symptoms. It is a very effective maneuver that takes just a few minutes to perform.

How does vertigo relate to labrynthitis?

Labyrinthitis or vestibular neuronitis is a presumed viral infection of the vestibular nerve. It causes sudden loss of function in the balance system of one ear. The brain normally compares the two ears. When you turn in any direction, the output of one ear to the brain goes up and the output of the other goes down. The brain looks at the difference between the two ears and says “I’m turning.” When one ear develops labyrinthitis, its output suddenly drops. The brain sees a difference between the two ears, and that produces the feeling of spinning. This is commonly associated with nausea and vomiting and the worst part of it usually lasts for about three days. For several weeks afterward, it is common to feel a little bit off balance. Typically, after three to four weeks the balance returns to normal.

Vertigo causes & treatment – Illnesses & conditions

Treatment for vertigo depends on the cause and severity of your symptoms.

During a vertigo attack, lying still in a quiet, darkened room may help to ease any symptoms of nausea and reduce the sensation of spinning. You may be advised to take medication.

You should also try to avoid stressful situations, as anxiety can make the symptoms of vertigo worse.

Read more about what to do if you’re struggling with stress

Labyrinthitis

Labyrinthitis is an inner ear infection that causes the labyrinth (a delicate structure deep inside your ear) to become inflamed. It’s usually caused by a viral infection and clears up on its own without treatment. In rare cases, where labyrinthitis is caused by a bacterial infection, antibiotics may be prescribed.

If you’ve experienced any hearing loss, your GP may refer you to an ear, nose and throat (ENT) specialist or an audiovestibular physician. This is a doctor who specialises in hearing and balance disorders. You may need emergency treatment to restore your hearing.

Labyrinthitis may also be treated with vestibular rehabilitation – also called vestibular rehabilitation training or VRT (see below).

See treating labyrinthitis for more information

Vestibular neuronitis

Vestibular neuronitis, also known as vestibular neuritis, is inflammation of the vestibular nerve (one of the nerves in your ear that’s used for balance). It’s usually caused by a viral infection.

The symptoms of vestibular neuronitis often get better without treatment over several weeks. However, you may need to rest in bed if your symptoms are severe. See your GP if your symptoms get worse or don’t start to improve after a week.

You may find your balance is particularly affected if you:

• drink alcohol
• are tired
• have another illness

Avoiding these can help to improve your condition.

Vestibular neuronitis can also be treated with vestibular rehabilitation and medication.

Benign paroxysmal positional vertigo (BPPV)

Like vestibular neuronitis, benign paroxysmal positional vertigo (BPPV) often clears up without treatment after several weeks or months. It’s thought that the small fragments of debris in the ear canal that cause vertigo either dissolve or become lodged in a place where they no longer cause symptoms. BPPV can sometimes return.

Until the symptoms disappear or the condition is treated, you should:

• get out of bed slowly
• avoid activities that involve looking upwards, such as painting and decorating or looking for something on a high shelf

BPPV can be treated using a procedure called the Epley manoeuvre.

The Epley manoeuvre

The Epley manoeuvre involves performing four separate head movements to move the fragments that cause vertigo to a place where they no longer cause symptoms. Each head position is held for at least 30 seconds. You may experience some vertigo during the movements.

Your symptoms should improve shortly after the Epley manoeuvre is performed, although it may take up to two weeks for a complete recovery. Return to your GP if your symptoms haven’t improved after four weeks. The Epley manoeuvre isn’t usually a long-term cure and may need to be repeated.

Brandt-Daroff exercises

If the Epley manoeuvre doesn’t work, or if it’s not suitable – for example, because you have neck or back problems – you can also try Brandt-Daroff exercises. These are a series of movements you can do unsupervised at home.

Your GP will need to teach you how to do the exercises. You repeat them three or four times a day for two days in a row. Your symptoms may improve for up to two weeks.

Referral to a specialist

Your GP may refer you to a specialist, such as an ear, nose and throat (ENT) specialist if:

• the Epley manoeuvre doesn’t work or can’t be performed
• you still have symptoms after four weeks
• you have unusual signs or symptoms

In rare cases, where the symptoms of vertigo last for months or years, surgery may be recommended. This may involve blocking one of the fluid-filled canals in your ear. Your ENT specialist can give more advice on this.

Ménière’s disease

If your vertigo is caused by Ménière’s disease, there are a number of treatment options for both the vertigo and other symptoms caused by the condition.

Possible treatments for Ménière’s disease include:

• dietary advice – particularly a low-salt diet
• medication to treat attacks of Ménière’s disease
• medication to prevent attacks of Ménière’s disease
• treatment for tinnitus (ringing in your ears) – such as sound therapy, which works by reducing the difference between tinnitus sounds and background sounds, to make the tinnitus sounds less intrusive
• treatment for hearing loss – such as using hearing aids
• physiotherapy to deal with balance problems
• treatment for the secondary symptoms of Ménière’s disease – such as stress, anxiety and depression

See treating Ménière’s disease for more information

Central vertigo

Central vertigo is caused by problems in part of your brain, such as the cerebellum (which is located at the bottom of the brain) or the brainstem (the lower part of the brain that’s connected to the spinal cord).

Causes of central vertigo include migraines and, less commonly, brain tumours.

If your GP suspects you have central vertigo, they may organise a scan or refer you to a hospital specialist, such as a neurologist or an ENT (ear, nose and throat specialist) or audiovestibular physician.

Treating your migraine should relieve your vertigo if it’s caused by a migraine.

Vertigo with an unknown cause

If the cause of your vertigo is unknown, you may be admitted to hospital if:

• you have severe nausea and vomiting, and can’t keep fluids down
• your vertigo comes on suddenly and wasn’t caused by you changing position
• you possibly have central vertigo
• you have sudden hearing loss, but it’s not thought to be Ménière’s disease

Alternatively, you may be referred to a specialist, such as:

• a neurologist – a specialist in treating conditions that affect the nervous system
• an ENT specialist – a specialist in conditions that affect the ear, nose or throat
• an audiovestibular physician – a specialist in hearing and balance disorders

While waiting to see a specialist, you may be treated with medication.  

Vestibular rehabilitation

Vestibular rehabilitation, also called vestibular rehabilitation training or VRT, is a form of “brain retraining”. It involves carrying out a special programme of exercises that encourage your brain to adapt to the abnormal messages sent from your ears.

During VRT, you keep moving despite feelings of dizziness and vertigo. Your brain should eventually learn to rely on the signals coming from the rest of your body, such as your eyes and legs, rather than the confusing signals coming from your inner ear. By relying on other signals, your brain minimises any dizziness and helps you to maintain your balance.

An audiologist (hearing specialist) or a physiotherapist may provide VRT. Your GP may be able to refer you for VRT, although it depends on availability in your area.

In some cases, it may be possible to use VRT without specialist help. Research has shown that people with some types of vertigo can improve their symptoms using a self-help VRT booklet. However, you should discuss this with your doctor first.

Medicines

Medication can be used to treat episodes of vertigo caused by vestibular neuronitis or Ménière’s disease. It may also be used for central vertigo or vertigo with an unknown cause.

The medicines are usually prescribed for 3 to 14 days, depending on which condition they’re for. The two medicines that are usually prescribed are:

• prochlorperazine
• antihistamines

If these medicines are successful in treating your symptoms, you may be given a supply to keep at home, so you can take them the next time you have an episode of vertigo.

In some cases you may be advised to take long-term medication, such as betahistine, for conditions like Ménière’s disease.

Prochlorperazine

Prochlorperazine can help relieve severe nausea and vomiting associated with vertigo. It works by blocking the effect of a chemical in the brain called dopamine.

Prochlorperazine can cause side effects, including tremors (shaking) and abnormal or involuntary body and facial movements.

It can also make some people feel sleepy. For the full list of possible side effects, check the patient information leaflet that comes with your medicine.

Antihistamines

Antihistamines can be used to help relieve less severe nausea, vomiting and vertigo symptoms. They work by blocking the effects of a chemical called histamine.

