What causes dizziness? Explore the various potential reasons for spinning head symptoms, including vertigo, infections, Meniere’s disease, circulation issues, medication side effects, and more. Find out how to identify the cause and get effective treatment.

Unraveling the Mysteries of Dizziness: Uncovering the Potential Causes

Dizziness can be a perplexing and unsettling experience, with a wide range of potential causes. From issues with the inner ear to problems with circulation, medication side effects, and even dehydration, understanding the root cause is crucial for finding the right treatment. In this comprehensive guide, we’ll delve into the various factors that can contribute to spinning head symptoms and provide insight into how to effectively address them.

Vertigo: When the World Seems to Spin

One of the most common forms of dizziness is vertigo, a sensation of spinning or the feeling that the room is moving around you. This type of dizziness is often associated with issues in the inner ear or the brainstem, which is responsible for maintaining balance. The most common cause of vertigo is benign paroxysmal positional vertigo (BPPV), where tiny calcium crystals in the inner ear become dislodged and cause the system to send incorrect signals to the brain.

BPPV can be triggered by simple head movements, such as rolling over in bed or sitting up, and is typically a temporary condition that can be treated with specialized head exercises known as the Epley maneuver. However, vertigo can also be a symptom of other underlying conditions, such as Meniere’s disease, labyrinthitis, or even a stroke or brain tumor.

Infections: When the Inner Ear Becomes Inflamed

Inflammation of the nerves in the ears, known as vestibular neuritis or labyrinthitis, can also lead to dizziness. These conditions are often caused by viral or bacterial infections, such as a middle ear infection or meningitis. In these cases, the dizziness is typically accompanied by other symptoms, including ringing in the ears, hearing loss, nausea, and fever.

While antibiotics may be necessary to treat the underlying infection, medication can also help alleviate the symptoms of dizziness as the infection runs its course.

Meniere’s Disease: A Puzzling Condition

Meniere’s disease is a chronic condition that causes episodes of intense vertigo, along with other symptoms like hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the affected ear. The exact cause of Meniere’s disease is not well understood, but it is believed to be related to an imbalance of fluid in the inner ear.

While there is no cure for Meniere’s disease, treatment options may include dietary changes (such as a low-salt diet), medications to control dizziness, and in some cases, surgical intervention.

Circulatory Issues: When Blood Flow to the Brain is Disrupted

Dizziness can also be a sign of problems with your circulation, particularly when it comes to blood flow to the brain. Conditions like blood clots, clogged arteries, heart failure, and irregular heartbeats can all lead to a decrease in oxygen-rich blood reaching the brain, resulting in lightheadedness or even fainting.

In these cases, it’s crucial to seek immediate medical attention, as some circulatory issues can be life-threatening if left untreated.

Medication Side Effects: When Drugs Disrupt Balance

Dizziness can also be a side effect of certain medications, including antibiotics, antidepressants, anti-seizure drugs, and blood pressure medications. If you’re experiencing dizziness and you take any of these types of medications, it’s important to speak with your healthcare provider about potential alternatives or adjustments to your treatment plan.

Dehydration and Low Blood Sugar: Other Potential Culprits

Surprisingly, even something as simple as dehydration or low blood sugar can lead to dizziness. When you’re severely dehydrated, your blood pressure can drop, and your brain may not receive enough oxygen, causing you to feel lightheaded. Similarly, if your blood sugar levels are too low, it can also contribute to dizziness.

To address these issues, it’s important to stay hydrated by drinking plenty of water and diluted fruit juice, while limiting caffeine-containing beverages like coffee and soda. For those with diabetes, closely monitoring and managing blood sugar levels can help prevent dizziness.

In conclusion, dizziness can have a wide range of underlying causes, from inner ear issues and circulatory problems to medication side effects and dehydration. By understanding the potential triggers and seeking prompt medical attention, you can take the necessary steps to identify the root cause and find effective treatment, ultimately restoring your sense of balance and well-being.

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

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

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

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

Is It Vertigo?

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

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

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

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

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

Is It an Infection?

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

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

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

Is It Meniere’s Disease?

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

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

Is It Your Circulation?

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

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

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

Is It Your Medication?

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

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

Is It Dehydration?

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

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

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

Is It Low Blood Sugar?

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

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

Is It Something Else?

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

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

Dizziness vs Vertigo: What is the Difference?

According to statistics from the National Center for Biotechnology Information, dizziness and vertigo affect 15% to 20% of adults each year. Dizziness and vertigo are terms that are often used either together or interchangeably. But, is there a difference in dizziness vs vertigo? 

Dizziness

Dizziness is used to describe certain sensations relating to motion and balance. Dizziness is a broad and inexact term because it might have different meanings for different people. It can also be difficult to put certain sensations into words and dizziness is an easy umbrella term to use for multiple feelings. Types of dizziness include light-headedness, faintness, or unsteadiness. Vertigo can also be called a type of dizziness even though it is a more specific sensation, described below.

All types of dizziness, including vertigo, can be incapacitating and interfere with daily life and make everyday activities either impossible or dangerous.

Vertigo

One of the ways that you can tell the difference between dizziness vs vertigo is noting that vertigo means something more specific. Vertigo is the false sensation of movement. Some describe it as feeling as if you are spinning around while the world around you. On the other hand, it may feel as if you are standing still and the world is spinning around you. Many people will describe the sensations of vertigo as dizziness because it does fall under that umbrella of sensations. However, it is the only type of dizziness that causes the spinning or whirling sensation.

Vertigo is often accompanied by other symptoms like nausea, vomiting, loss of balance, or trouble walking. Another possible symptom experienced during an episode of vertigo is nystagmus, which the American Optometric Association describes as a condition in which the eyes make repetitive, uncontrolled movements. Vertigo and related symptoms are disabling and interrupt regular life.

Causes

The causes of dizziness vs vertigo vary, but underlying conditions are rarely life-threatening.

• Paroxysmal Positional Vertigo (BPPV): The most common cause of vertigo is BPPV, which is triggered by a rapid change in head position or movement. Quick movements that trigger episodes of vertigo include sitting up, turning around, or turning over in bed. 
• Meniere’s Disease: Meniere’s disease is a condition in which fluid builds up in the inner ear. Individuals with Meniere’s disease experience sudden episodes of vertigo that may last several hours. Other symptoms of Meniere’s disease include ringing in the ear, fluctuating hearing loss, or feeling like the ear is plugged.
• Vestibular Neuritis: Vestibular neuritis occurs when a viral infection (flu, measles, chickenpox, shingles, mumps, rubella, mono)  spreads to the vestibular nerve in the inner ear. When the nerve is inflamed, it causes vertigo as well as nausea, vomiting, balance issues, and difficulty concentrating.
• Labyrinthitis: Labyrinthitis is also the result of an infection in the inner ear, but it affects the cochlear nerve as well as the vestibular nerve. The cochlear nerve is responsible for communicating with the brain about hearing, so in addition to the symptoms of vestibular neuritis, labyrinthitis causes difficulty hearing and ringing in the ears.
• Migraine: Vertigo is sometimes a symptom of migraine headaches. Vertigo episodes associated with migraines may last minutes or even hours. Vertigo may be accompanied by a headache and light and noise sensitivity. Sometimes migraine-related vertigo occurs without a headache.
• Other Causes of Dizziness: Dizziness may be caused by other factors unrelated to a chronic condition or infection. These causes include:
  • A drop in blood pressure when standing or sitting up too quickly
  • Overheating
  • Dehydration
  • Anxiety disorders
  • Medication side effects
  • Low iron levels
  • Low blood sugar

Diagnosis & Treatment

If you are experiencing episodes of dizziness or vertigo, your doctor will get more information about your symptoms and give you a physical exam in which your balance and other functions are checked. They may perform a few different tests to find the root cause and determine if the sensations you have qualify as dizziness vs vertigo.