Possible antihistamines that may be prescribed include:

• cinnarizine
• cyclizine
• promethazine teoclate

Like prochlorperazine, antihistamines can also make you feel sleepy. Headaches and an upset stomach are also possible side effects. Check the patient information leaflet that comes with your medicine for the full list of possible side effects.

A medication called betahistine works in a similar way to antihistamines. It has been used to treat Ménière’s disease and may also be used for other balance problems. It may have to be taken for a long period of time. The beneficial effects vary from person to person.

Safety

If you have vertigo, there are some safety issues to consider. For example:

• you should inform your employer if your job involves operating machinery or climbing ladders
• you may be at increased risk of falls – see preventing falls for advice on making your home safer and reducing your risk

Vertigo could also affect your ability to drive. You should avoid driving if you’ve recently had episodes of vertigo and there’s a chance you may have another episode while you’re driving.

It’s your legal obligation to inform the Driver and Vehicle Licensing Agency (DVLA) about a medical condition that could affect your driving ability. Visit the GOV.UK website for more information on driving with a disability.

Benign Paroxysmal Positional Vertigo (BPPV)

Topic Overview

What is benign paroxysmal positional vertigo (BPPV)?

Vertigo is the feeling that you are spinning or the world is spinning around you. Benign paroxysmal positional vertigo is caused by a problem in the inner ear. It usually causes brief vertigo spells that come and go.

For some people, BPPV goes away by itself in a few weeks. But it can come back again.

BPPV is not a sign of a serious health problem.

What causes BPPV?

Benign paroxysmal positional vertigo (BPPV) is caused by a problem in the inner ear. Tiny calcium “stones” inside your inner ear canals help you keep your balance. Normally, when you move a certain way, such as when you stand up or turn your head, these stones move around. Sometimes these stones move into an area of your inner ear called the semicircular canal. When you move your head in certain ways, the stones in the semicircular canal move. Sensors in the semicircular canal are triggered by the stones, which causes a feeling of dizziness.

What are the symptoms?

The main symptom is a feeling that you are spinning or tilting when you are not. This can happen when you move your head in a certain way, like rolling over in bed, turning your head quickly, bending over, or tipping your head back.

BPPV usually lasts a minute or two. It can be mild, or it can be bad enough to make you feel sick to your stomach and vomit. You may even find it hard to stand or walk without losing your balance.

How is BPPV diagnosed?

Your doctor can usually tell that you have BPPV by asking you questions about your vertigo and doing a physical exam. You may have a test where your doctor watches your eyes while turning your head and helping you lie back. This is called the Dix-Hallpike test.

There are other things that can cause vertigo, so if your doctor doesn’t think you have BPPV, you may have other tests too.

How is it treated?

Your doctor can usually do one of two procedures in the office that works for most cases of BPPV. These procedures are called the Epley maneuver and the Semont maneuver. If you don’t want treatment or if treatment doesn’t work, BPPV usually goes away by itself within a few weeks. Over time, your brain will likely get used to the confusing signals it gets from your inner ear. Either way, you can do some simple exercises that train your brain to get used to the confusing vertigo signals.

Medicine may help with severe nausea and vomiting.

Be extra careful so that you don’t hurt yourself or someone else if you have a sudden attack of vertigo.

• Do not drive or cycle if there is any chance that vertigo could strike and make you lose control. (This depends on what kind of movement triggers vertigo for you.)
• At home, keep floors and walkways free of clutter so you don’t trip.
• Avoid heights.
• Don’t use tools or machines that could be dangerous if you suddenly get dizzy or lose your balance.

All About Vertigo: Symptoms and Treatments

Have you even experienced a spinning sensation when you bend down to empty the dishwasher, lean back in a dentist’s chair or merely roll over in bed?   

Vertigo is a temporary sensation that makes you feel like you’re in a spinning or tilting room. This isn’t necessarily a dangerous condition, but it can feel scary when it’s happening.

Types of vertigo

There are two types of vertigo. Peripheral vertigo happens because of inner ear problems. Central vertigo happens when you have health complications in your central nervous system, which includes your brain and spine.

Although vertigo can be caused by various medical conditions, the most common disorder is Benign Paroxysmal Positional Vertigo, or BPPV. This kind of vertigo occurs more frequently in older adults as the tiny calcium carbonate crystals of your inner ear loosen and migrate into a different part of the ear canal, signally to the brain that you’re moving when you’re not. The resultant spinning sensation usually lasts only a minute or so. However, changes in head position can bring it on multiple times a day and at times can be intense enough to cause nausea.

Risk factors for vertigo

Besides inner ear and nervous system problems, you can be at risk of having vertigo if:

• You have a head injury
• You’ve overindulged in alcohol
• You take antiseizure medications

Though women over 65 are more at risk for vertigo, it can happen to anyone at any age. For example, Meniere’s disease often affects people between 40 and 60 years of age.

Symptoms of vertigo

If you suddenly feel like the world around you is tilting or spinning, you may have vertigo. Along with a spinning sensation, you may feel nauseous, headachy and lightheaded. If you feel like you want to faint, it’s probably not vertigo.

While vertigo itself isn’t dangerous, people who experience it are more likely to have balance issues. This can lead to a higher fall risk and make people less able to complete those daily activities such as bathing and dressing due to fear and balance issues. Some feel so unsteady that they hold onto walls or furniture for safety when walking.

If you think you are suffering from vertigo, you’ll want to see your health care provider to get properly diagnosed.

Treatments for vertigo

An episode of peripheral vertigo usually goes away on its own in a few minutes. Sometimes it lasts for hours or weeks. If your vertigo lasts a long time, there is treatment. Doctors often prescribe anti-nausea drugs to slow down the dizziness. You can also use a cane or walking device to prevent falls.

Good news with BPPV specifically, it is treatable. This is accomplished by a repositioning technique known as the Epley maneuver. The process is quick and generally symptoms can be resolved in just several treatments.

Feeling dizzy isn’t a normal part of aging. If you suffer from vertigo, consult your physician regarding BPPV specifically. A referral to Mercy Health Rehabilitation Center where trained therapists can evaluate your condition and provide treatment will have you feeling better in no time. 

Benign paroxysmal positional vertigo: What can you do if you have BPPV? – InformedHealth.org

If benign paroxysmal positional vertigo (BPPV) is hard to cope with or doesn’t go away on its own, a simple treatment can be done. The treatment consists of doing certain head and body movements in a specific order. The aim is to make the problems in the organ of balance go away.

In about half of all people who have BPPV, the symptoms go away after only 1 to 3 months. So treatment isn’t always needed.

If the dizzy spells don’t go away on their own or are very difficult for the person to cope with, repositioning maneuvers can help. They are a common treatment for benign paroxysmal positional vertigo.

How do repositioning maneuvers work?

To do a repositioning maneuver, the doctor shows you how to get into various sitting and lying positions while holding your head at certain angles.

In BPPV, the vertigo is caused by loose calcium deposits (crystals or “ear rocks”) in the organ of balance (vestibular system) inside our ear. The aim of following a certain order of head and body movements is to move the loose crystals to a position where they no longer cause dizzy spells.

The vestibular system has three semicircular canals in it. The Epley maneuver and the Semont maneuver are two very simple and effective repositioning procedures for the treatment of BPPV that is caused by crystals in the posterior semicircular canal. The exercises are usually repeated several times under the supervision of a doctor. There are also slightly different versions that you can do on your own at home as well.

This treatment doesn’t have many side effects. But the movements can lead to nausea or vomiting, similar to during an episode of vertigo. Repositioning maneuvers aren’t suitable for some people – for instance, those who can’t move the neck region of their spine freely.

What does a repositioning maneuver involve?

The Epley maneuver is done in the following way (the person in this example has loose crystals in their left ear):

1. Sit upright.

2. Tilt your head back slightly and move it about 45° to the left.

3. Lie on your back, keeping your head turned to the left. Wait for about 30 seconds.

4. Now turn your head to the right by 90°, keeping it tilted back slightly. Wait for about 30 seconds.

5. Now turn your whole body to the right. Your head moves with your body until you are almost facing the floor. Wait for about 30 seconds.

6. Sit upright again.

After having this treatment, you can move or lie down normally again.

Sequence of movements in the Epley maneuver for the treatment of BPPV caused by deposits in the left ear

In most cases the symptoms are caused by loose crystals in the posterior semicircular canal. The crystals only rarely develop in either of the other two semicircular canals of the vestibular system. If they do, other repositioning maneuvers can be done that are a little different to the Epley and Semont maneuvers. One example is the Gufoni maneuver.

Are there other treatment options?

If the Epley or Semont maneuvers don’t help, aren’t possible or the patient doesn’t want to do them, certain exercises can be done. Your doctor can show you how to do them in his or her practice, and then you can do them at home on your own.

Other treatments, such as anti-nausea medication, are only needed in rare cases.

If the symptoms are very severe and don’t go away, surgery on the vestibular system (the organ of balance) may be considered. This involves destroying either the nerve fibers in the affected semicircular canal, or the semicircular canal itself. The sensory hair cells can then no longer pass information on to the brain. As a result, the loose crystals don’t cause dizziness any more, but the organ of balance in that ear is permanently affected by the surgery.

Epley, Semont, Foster, and Brandt-Daroff

The spinning sensation and dizziness you get from vertigo can limit your activities and make you feel sick. Depending on the cause, though, some simple maneuvers you can do at home might bring relief.

The most common type of this condition is BPPV (benign paroxysmal positional vertigo). It happens when small crystals of calcium get loose in your inner ear. You may feel it when you’re getting in or out of bed, or tilting your head up. People over age 60 are more likely to get BPPV. It’s also the easiest type of vertigo to treat.

Before you try to treat it yourself, see your doctor. If you have vertigo, you’ll need to know what type it is and which ear has the problem. To determine affected side:

• Sit on bed so that if you lie down, your head hangs slightly over the end of the bed.
• turn head to the right and lie back quickly.
• Wait 1 minute.
• If you feel dizzy, then the right ear is your affected ear.
• If no dizziness occurs, sit up.
• Wait 1 minute.
• Turn head to the left and lie back quickly. 8.Wait 1 minute. 9.If you feel dizzy, then the left ear is your affected ear.

If you have BPPV, certain actions can move the calcium crystals that cause the problem out of your ear canal. That should bring relief.

Your doctor or a therapist can show you how to do these moves.

Epley Maneuver

If your vertigo comes from your left ear and side:

1. Sit on the edge of your bed. Turn your head 45 degrees to the left (not as far as your left shoulder). Place a pillow under you so when you lie down, it rests between your shoulders rather than under your head.
2. Quickly lie down on your back, with your head on the bed (still at the 45-degree angle). The pillow should be under your shoulders. Wait 30 seconds (for any vertigo to stop).
3. Turn your head halfway (90 degrees) to the right without raising it. Wait 30 seconds.
4. Turn your head and body on its side to the right, so you’re looking at the floor. Wait 30 seconds.
5. Slowly sit up, but remain on the bed a few minutes.
6. If the vertigo comes from your right ear, reverse these instructions. Sit on your bed, turn your head 45 degrees to the right, and so on.

Do these movements three times before going to bed each night, until you’ve gone 24 hours without dizziness.

Semont Maneuver

This exercise is for dizziness from the left ear and side:

1. Sit on the edge of your bed. Turn your head 45 degrees to the right.
2. Quickly lie down on your left side. Stay there for 30 seconds.
3. Quickly move to lie down on the opposite end of your bed. Don’t change the direction of your head. Keep it at a 45-degree angle and lie for 30 seconds. Look at the floor.
4. Return slowly to sitting and wait a few minutes.
5. Reverse these moves for the right ear.

Again, do these moves three times a day until you go 24 hours without vertigo.

Half-Somersault or Foster Maneuver

Some people find this maneuver easier to do:

1. Kneel down and look up at the ceiling for a few seconds.
2. Touch the floor with your head, tucking your chin so your head goes toward your knees. Wait for any vertigo to stop (about 30 seconds).
3. Turn your head in the direction of your affected ear (i.e. if you feel dizzy on your left side, turn to face your left elbow). Wait 30 seconds.
4. Quickly raise your head so it’s level with your back while you’re on all fours. Keep your head at that 45-degree angle. Wait 30 seconds.
5. Quickly raise your head so it’s fully upright, but keep your head turned to the shoulder of the side you’re working on. Then slowly stand up.

You may have to repeat this a few times for relief. After the first round, rest 15 minutes before trying a second time.

Brandt-Daroff Exercise

Here’s what you need to do for this exercise:

1. Start in an upright, seated position on your bed.
2. Tilt your head around a 45-degree angle away from the side causing your vertigo. Move into the lying position on one side with your nose pointed up.
3. Stay in this position for about 30 seconds or until the vertigo eases off, whichever is longer. Then move back to the seated position.
4. Repeat on the other side.

You should do these movements from three to five times in a session. You should have three sessions a day for up to 2 weeks, or until the vertigo is gone for 2 days.

Follow Up

For the rest of the day after doing any of these exercises, try not to tilt your head too far up or down. If you don’t feel better after a week of trying these moves, talk to your doctor again, and ask them what they want you to do next.

You might not be doing the exercises right, or something else might be the cause of your dizziness.

Peripheral, Central, BPPV, and More

If you’ve been on your share of amusement park rides, you probably know what vertigo is like — the feeling that the world is spinning around you. But if you feel dizzy and didn’t just step off a roller coaster, check with your doctor to see if you’ve got one of the two most common forms of vertigo: central and peripheral.

There are drugs and other treatments for both types. Finding out which one you’ve got — and what’s causing it — can help you and your doctor decide how to manage it.

Keep in mind that vertigo is a symptom of a medical condition, not a disease by itself. Your doctor will try to figure out what’s behind it.

What Causes Peripheral Vertigo?

If your doctor tells you that you have peripheral vertigo, you’ve got plenty of company. It’s the most common type of vertigo. Most cases are caused by a problem in the inner ear, which controls your balance.

The most common causes of the inner ear trouble that leads to peripheral vertigo are:

• Benign paroxysmal positional vertigo (BPPV)
• Vestibular neuronitis
• Meniere’s disease

Continued

BPPV is a condition that causes small crystals to get loose and start to float in the fluid of your inner ear. The movement of the crystals and the fluid leads you to feel dizzy. Sometimes an ear injury can lead to BPPV.

Vestibular neuronitis causes severe dizziness that comes on suddenly and lasts for 2 to 3 weeks. Doctors think an infection with a virus may be the cause.

Meniere’s disease is condition that combines symptoms of dizziness with occasional hearing loss. Doctors aren’t sure what causes it, though stress can be a trigger, along with eating salt or drinking caffeine and alcohol.

There are some other conditions of the inner ear that also lead to peripheral vertigo, including:

• Labyrinthitis
• Perilymph fistula
• Superior semicircular canal dehiscence syndrome (SSCDS)

Labyrinthitis may be caused by a viral infection of your inner ear. Perilymph fistula may be due to a head injury or sudden pressure change, such as from scuba diving. SSCDS may be due to a breakdown of part of a bony part of a canal that carries fluids in your inner ear.

What Other Symptoms May I Have With Peripheral Vertigo?

Nausea and vomiting, sweating, and ear problems are all common symptoms that you may have along with vertigo.

If your peripheral vertigo is caused by an inner ear infection or a disease, you may have some pain or a feeling of fullness in your ear.

In labyrinthitis and Meniere’s disease, you may have hearing loss and tinnitus (ringing of the ears) in one or both ears along with the vertigo.

There are some common features of peripheral vertigo that can help your doctor make a diagnosis. Vertigo that starts without warning, and stops just as quickly, is more likely to be peripheral vertigo.

Your eyes may also move without your control. This movement may go away when you try to focus your vision on a fixed point. It also tends to only happen during the first few days of vertigo symptoms and then disappears.

How Is Peripheral Vertigo Treated?

You can treat peripheral vertigo by managing the condition that’s causing it.