One test used to diagnose the cause of balance disorders is called a videonystagmography (VNG) balance test. VNG tests the inner ear and motor function to find the cause of dizziness or vertigo.

Sometimes vertigo resolves itself without treatment. However, treatments are available to manage symptoms and/or treat underlying conditions. Treatments include:

• Diuretics
• Dizziness medication
• Nausea medication
• Anti-anxiety medication
• Medication to prevent migraine
• Balance therapy
• Head position maneuver therapy

At Regional Neurological Associates, we know how disabling dizziness and vertigo can be. We are pleased to offer VNG at our office to help with diagnosing vertigo and dizziness. Our physicians are experienced in the evaluation and management of conditions causing dizziness or vertigo. Call us at (718) 515-4347 to schedule an appointment today.

Stop the Room From Spinning: Causes and Treatments of Vertigo

Jul 14, 2015 10:00 AM

Author:
Libby Mitchell

It’s the thing that makes you go “ahh:” Vertigo.

“Vertigo is a specific sensation of spinning or turning that you get when your sense of place is not stable,” says Tom Miller, MD, chief medical officer of University of Utah Hospitals and Clinics. “It’s that feeling of ‘my head is turning.’”

There are many causes of vertigo, including those that are rare, like vestibular neuritis, and Meniere’s disease. Vertigo can also occur with migraine headache. It is also possible to induce vertigo by spinning quickly in circles, or through intoxication. A fairly common cause of vertigo is benign paroxysmal positional vertigo (BPPV). “Your lifetime risk of that is about two and a half percent,” says Miller. “So, if you look at large numbers of patients it’s pretty common.”  

BPPV is caused by tiny crystals in the inner ear. “Those crusty little crystals get into the semi circular canals and rattle around and send aberrant signals to the brain,” says Miller. “If there’s an imbalance in signal input you get that abnormal sensation of spinning. ”

The spinning effect from BPPV only comes with movement. “It’s the snow globe effect,” Miller says. “So when you move all those little crystals move around. If you’re still the crystals don’t do anything.” Any motion, looking up, looking down or even rolling over in bed can set it off. “It lasts about 30 seconds, and then it goes away,” Miller says.

In most cases diagnosing BPPV is usually done with a procedure known as the Dix-Hallpike maneuver. “It’s usually in one ear or the other,” Miller says. “You lean them back and, woah, the crystals move and they get dizzy. You watch their eyes. Their eyes move back and forth uncontrollably.”

Treating BPPV is usually as simple as diagnosing the condition. “You don’t need surgery or medicine; you need physical therapy for this,” says Miller. “Once you figure out which side it’s on you put them through a specific physical therapy called the Epley maneuver, and it’s 85 percent effective at getting all of those crystals out.”   

Then you can breathe a sigh of relief.  

Libby Mitchell is the Social Media Coordinator for University of Utah Health Care. Follow her on Twitter @UUHCLibby.

Definition

Dizziness is a term used to describe a range of sensations, such as feeling faint, woozy, weak or unsteady. Dizziness that creates the false sense that you or your surroundings are spinning or moving is called vertigo.

Dizziness is one of the more common reasons adults visit their doctors. Frequent dizzy spells or constant dizziness can significantly affect your life. But dizziness rarely signals a life-threatening condition.

Treatment of dizziness depends on the cause and your symptoms. It’s usually effective, but the problem may recur.

Symptoms

People experiencing dizziness may describe it as any of a number of sensations, such as:

• A false sense of motion, rocking, turning or spinning (vertigo)
• Lightheaded, “head rush” or feeling faint
• Unsteadiness or loss of balance
• A feeling of floating, wooziness, fogginess

These feelings may be triggered or worsened by walking, standing up or moving your head. Your dizziness may be accompanied by nausea or be so sudden or severe that you need to sit or lie down. The episode may last seconds to days and may recur.