Continued

BPPV, the most common cause of peripheral vertigo, can be treated with a 15-minute exercise known as the Epley maneuver. This series of movements, done in your doctor’s office, helps return the crystals that control balance to the correct place in your inner ear.

Anti-inflammatory drugs can sometimes help ease symptoms if your peripheral vertigo is caused by vestibular neuronitis, Meniere’s disease, or labyrinthitis. Meniere’s disease can also be controlled by cutting down on salt, caffeine, and alcohol and lowering your stress.

For some conditions, such as perilymph fistula or SSCDS, your doctor may recommend surgery to correct problems in your inner ear.

Some conditions causing peripheral vertigo may be chronic, meaning they are ongoing. In these situations, you’ll need a combination of balance exercises, lifestyle changes, and medication to manage the vertigo. Motion sickness medicine may also help ease nausea. Your doctor may also prescribe medicines that help reduce balance problems.

What Causes Central Vertigo?

Central vertigo is caused by a disease or injury to the brain, such as:

• Head injuries
• Illness or infection
• Multiple sclerosis
• Migraines
• Brain tumors
• Strokes
• Transient ischemic attacks (“mini” strokes that last for a short time and don’t cause permanent damage)

What Other Symptoms Could I Have From Central Vertigo?

While episodes of peripheral vertigo tend to pass quickly, central vertigo often comes without warning and may last for long periods of time. The episodes are generally much more intense than peripheral, and you may be unable to stand or walk without help.

Eye movement that you can’t control happens in both types of vertigo. But in central vertigo this eye movement lasts longer (weeks to months during vertigo episodes) and it does not go away when you’re asked to focus on a fixed point.

The hearing problems that frequently happen in peripheral vertigo or AICA strokeare rare with central vertigo. But other symptoms — like headaches, weakness, or trouble swallowing — are common with central vertigo.

How Is Central Vertigo Treated?

Finding out the root cause of the vertigo and treating it is the only way to manage central vertigo. If migraines are the cause, for instance, medication and reducing your stress may help.

For some ongoing conditions, such as multiple sclerosis stroke, and some tumors, treatment may consist of managing the symptoms. This may include medicines for nausea and drugs that help lessen the sensation of movement.

A stroke in the brain can trigger not only vertigo but dysarthria (slurred speech), ataxia (problems moving), weakness, and numbness/tingling. You should get emergency help right away.

90,000 causes and treatment. Why dizzy and how to get rid of it – health articles

Contents

Dizziness is not a disease, but a symptom that occurs in a number of very different diseases, causing the patient to disorientate in space, a false sensation of mobility of objects and stationary objects relative to him or the person himself relative to the objects around him. It is extremely common, especially among elderly patients and females: in terms of the frequency of medical complaints, it is in second place after headache.

The diagnosis of vertigo is difficult, since the sensation of instability in space is extremely subjective and can differ significantly in different patients both in the degree of manifestation and in the sensory phenomena that arise in this case.

The condition can arise suddenly, be of an episodic nature: the patient experiences something like a jolt, as if he is “led” to one side.

Status description

The condition can arise suddenly, be of an episodic nature: the patient experiences something like a jolt, as if he is “led” to one side.In other cases, there may be a feeling of movement of surrounding objects in a circle or a feeling of rotation of the person himself, as after a long spin on a carousel. This state can persist long enough, up to an hour. But more often dizziness is expressed in a feeling of general instability of objects and the person himself, a violation of the sense of balance. The patient experiences uncertainty when walking, it seems to him that he is about to fall or stumble, the earth is slipping from under his feet. Sometimes the symptoms become so severe that the patient grasps objects and feels lightheaded, as before losing consciousness.

When should I see a doctor immediately?

• First time dizziness, accompanied by nausea, vomiting or headache
• Dizziness led to loss of consciousness
• Weakness, tremors (tremors) of the extremities, tachycardia, sweating, feeling of shortness of breath, chest pain
• Condition lasts more than an hour
• Along with dizziness, sensitivity sharply decreased or weakness occurred in one half of the body, face or limb

These symptoms indicate a possible development of an emergency and require urgent medical attention.

What diagnostics can be prescribed by a doctor?

Symptomatic treatment of dizziness is possible only after the doctor has established the cause that caused it.

To determine the type of dizziness and its possible causes, it is necessary to perform laboratory and instrumental diagnostics. It is:

• cardiogram
• blood tests (general, biochemical, for coagulability)
• Ultrasound of the vessels of the head and neck
• MRI or CT of the brain

Drug therapy

• In case of circulatory disorders, drug therapy will include the use of vasodilators and antihistamines and drugs that improve the rheological properties (fluidity) of blood
• Neurogenic dizziness requires taking nootropics (Picamilon, or gamma-aminobutyric acid), which improve blood circulation and nerve conduction
• Vertigo caused by osteochondrosis requires taking muscle relaxants to relieve muscle spasm
• In women, the treatment of dizziness caused by menopausal changes or irregularities in the cycle is carried out with hormonal drugs that allow the body to return the hormonal background to normal

Mode. Reduced to adherence to the daily routine, the correct alternation of mental and physical exertion, sleep and wakefulness.

Diet. Eliminates the use of foods that increase blood pressure and cause vasospasm, stimulating the nervous system (coffee, strong tea, alcohol, nicotine, very salty or spicy foods).

Gymnastics. To train the vestibular apparatus outside of an attack, it is recommended to perform some exercises:

• Rotation of the head, trunk from side to side with closed and open eyes
• Swing on a swing with a gradual increase in amplitude
• Balance Exercises (Stand on one leg with eyes open and closed)
• Rotation of eyes in different directions
• Swimming

Home treatment for vertigo

If vertigo attacks occur intermittently and the cause is known, you can relieve the symptoms yourself.

If vertigo attacks occur intermittently and the cause is known, you can relieve symptoms yourself using the following techniques:

• If your head is dizzy after getting up suddenly, tilt your head forward and exhale completely
• While sitting, bend over to the knees, maintain the position until symptoms stop
• Take a stable position (sitting with your legs apart, rest on the floor) and focus your gaze at one point on a stationary object
• Splash cold water on your face
• Inhale ammonia vapors
• Drink some hot sweet tea
• In the future, care should be taken when changing the position of the body: slowly lie down, bend over and get up

Benefits of treatment at MEDSI

• Receptions are conducted by qualified neurologists with extensive practical experience
• Clinics are equipped with equipment that allows for complete diagnosis of vertigo
• Assisting with dizziness emergencies

To make an appointment, call the round-the-clock phone 8 (495) 023-60-84.

Our doctors

Head of the Neurology Center, doctor MEDSI Premuim

Doctor of Medical Sciences, Professor, Doctor of the highest qualification category

Head of the Center for Neurology, Vertebrology and Psychosomatics, neurologist

Head of the Department of Psychotherapy and Neuropsychology, Psychiatrist, Psychotherapist, Psychologist

Candidate of Medical Sciences, Doctor of the highest qualification category

Neurologist

• Diagnostics and treatment of insomnia
• Diagnosis and treatment of sleep apnea
• Treatment of anxiety disorders

90,000 Symptoms and causes of dizziness

Table of contents:

General

Dizziness is a general term that generally denotes weakness, lack of clarity of consciousness, loss of balance or sensation of rotation. Dizziness attacks usually do not pose a great threat to health, but sometimes they can be based on serious disorders (stroke, brain tumor, anemia). Mild dizziness, occurring in the form of episodes of confusion, confusion, can occur when the head is turned in different directions, when the position of the head changes, and also when a person gets out of a chair or bed. Such attacks of dizziness last no more than a minute. More severe vertigo can last for minutes, hours, or even days and is accompanied by symptoms such as loss of balance (at risk of falls), unsteady gait, hearing impairment, nausea, ringing in the ears, and blurred vision.During such an attack, you may feel a sharp weakness, as if you could faint. Such attacks occur with diseases of the inner ear, anxiety, hyperventilation. Some people feel dizzy when they rise too quickly from a sitting or horizontal position. This type of dizziness, which occurs when changing position, is also called orthostatic hypotension and is caused by a sharp outflow of blood from the brain during a sharp change in position. At the same time, the pressure in the vessels supplying the brain decreases rather quickly. To avoid this condition, you need to get up not abruptly, gradually. Before getting up, sit on the edge of a bed or chair to find a fulcrum. When lifting, the muscles of the legs should be tense, so that more blood will flow to the brain. There are other causes of vertigo. These include dehydration, high blood pressure, heart disease, and anxiety. Be sure to tell your doctor if you have hypertension or heart disease or feel dizzy.

If you have problems with balance becomes hard to walk smoothly and straight. There is a feeling that the unsteady feet on the ground, and now you will fall. This type of balance disorder is a serious hazard, as there is a high risk of injury if you fall. Impaired ability to maintain balance is often caused by age-related changes in the vestibular apparatus of the inner ear (labyrinth), decreased sensitivity of receptors balance of the lower extremities and joints, arthritis and poor eyesight. Consult your doctor if you feel the inability to maintain balance, or lose the feeling of support to her feet. To protect yourself from falling, do not turn off the light at night, remove the carpet, because you can trip over them, walk with a cane or a special stick.

With systemic dizziness, there is a feeling of rotation, whirling, twisting of the surrounding objects. This can also cause nausea, vomiting and flies before the eyes. This type of vertigo is usually temporary and does not represent a great danger to life and caused it a violation in the semicircular canals of the inner ear, which are responsible for the maintenance of equilibrium.Such violations include labyrinthitis, benign positional vertigo and Meniere’s disease.

Labyrinthitis is an inflammation of the inner ear, often of viral etiology. In this condition, the centers of equilibrium in the brain are overstimulated, which leads to a sudden significant imbalance, accompanied by nausea, vomiting, and involuntary movements of the eyeballs. These symptoms can appear suddenly during the day, but sometimes a person may wake up with similar complaints.Severe dizziness can last for several days. Fortunately, the labyrinthitis usually subsides over time and does not recur. It usually takes several months for symptoms to disappear completely. During this time, transient sensations of loss of balance may occur with certain movements of the head or with a certain position of it, and this condition is called benign positional vertigo. Benign positional vertigo occurs only when you change the position of the head (as a rule, when turning in bed, leaning backwards and in front of the head).This is the most common type of vertigo in adults. Usually, this feeling of rotation lasts no more than a minute and can occur both once a day and whenever a person turns his head. Benign positional vertigo can occur as a complication of labyrinthitis or as an independent disease. Usually it takes about 4 months to complete disappearance of symptoms. If you have episodes of severe dizziness, discuss them with your doctor.

Meniere’s disease is a consequence of an increased concentration of sodium in the inner ear fluid.A high sodium content increases the pressure in the inner ear space, which leads to imbalance and also to hearing fluctuations. This condition is fairly common among adults of all age groups. Patients marked tinnitus, sensation of fullness, pressure in one ear. Nausea and vomiting may also occur. Symptoms can come and go, be mild and very intense, and usually last from a few hours to a few days. Episodes of inner ear disorders can recur every few days or every few years.In the intervals between these attacks, most patients with Meniere’s disease feel well.

Reasons

• A sharp rise from a sitting or lying position
• Hunger, stress, high temperature
• Diseases of the visual apparatus
• Certain medicines, alcohol
• A sharp rise to a great height (in an airplane), because at high altitudes, the oxygen content in the air is less than on the ground.
• Motion sickness

Dizziness can be a sign of more serious medical conditions:

• Anemia
• Hypoglycemia (low blood sugar)
• Heart disease
• Temporary partial blockade of blood flow in the arteries supplying the brain
• Heavy blow to the head
• Subdural hemorrhage (bleeding in the space between the membranes covering the brain)
• Brain tumor

Symptoms

• Periodic dizziness and feeling of disorientation, weakness when getting out of bed.
• Imbalance, feeling of circling objects around, lasting more than three days.
• Imbalance in combination with nausea and vomiting.
• A feeling of disorientation in space associated with fever, hearing loss, ringing in the ears, or pain in the ear.
• A feeling of disorientation in space with a head injury or severe headache.
• Dizziness with feeling of numbness, weakness in the limbs and involuntary urination and defecation.
• Dizziness and flies before the eyes or double vision, hearing loss, slurred speech
• Loss of balance combined with symptoms of shock (rapid pulse, shallow breathing, cold, damp to the touch, pale face).
• Loss of balance and feeling of pressure or chest pain.

What You Can Do

If an attack of dizziness begins when you stand up quickly, do it slowly, slowly.If you are currently feeling dizzy, sit up slowly and assume a reclining position. This makes it less likely that you will fall and injure yourself. If you feel that you may pass out, or your eyes become dark, sit with your head between your knees.

Drink plenty of fluids to stay hydrated and maintain normal blood pressure.

Give up alcohol, caffeine, smoking.

Do not drive

Relaxation techniques can be used to overcome anxiety.Breathe slowly and deeply

If you feel an attack of dizziness approaching, do not close your eyes and focus your vision on any one stationary object. This can help reduce the intensity of the discomfort.

If your family members also feel dizzy, have a headache, or complain of nausea or vomiting, this could be due to carbon dioxide poisoning. Go outside immediately and seek help from a hospital.

Consult a physician if dizziness persists, recurs frequently, becomes more intense, or is accompanied by visual impairment, hearing impairment, numbness or weakness in the arms and legs.

What a doctor can do

The doctor can determine the immediate cause of dizziness, prescribe appropriate medications (for example, antiemetic or antihistamines). If your doctor discovers any serious health problems that are causing you dizziness, he or she may refer you to an appropriate specialist.

90,000 Benign paroxysmal positional vertigo: disease treatment

Fast passage

Benign paroxysmal positional vertigo (BPPV) is one of the most common diseases of the peripheral vestibular analyzer.

The main symptom is a sudden short-term attack of systemic vertigo when changing the position of the head.

The incidence of BPPV varies from 11 to 64 cases per 100,000 population. Women get sick 2-3 times more often than men. The risk of developing BPPV increases after age 35, with the peak incidence at age 60.

In the structure of all causes of dizziness, BPPV ranks first and accounts for 18-25% of all cases of dizziness.

About 90% of cases of BPPV are idiopathic (cause remains unknown).Only in 10% of cases it is possible to identify the predisposing factors for the development of the disease: head trauma, whiplash or operations on the bones of the skull, dental implantation, diseases of the middle and inner ear, their surgical treatment, prolonged bed rest.

Anatomy

The inner ear is represented by a labyrinth located in the temporal bone. The labyrinth consists of three semicircular canals (anterior, posterior, horizontal) and a cochlea. The semicircular canals are located in three mutually perpendicular planes: the horizontal (HPC) is located at an angle of 30 ° to the horizontal plane, and the anterior (PPK) and posterior (ZPC) – at an angle of 45 ° to the sagittal plane.The hairs of sensitive cells of the otolith receptor form a network that is immersed in a jelly-like mass containing otoliths – crystals of phosphate and calcium carbonate, which together form an otolith membrane.

According to one of the theories of BPPV, a vertigo attack occurs when otoliths detach from the membrane and enter the lumen of one or more semicircular canals. During the displacement of otoliths in the lumen of the semicircular canal, under the influence of gravity when turning the head, movement of the endolymph occurs, which leads to excitation of nerve endings, the appearance of nystagmus (involuntary oscillatory eye movement) and dizziness.

With BPPV, each of the semicircular canals can be affected, and in some cases, several canals at once.

Most often (85-90% of cases), BPPV of the posterior semicircular canal is detected – due to its anatomical location relative to the action of gravity, in 5% of cases, the HPC is affected, in 1% of cases – PPK.

Symptoms of the disease

Patients complain of an attack of systemic (rotational) dizziness after a change in head position: turning the head from side to side in bed, getting out of bed, going to bed, throwing the head back when looking up, any sharp turns of the head.The dizziness attack lasts about a minute and is usually not accompanied by other symptoms. Rarely, patients experience nausea, even more rarely vomiting. In most cases, patients feel well between attacks.