Causes

Dizziness has many possible causes, including inner ear disturbances, headache disorders, motion sickness, infection and medication effects. 

The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause.

Your sense of balance depends on the combined input from the various parts of your sensory system. These include your:

• Eyes, which help you determine where your body is in space and how it’s moving
• Sensory nerves from your neck, spine and lower limbs, which send messages to your brain about body movements and positions
• Inner ear, which houses sensors that help detect gravity, turning and back-and-forth motion

Inner ear problems that cause dizziness (vertigo)

Vertigo is the false sense that your surroundings are spinning or moving. With inner ear disorders, your brain receives signals from the inner ear that aren’t consistent with what your eyes and sensory nerves are receiving. Vertigo is what results as your brain works to sort out the confusion.

• Benign paroxysmal positional vertigo (BPPV). This condition causes an intense and brief but false sense that you’re spinning or moving. These episodes are triggered by a rapid change in head movement, such as when you turn over in bed, sit up or experience a blow to the head. BPPV is the most common cause of vertigo.
• Infection. A viral infection of the vestibular nerve, called vestibular neuritis, can cause intense, constant vertigo. If you also have sudden hearing loss, you may have labyrinthitis.
• Meniere’s disease. This disease involves the excessive buildup of fluid in your inner ear. It’s characterized by sudden episodes of vertigo lasting as long as several hours. You may also experience fluctuating hearing loss, ringing in the ear and the feeling of a plugged ear.

Neurologic causes of vertigo

• Migraine. People who experience migraines may have episodes of vertigo or other types of dizziness even when they’re not having a severe headache. Such vertigo episodes can last minutes to hours and even days and do not need to be associated with headache
• Other neurologic problems such as Parkinson’s disease and multiple sclerosis can lead to progressive loss of balance, but not vertigo.

Other causes of dizziness

• Drop in blood pressure. A dramatic drop in your systolic blood pressure — the higher number in your blood pressure reading — may result in brief lightheadedness or a feeling of faintness. It can occur after sitting up or standing too quickly. This condition is also called orthostatic hypotension.
• Poor blood circulation. Conditions such as cardiomyopathy, heart attack, heart arrhythmia and transient ischemic attack could cause dizziness. And a decrease in blood volume may cause inadequate blood flow to your brain or inner ear.
• Medications. Dizziness can be a side effect of certain medications — such as anti-seizure drugs, antidepressants, sedatives and tranquilizers. In particular, blood pressure lowering medications may cause faintness if they lower your blood pressure too much.
• Anxiety disorders. Certain anxiety disorders may cause lightheadedness or a woozy feeling often referred to as dizziness. These include panic attacks and a fear of leaving home or being in large, open spaces (agoraphobia).
• Low iron levels (anemia). Other signs and symptoms that may occur along with dizziness if you have anemia include fatigue, weakness and pale skin.
• Low blood sugar (hypoglycemia). This condition generally occurs in people with diabetes who use insulin. Dizziness (lightheadedness) may be accompanied by sweating and anxiety.
• Overheating and dehydration. If you’re active in hot weather, or if you don’t drink enough fluids, you may feel dizzy from overheating (hyperthermia) or from dehydration. This is especially true if you take certain heart medications

When to seek medical attention?

Call 911 or go to an emergency room if you experience:

• Dizziness after a head injury,
• Fever over 101°F, headache, or very stiff neck,
• Convulsions or ongoing vomiting,
• Chest pain, heart palpitations, shortness of breath, weakness, a severe headache, inability to move an arm or leg, change in vision or speech, or
• Fainting and/or loss of consciousness

Consult your doctor if you:

• have never experienced dizziness before,
• experience a difference in symptoms you have had in the past,
• suspect that medication is causing your symptoms, or
• experience hearing loss.

How will my dizziness be treated?