Diagnostics

The main method for diagnosing BPPV is to evaluate the results of positional tests, during which successive turns and tilts of the head are made, which leads to displacement of free otoliths, nystagmus appears and an attack of dizziness may occur.The most common test for diagnosing BPPV is the Dix-Hallpike test. The test is considered positive if the doctor fixes a certain type of nystagmus. For each semicircular canal, its own diagnostic tests have been developed.

In typical cases, there is no difficulty in diagnosing BPPV, since nystagmus has a strict specificity when performing positional maneuvers. If positional nystagmus and vertigo do not fit within the parameters expected on positional tests, and the disease cannot be treated with positional maneuvers, central genesis of vertigo should be suspected and additional examinations should be prescribed.

Differential diagnosis

Central vestibular disorders affecting the cerebellum and brainstem (stroke, transient ischemic attack, multiple sclerosis, tumors).

Vestibular migraine – usually accompanied by a headache.

Vestibular neuronitis is a lesion of the vestibular ganglion, presumably of inflammatory genesis. It manifests itself as an acute episode of dizziness, accompanied by a disorder of balance with preserved hearing.

Meniere’s disease is a disease of the inner ear, manifested by a triad of symptoms: systemic dizziness, hearing loss of the sensorineural type, subjective ear noise.

BPPV Treatment

BPPV often goes away on its own before going to the doctor. About 20-28% of patients with BPPV experience spontaneous disappearance of symptoms within 1 month.

Therapeutic tactics consists in using a certain sequence of head turns (repositioning maneuvers), in which the otoliths move from the affected canal back to the threshold of the maze.

If the effectiveness of repositioning maneuvers is insufficient, the patient may be additionally recommended to perform the necessary set of exercises at home.

Surgical treatment is used only if the maneuvers are ineffective, when BPPV disables the patient.

According to various studies, the risk of BPPV recurrence is 15% during the first year and 37-50% during the next 5 years.

How is BPPV treated at the Rassvet clinic?

Since BPPV is a mechanical disease, its treatment is based solely on repositioning maneuvers. Antiemetics may be prescribed for severe nausea and vomiting.

We do not prescribe vascular therapy, homeopathic remedies or other drugs and treatment methods (acupuncture, osteopathy) to patients with BPPV with unproven efficacy.

Specific prophylaxis of the disease has not yet been developed. Currently, there is an active study of the connection between BPPV and vitamin D deficiency.

Authors:

Elena Chekaldina
otorhinolaryngologist, Ph.M.Sc.

90,000 Dizziness – Family Clinic “Medis”

The author of the article: Neurologist at the Medis Family Clinic, Candidate of Medical Sciences Irina Fedorova

We are used to treating dizziness lightly. “I’m dizzy, now I’ll sit and it will pass,” we say frivolously, feeling unwell. Indeed, light dizziness in most cases is not dangerous. You can only stumble when you feel vertigo – this is what doctors call this phenomenon.

But it often happens that dizziness is a symptom of very unpleasant and even life-threatening diseases – tumors, stroke, meningitis … Doctors advise in certain cases to go to clinics faster or even call an ambulance. When is it worth worrying?

– if dizziness is repeated daily or lasts more than an hour;

– if dizziness occurs in paroxysms. You try to get out of bed in the morning, but you cannot even get up because of sudden dizziness;

– if dizziness is unconventional, for example, objects move not in a circle, but in a different plane;

– if dizziness is accompanied by a sharp increase or decrease in pressure.

About 80 reasons that can cause dizziness have been identified, of which about 20% are complex. But most often these reasons are associated with neurology, therefore, with a complaint of dizziness, it is best to first consult a neurologist.

What is dizziness from a medical point of view?

In a healthy person, a state of balance occurs due to a combination of signals coming into the cerebral cortex from the vestibular, visual and proprioceptive systems. Impulses from the cerebral cortex reach the skeletal and eye muscles and provide a stable posture and the desired position of the eyeballs.In the event that the flow of impulses from the vestibular sections to the cortex of the temporal and parietal lobes is impaired, the perception of surrounding things or the whole body becomes illusory. It seems to a person that he himself or the objects around him move in space in a circle. Constant companions of dizziness are nausea and vomiting, tinnitus. The gait becomes wobbly and unstable, and weakness begins. It seems to a person that his heart began to beat faster, he is sweating. After an attack of dizziness, he falls asleep.An increase in body temperature is possible.

Dizziness can be a symptom of what neurological diseases?

Various diseases of the brain can cause dizziness, then it is called central. I will name some of the common diseases characterized by dizziness.

• Viral meningitis is a serious disease that is an inflammatory process in the membranes surrounding the spinal canal and brain. Symptoms are similar to those of the flu, and include a stiff neck and severe headache.

• Stroke. Dizziness on the eve of a stroke is common in older people. This is due to damage to the back of the brain that causes poor circulation. You can reduce your risk of stroke by controlling your weight, stopping cigarettes, being active, and reducing your alcohol intake.

• Circulatory disorders of the brain. During sedentary work, a large load is placed on the spine and cervical spine, as a result of which, if you do not get up for a long time, the blood circulation of the brain is impaired.Therefore, when a person stands up, a slight dizziness appears.

• Vestibular migraine. About 40% of people suffering from migraines also feel dizzy. Then nausea and loss of balance are added to the strongest headache.

• Cervical osteochondrosis. Dizziness with osteochondrosis increases with head movement, especially with sharp turns and rises. Patients sometimes have unstable gait and disorientation in space. All this is accompanied by pain and limited movement in the cervical spine.

• Perilymphatic fistula. It is characterized by dizziness, tinnitus, sudden one-sided deafness. Also, patients suffer from nausea and vomiting.

Vertigo can also occur from damage to the inner ear or vestibular nerve. This vertigo is called peripheral and is dealt with by ENT doctors. Otorhinolaryngologist-audiologist Zlata Polishchuk explains what might be wrong if you feel dizzy:

The organ of hearing is located in the temporal part of the skull.In the same zone, the vestibular apparatus is located, which is responsible for the sense of space and body balance. Therefore, diseases of the ENT organs are often accompanied by dizziness. It could be:

• Calcium deposits in the inner ear. The problem is more related to older women. In this case, benign positional vertigo appears. It can last for many months, often occurs with head movements, and may be accompanied by involuntary eye movements.

• Meniere’s disease is a disorder of the inner ear that causes dizziness, ringing in the ears and hearing problems.It is a chronic condition that has no treatment, but it is possible to reduce the severity of symptoms. Dizzy spells plague people with this condition because the tissues of the inner ear are under powerful pressure from fluids, which causes the abnormal condition.

• Acute labyrinthitis. Inner ear otitis media can cause very severe dizziness. When the nerves in the inner ear are affected by inflammation, the brain is unable to normally recognize information about head position and balance.A variety of infections, from measles to hepatitis, can cause this condition.

Since there can be many reasons for dizziness, the patient needs to undergo a comprehensive examination.

First, the neurologist will suggest that the patient undergo several tests, which will be aimed at assessing the functioning of the vestibular apparatus. This can be a caloric test or rotational tests, a posturographic method. Then, depending on the symptoms, the following can be prescribed:

– MRI of the brain.MRI of the neck,

– Doppler ultrasound of the vessels of the brain and blood vessels and duplex scanning of the brachiocephalic vessels,

– fundus check by an ophthalmologist,

– X-ray of the cervical spine, with functional tests,

– registration of visual evoked potentials,

– audiometry and acoustic impedance measurement.

To assess the state of the vascular system, the patient may be referred for CT or ultrasound.It is also possible to perform an EEG.

You should not be afraid of dizziness, panic with this symptom is unnecessary. However, there is no need to hesitate to see a doctor if dizziness begins to bother you. Experienced specialists are waiting for you at the Medis clinic, who will not fight the symptoms, but will find out the cause of the dizziness and cure them.

90,000 Vertigo Clinic

Our clinic for the treatment of vertigo provides services for the diagnosis and treatment of patients with dysfunction of the balance organ in the inner ear and the nerves of the vestibular apparatus.The symptoms of the disease are felt as dizziness with the sensation of riding a carousel or swimming, i.e. severe dizziness to loss of balance and falls; feelings of immersion or free fall.