Your Comprehensive ENT physician will ask you to describe your dizziness and answer questions about your general health. Along with these questions, your doctor will examine your ears, nose, and throat. Some routine tests will be performed to check your blood pressure, nerve and balance function, and hearing. Possible additional tests may include a CT or MRI scan of your head, special tests of eye motion after warm or cold water or air is used to stimulate the inner ear (VNG: videonystagmography), and in some cases, blood tests, neurology evaluation or a cardiology (heart) evaluation. Together you and your doctor will determine the best treatment based on your symptoms and the cause of them. Treatments may include medications, surgery or balance exercises.

Sudden Dizziness? It Could Be Benign Paroxysmal Positional Vertigo

Background:

Benign Paroxysmal Positional Vertigo, also known as BPPV is an inner ear disorder. It is one of the most common causes of vertigo which is a sudden sensation of room spinning around you or that the inside of your head is spinning. BPPV causes brief episodes of intense dizziness, typically triggered with head movement in a certain way, rolling over in bed, turning your head quickly, bending over, or tipping your head back.

Causes:

Within the inner ear, collections of calcium crystals known as otoliths lie inside. Those crystals inside our ear monitor different movements of our head in all directions related to gravity. In patients with BPPV, the crystals are dislodged from their usual position, and migrate over time to a different location in the ear into the semicircular canals that contain fluid and fine, hair-like sensors that monitor the rotation of our head especially with a laying down position. This causes the semicircular canal to become very sensitive to head position changes causing you to have repeated episodes of dizziness or spinning sensations.

Signs and Symptoms:

People with BPPV do not usually feel dizzy constantly. Severe dizziness episodes occur as attacks triggered by the slightest head movements. At rest between episodes, patients typically have few or no symptoms. The onset of severe dizziness is typically sudden. Many patients wake up with the condition, noticing the vertigo while trying to sit up suddenly. The main symptom is a feeling that you are spinning around or tilting when you are not. In many cases, the symptoms periodically resolve and then return. The signs and symptoms of BPPV vary among patients, but most episodes are short in duration, with symptoms commonly lasting around 30-seconds. In severe cases, the slightest head movement may also be associated with nausea and vomiting.

Diagnosis:

The diagnosis of a BPPV is based on signs and symptoms. Your clinical history provides a valuable information. Neuroimaging may be necessary to rule out other medical causes of your dizziness. The neurologist will examine you and perform different maneuvers of head movements in the clinic as part of the physical examination to check for vertigo or involuntary eye movements called nystagmus.

Canalith Repositioning Maneuver (Vertigo Treatment):

This maneuver is called the Epley maneuver and will be performed in our office. The canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to rearrange the displaced crystals and move them from the fluid-filled semicircular canals of your inner ear back into the otolith organs in your ear where these particles don’t cause symptoms of vertigo. This therapy has a very high success rate for patients with BPPV.

Each position is held for about 30-seconds after any symptoms or abnormal eye movements stop. This procedure is usually effective and may be repeated if necessary.

Other options are also available but only few medications can be used. These medications usually does not stop the vertigo but it may provide minimal relief for some patients.

Test Preparation:

There is no specific test preparation. The study is very short in duration. The patient generally will be ready to go home immediately following the test. Your neurologist will teach you how to perform the canalith repositioning procedure so that you can do it at home when necessary.

Resources

Vestibular Disorders Association (VEDA)
www. vestibular.org

Citation

Li, John C. “Benign Paroxysmal Positional Vertigo”: Background, Pathophysiology, Epidemiology, Medscape.
URL: emedicine.medscape.com/article/884261
Updated June 29, 2015. Accessed October 13, 2015.

Differentiating ‘dizziness’ and vertigo | ACP Internist

Dizziness is common in internal medicine patients, accounting for up to 5% of visits
to primary care clinics, according to a paper in the August 15, 2010, American Family Physician. Yet because patients use the terms “dizziness” and “vertigo”
to describe a broad range of sensations, the symptom can pose a diagnostic challenge.

“‘Dizziness’ is an ambiguous term, so the first thing to do is clarify
what patients are talking about by asking them to describe what they’re feeling,”
said Yolanda Reyes-Iglesias, MD, assistant professor of clinical neurology and chief
of the neurology department at the Miami VA Healthcare System and director for undergraduate
medical education at the University of Miami’s Miller School of Medicine. “Then,
based upon their description, you can tell if they are talking about light-headedness,
vertigo, near syncope, or gait problems.”

The most important task primary care physicians have in working up patients with potential
vertigo is to rule out stroke, and keeping the patient’s age and comorbidities in
mind can help. Photo by iStock

When patients say they’re dizzy, they’re usually describing one of four conditions,
said Martin Samuels, MD, MACP, chair of the department of neurology at Brigham and
Women’s Hospital and Miriam Sydney Joseph Professor of Neurology at Harvard Medical
School in Boston. Dr. Samuels breaks it down this way:

• true vertigo, in which there is a feeling of motion when there is no motion;
• near syncope, in which there is a sensation just short of fainting, to include lightheadedness;
• disequilibrium, which is more a gait or stance disorder in which patients describe
  feeling unstable on their feet or like they’re about to fall, and
• anxiety, in which patients use the term “dizzy” to describe feelings
  of fear, worry, or anxiousness.

“Most patients have one, and many have two of the four, but it’s rare to have
a full house of all of them,” Dr. Samuels said.

From there, physicians can delve deeper into symptoms, said Dr. Reyes-Iglesias. “Think
about symptoms that could be associated with either the ear or the brain. Is there
hearing loss or ringing or buzzing in the ear? Are there problems with vision, balance,
or weakness? Did symptoms start acutely and are getting better, have they built up
slowly over time, or do they fluctuate? Are there associated headaches?”

Make sure it’s not stroke

The most important task primary care physicians have in working up patients who report
“dizziness” is to rule out stroke, and keeping the patient’s age and
comorbidities in mind can help, said Douglas Paauw, MD, MACP, professor in the department
of internal medicine and director of internal medicine medical student programs at
the University of Washington in Seattle.

“I look at vertigo based on patient age, what is likely to occur, and what
you don’t want to miss. Recurrent dizziness for 5 minutes at a time in a 20-year-old
could mean a variant of migraine. But if the patient is 80 years old, the symptoms
could point to blood flow problems related to ischemia,” said Dr. Paauw. “The
most scary causes of vertigo are the vascular causes we see in the elderly because
they can signify the start of stroke syndrome. These patients will usually have other
risk factors as well, such as hypertension, diabetes, and past smoking.”

Dr. Reyes-Iglesias agreed. “Do a careful history and exam. Isolated vertigo
is rare in stroke. The patient will have risk factors for stroke, and there are usually
other symptoms such as gait issues, focal weakness, and clumsiness.”

It’s a reassuring sign when the patient feels very ill, Dr. Reyes-Iglesias added.
“The sicker the patient is with the vertigo, the less worried I am. If there
is distressing nausea and vomiting, it’s usually a problem in the ear. But the less
nausea and vomiting there is, the more I’m worried because then I start thinking about
the brain.”

If a patient has what Dr. Samuels called “true vertigo,” the sensation
of movement when there is no motion, he suggested the three-part oculomotor head impulse,
nystagmus, and test-of-skew (HINTS) method as a quick way to rule out stroke. Outlined
in the Nov. 1, 2009, Stroke, the HINTS method has been shown to be an effective way of differentiating brainstem
or cerebellar strokes from acute peripheral vestibulopathy caused by a virus.

“Once you determine your patient is not experiencing symptoms of stroke, then
you’re left with common disorders: problems in the ear, issues with sensation in the
lower extremities, or anxiety,” said Dr. Samuels.