Vertigo and dizziness

Vertigo is a sudden sensation of loss of balance or movement of the surrounding space in front of the eyes. You may feel that you are spinning like a carousel or that your head is spinning inward. In the first case, the patient feels that everything is spinning in front of him or his body is spinning.This usually occurs as a result of a sudden illness or disturbance of the organs of balance. Dizziness is characterized by weakness or frustration, usually caused by low blood sugar or low blood pressure in a chronic condition.

Vertigo can be observed after a long flight or travel on water, in which a person’s consciousness becomes accustomed to turbulence, which leads to the patient feeling that he is moving up and down. This feeling usually goes away after a few days.Vertigo also occurs when exposed to a very loud sound from its pressure in the inner ear, which relieves the load on the organ of balance. Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that vertigo can cause and is characterized by short-term episodes of mild to severe vertigo when head position changes.

Diseases that can cause vertigo and deafness

Vertigo may result from:

1. Otitis media – inflammation or infection of the middle ear.
2. Eustachian tube dysfunction (EST) or auditory tube dysfunction: Occurs when the tube cannot open when swallowing or yawning.
3. Internal otitis media – inflammation of the labyrinth of the inner ear: The primary symptoms of internal otitis media are vertigo, which is accompanied by hearing loss and tinnitus.
4. Head Injury: Refers to injuries that can affect the inner ear.
5. Meniere’s disease: characterized by episodes of dizziness and tinnitus and usually unilateral hearing impairment.
6. Positional vertigo: Benign paroxysmal positional vertigo (BPPV) (sometimes called DPV) is the most common cause of vertigo attacks. This group of patients suffers from vertebrobasilar insufficiency (VBI) or vertebrobasilar ischemia, which leads to the development of short-term symptoms of decreased blood supply in the vertebrobasilar area of ​​the brain.
7. Degenerative changes or disorders in the central nervous system (CNS): Alzheimer’s disease, Parkinson’s disease or senile dementia.
8. Acute peripheral vestibulopathy: sudden, persistent dysfunction of the peripheral vestibular system against a background of nausea, vomiting and vertigo. Vertigo usually lasts 2 weeks.
9. Acoustic neuroma: (also known as acoustic neuroma, acoustic neuroma or acoustic schwannoma) is a benign, usually slow-growing tumor mass that develops in the vestibular and auditory nerves.
10. Other syndromes of dysfunction of the central nervous system or brain: physical illness, diabetes mellitus, high blood pressure, infectious diseases, kidney disease, heart disease, thyroid dysfunction.

Given the variety of reasons, many factors must be taken into account when diagnosing, including:

• The patient’s history of vertigo (its type and duration of seizures)
• Physical examination

Special diagnostic techniques

A. Hearing examination

1. Audiometry: to determine the speed of response of hearing
2. Tympanometry and acoustic reflex to test middle ear function
3. Bekesy – automatic audiometry

B.Examination of the vestibular apparatus

1. Posturography
2. Caloric test
3. Positioning Test
4. VNG

C. Physiological examination

1. Brain stem electrical response audiometry (BERA – ABR)

Summary

Vertigo – a sudden feeling of loss of balance and movement of objects around you. Feeling like you are spinning on a carousel or dizzy inside.There are many reasons for the development of this condition, so if you suffer from vertigo, you need to consult with a specialist to find out the cause and treatment.

90,000 How I cured dizziness: after many years of ordeal, forty minutes were enough

First come out. I get dizzy from time to time. Quite a long time ago, from twenty-five years. Spins when you throw it back. Or, conversely, when you look down. Or in a dream when you roll over on the other side.

Such garbage rolls over unexpectedly and lasts from several days to a month. Gradually, the head stops spinning and may no longer do this for a whole year. Or two years. Or three. There is no system in her behavior. I do not know why it starts and why it stops.

Many times I tried to find out why she is spinning and how to treat her all the same. I went to various specialists. All the doctors I have turned to in my life can no longer be recalled. But those whom I came to in the last five or six years were definitely good professionals.

All of them were receiving appointments in state and commercial clinics and medical centers. Real doctors, not paramedics. Someone was recommended to me. Having saved up money, I went to someone myself, deciding that I can trust him, since he works in an expensive and prestigious medical institution, because a bad specialist will not be hired there.

I do not mention the names of the medical centers here, so as not to make them anti-advertising advertising. But, believe me, they are all very worthy, well-known and have been working in Moscow for many years.

With dizziness, you have to go to a neurologist – that’s what they told me in any clinic. And the therapist also always referred to the neurologist. So I went to neurologists.

Neurologists examined me very carefully. They tapped them with hammers, put them down, crushed them, sent them to ultrasound of the vessels of the neck, MRI of the brain and upper spine, and demanded to pass all sorts of cunning blood tests.

According to the results of research, on which I spent about ten thousand each time, if not more, it turned out that I, of course, had osteochondrosis.The vertebrae in the neck are displaced from working on a computer or perhaps from a birth injury. Because of this, some vessels are clamped in the neck and the blood supply to the brain is disrupted. And the head is spinning.

Neurologists wrote terrible diagnoses in their reports. And some kind of encephalopathy, and something vascular, and something vegetative.

I was upset, of course. “Unfortunately, the vertebrae cannot be moved back,” kind neurologists reassured, “it will get worse with age. High blood pressure, stroke, you are at risk.But now we will treat you and you will feel better. In general, you need to sit at the computer less, sleep more, walk, relax, exercise therapy and a pool, swimming is very useful for you. ”

Treatment for all doctors was the same – for ten days to go to IVs with some kind of vascular strengthening drugs plus massage, chiropractor, acupuncture, physiotherapy and therapeutic gymnastics. Or all together, or something to choose from. But in any case it cost a lot of money.

Once I decided to limit myself to droppers.A month later, my head really stopped spinning, but before it stopped even without droppers, so I didn’t have much faith in such treatment.

Another time I had fatty insurance, which paid not only for IVs, but also for procedures. “Any whim for your money,” said the neurologist, writing out a thick stack of referrals, and for three weeks I went to this medical center as to work. Dropper, electrophoresis, magnets, massage, manual loosening of the head, needles. My head, however, was spinning even more and stopped only after my treatment stopped and passed again for about a month.

I must say that a long time ago – ten years ago, probably, I casually told my friend about the head. She graduated from the Moscow Medical Institute back in Soviet times. Then she went abroad and works there as an ordinary general practitioner. “And how dizzy – like on a ship or like a merry-go-round?” She asked immediately. I said it was more like a carousel. “Go to the earhogolonos,” she advised. In our youth, the name of an otolaryngologist was called “Ukhogorlonos”. A friend explained that she was dizzy because of the crystals in her ears.They were somewhere out of place with me, and the “ear-throat” will return them to the right place with elementary manipulations. They know how, it’s not difficult.

While dragging about neurologists, I sometimes recalled this strange advice and once decided to follow it. I went to an otolaryngologist of the highest qualifications, to a paid, reputable clinic with an excellent reputation.

Here, I say, my head is spinning. Put the crystals back in my ears.

A highly qualified otolaryngologist looked at me like a fool who had fallen from the sky.She had never heard of crystals. “With dizziness to the neurologist. You shouldn’t have come to me. ”

This was the end of my relationship with the uhogorlonos. And with the neurologists, the sluggish ones continued.

***

A couple of months ago – at the beginning of summer – my head was not spinning at all. And it hadn’t been spinning for so long that I forgot to think about it.

Without any connection with my head, I decided to make my old dream come true – I signed up for a “light swimming” course in order to learn how to crawl long distances in open water and eventually swim across the Volga at its widest point or even the English Channel.

Contrary to the assurances of neurologists in the exceptional benefits of swimming in osteochondrosis, the head began to spin dangerously after the third lesson. I did not give up, I continued my studies. Do not give up, once it is packed.

Completed the course. But the head spun as much as it had never spun in my life.

She behaved well only when looking straight ahead. But from turns and tilts to the right, left, up, down, a rapid rotation of everything that is in the field of view began.

I could only sleep while sitting. To brush my teeth, I had to undress and get into the bathtub, because it was impossible to bend over to the sink. My head began to spin so that I could easily bump my forehead into this sink. Behind the wheel, you had to look only straight, and park on the mirrors, in no case turning your head sharply. In general, I was desperate, to be honest. Damn neck. My poor brain. He is not supplied with blood at all. What to do? Should we go to a neurologist again? But how can he help if useless droppers and massage are his entire arsenal.

Photo: Gennady Cherkasov

In addition to the head, a tooth ached. In dentistry, for some reason, I was seen by an otolaryngologist. Leaving the dentist, I went to him. Absolutely non-pathos specialist. Fortunately, there was no queue or entry. And she told about the head. And about the crystals.

The diagnosis was made instantly: benign positional vertigo. “You need to see an otoneurologist,” said the otolaryngologist. – He will manipulate you.There is only one specialist in Moscow who will do it competently, and he has all the necessary equipment. If you go, then to him. ”

And I went to him. And everything worked out. Three weeks of agony and years of depression from the “poor blood supply to the brain” ended in forty minutes.

The otoneurologist put on special glasses on me, laid me on the couch and began to turn somehow cunningly and carefully. At first, my head was spinning mercilessly at every turn. It was sickening, disgusting, I wanted to sit down immediately to calm the rotation.But by the fourth series of turns, everything had somehow improved. I rolled over both on the left side and on the right and looked forward to how I would sleep lying down – forgotten happiness! – already tonight.

***

Benign positional vertigo occurs due to irregularities in the vestibular apparatus. Osteochondrosis, constricted blood vessels and poor blood supply to the brain have nothing to do with it. It’s all from another opera altogether.

In the human inner ear, there are two receptors – auditory and vestibular, which are directly involved in the balance system.The inner ear (ear labyrinth) contains calcium crystals. They lie there in the so-called pouches and provide a sense of gravity.

These crystals are called kanalits. They can break down for various reasons. The released crystals can float out of the sacs into the semicircular canals filled with fluid. There are three such semicircular canals in total. Most often, the canals float into the vertical channel. But they can swim in any.

If they swam, a change in the position of the head can cause a shift in the channels, and then the person will have a feeling of rotation.It is very strong. Lasts less than a minute, but causes nausea, imbalance, and these sensations last for hours.

Such vertigo happens to both children and the elderly. No regularities have been identified that would allow us to indicate their cause. Apparently, these are structural features of the vestibular apparatus. Some kind of pathology. But quite common.

In general, the head can be spinning from a variety of reasons. But the crystals that come out are the most common. About 20% of all people suffering from dizziness suffer from them precisely because of the fact that they have “untied” canalitis.

It cannot be cured by medicines. Massages and manuals – too. The crystals that have come out just need to be driven back to where they should be. This is exactly what the otoneurologist did to me. With a series of light movements, I moved the emerging canals to the area of ​​the ear labyrinth, where they would not damage the balance system.

Someday they may swim again into the semicircular canals. Then I will go to him again, and he will drive them back into place. Since this does not happen often, this is not a big problem.

***

I wrote about the interesting behavior of crystals on my page in social networks. Those who live in our country responded with comments like “my case, give the coordinates of the doctor, for many years I have been sinning on blood vessels and osteochondrosis, I am poisoned with drugs, there is no sense.” Those who live abroad were also surprised. But not that there is such a dizziness, which is “repaired” by manipulations, but that in Russia very few people know about it. “Physiotherapists do it here, they teach such manipulations in the first year,” wrote the Swede.“I had the same, but I was immediately referred to the ENT,” wrote the Israeli woman. “In America, it is treated with one session of physiotherapy,” – wrote the American.

The otoneurologist, who “repaired” me, said that doctors relatively recently learned that positional vertigo is caused by floating crystals. This became known only in 1995 – due to an unsuccessful operation performed by a Canadian surgeon.

Over the past 22 years, foreign medicine has “incorporated” a new disease into its health care system, defining a clear place for it: how it is diagnosed, by what symptoms, at what stage of examination, by what specialists, who treats, whom to teach to treat.

This did not happen in our health care system.

Yes, many experts know about positional vertigo. But many do not even know.

Although if they are referred to neurologists with dizziness, neurologists should definitely know about it. And it’s not easy to know. It should be included in the algorithm of their actions: before looking for vasoconstriction and a brain tumor, it is still necessary to check whether the patient is dizzy because of crystals. Because if because of the crystals, then he should not be driven by apparatus studies and droppers, but sent to another specialist – an otoneurologist.

Otherwise, the health care system is ineffective. Patients are not cured, and huge amounts of money are spent – both by insurance companies and by the patients themselves.

***

Who should I ask why benign positional vertigo was in the freeze? Minister of Health? But the minister cannot keep track of all the news of medicine and look for a place of practical application for each news. This is not the task of the ministry. This is the task of the professional medical community.

Clinical practice requires clinical guidelines – a specific list of necessary diagnostic and treatment methods for a specific disease. In the West, such recommendations are developed by professional associations of doctors of various specializations. The Association of Surgeons designs for surgeons, an association of physicians for general practitioners, and an association of neurologists for neurologists. Doctors are guided by these clinical guidelines.

It’s not like that with us.

There are no clinical guidelines, and they are not being developed, and even Western ones are not translated into Russian, although it would be faster and easier. Gaps in clinical practice are filled by chance rather than systematically.

“For ten years we have been telling everyone about benign positional vertigo at meetings of the Moscow City Scientific Society of Physicians,” said Professor Pavel Vorobyov, having learned about my ordeal with my head. – It’s a frequent thing, people are poisoned with senseless medicines, and the chest opens simply. Yes, there are other causes of dizziness, but it is a shame that most of the sufferers can be helped. “

Moscow City Scientific Society of Physicians – professional association. Okay, she’s doing her job – talking about positional vertigo at meetings. But who hears her? A handful of “living” doctors who are really interested in the profession. It’s useless to tell the rest. They need an order from the head physician, where an algorithm will be written, how, when and who should be examined in order to detect positional dizziness. Then they will examine. If there is no order, they will not.

This is our order – both in state medical institutions and in private ones. Bureaucratic. Reliable, time-tested.

Still it would work, and it would be very good.

***

Massage of the collar zone, to which neurologists first directed me, turns out to be harmful in case of positional vertigo. “It will be even worse,” the otoneurologist-savior warned. The neck usually hurts terribly with this dizziness, yes. But it hurts not because of the crooked vertebrae, but because the muscles are constantly trying to hold the head and stop the rotating picture.

And swimming is also not useful. Especially crawl. Because the position in which the body is located can provoke a massive “swim” of the canals. It seems that this is exactly what happened to me. So the English Channel will wait.

P.S. I know very well what will happen after the publication of this article. Different people who need an otoneurologist will start calling and writing to me to find out where he is taking. People will solve their particular problems in this way. And they will decide. But I wrote the article not for the sake of solving particular problems, but in order to highlight a general problem.Systemic. The health care system is not working the way it should. And someone in power should finally understand this. Recognize the problem and tackle it.

90,000 Dizziness with menopause. Vertigo treatment

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

Causes of dizziness with menopause

Against the background of a decrease in the level of estrogen, the tone of the vessels is disturbed, the pressure fluctuates and the uniform constant flow of blood to the brain is disturbed. A blood deficiency that forms during active brain activity can lead to hypoxia (lack of oxygen), which forms attacks of 90 150 dizziness with menopause 90 151, manifested in the form of seizures.There are episodes when objects and people are felt around the body against the background of the appearance of dark spots and flashes of light, changes in the pictures of the surrounding world.

Against the background of such attacks, and can form:

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

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

Examination by a neurologist

In addition to dizziness, you may experience:

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

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

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

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

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

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

Treatment of dizziness with menopause

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

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

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

How to help with dizziness during menopause

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

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

It is important to control weight and salt intake in order to avoid unnecessary stress on blood vessels and an increase in pressure, leading to 90,059 menopause dizziness .

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

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

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

Questions left

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

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

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