Common causes

According to a consensus statement of the Committee for the Classification of Vestibular
Disorders of the Bárány Society published in the Journal of Vestibular Research in 2015, one of the most common forms of vertigo is benign paroxysmal positional vertigo
(BPPV), in which calcium carbonate crystals that normally reside in the utricle of
the ear are dislodged and end up in the semicircular canals. The paper noted that
about 10% of the general population experiences BPPV at least once in life.

“It’s super common in any age group but especially common in the elderly,”
said Dr. Paauw, adding that it’s fairly easy to diagnose. “The history is incredibly
specific. Movement causes a violent spinning sensation that lasts 30 seconds or so
and then goes away rapidly. It usually happens when the patient is lying down and
turns over.”

In addition to vertigo that is provoked by lying down or turning over and a short
duration of attacks, the Bárány Society’s consensus statement lists
positional nystagmus prompted by the Dix-Hallpike maneuver among its diagnostic criteria.
The maneuver involves positioning a seated patient’s head 30 to 45 degrees toward
one side and, while supporting the patient’s head, having the patient lie back quickly
so his or her head hangs off the exam table. If the patient experiences vertigo or
nystagmus, the patient most likely has BPPV. The test can also help determine which
ear is affected.

If there is hearing loss, ask questions to determine if the patient has Ménière’s
disease, said Dr. Paauw. “The patient will have a combination of vertigo, hearing
loss, ringing in the ears or tinnitus, and a feeling of fullness in the ear.”

Michael Teixido, MD, associate chief of otolaryngology at the Christiana Care Health
System in Wilmington, Del., pointed out that vestibular migraine has emerged as another
common cause of vertigo and dizziness, occurring in up to half of patients who seek
treatment for vertigo.

“Vestibular migraine is 15 to 20 times more common than Ménière’s
disease. The work-up is obvious when the patient has a headache at the same time as
the vertigo, but many patients don’t have concurrent headaches,” said Dr. Teixido.
“There may instead have been an increase in headache activity in the prior
3 months, and the dizziness may act like a migraine in that it responds to typical
migraine triggers like stress, fatigue, changes in the weather, hormonal changes,
caffeine, or foods like chocolate or red wine.”

Vestibular migraine and BPPV are often related, Dr. Teixido added. “When we
see BPPV in patients younger than 60, most either have had some kind of head injury
like an airbag deployment that knocked the crystals loose or they have migraine. Patients
who have migraine headaches are about 5 times as likely to get BPPV. We think this
is because changes in the blood vessels may actually injure the inner ear and allow
the crystals to become loose.”

Orthostatic hypotension is another common cause of vertigo and dizziness and plays
into presyncope, said Dr. Samuels. “Check the blood pressure while the patient
is standing, sitting, or lying down. Also round up the usual suspects: medications
[that could be interacting or incorrectly dosed] and volume depletion. Consider whether
the patient may have heart disease.”

A general unsteadiness may point to issues with sensation, said Dr. Samuels. He suggests
the Romberg test as the go-to method of assessment. “Have the patient stand
at attention, look in the distance, and then close his or her eyes. If the patient
is unbalanced with the eyes closed, that means something is wrong with sensation from
the lower extremities.”

Dr. Samuels added that if there are signs of trouble with sensation, the next step
is to determine if the problem is peripheral, such as diabetic neuropathy, or in the
spinal cord or brain. “Check the tendon reflexes. If the reflexes are depressed
in the legs, it’s probably a peripheral problem. If not, look for Babinksi’s sign:
Scratch the bottom of the foot, and if the big toe goes up, not down, it almost always
means there’s a central nervous system problem.”

When patients use terms like “dizziness” and “vertigo”
as a metaphor for anxiety, the physician may pick up on the condition in the exam
room, Dr. Samuels said. “It actually makes you anxious as an examiner, so if
you find yourself becoming anxious, look into the patient’s history for depression
or primary anxiety disorders.”

When to refer

While it’s obvious that signs of stroke require an immediate ED visit, patients should
also be referred to the ED if symptoms of vertigo or dizziness are new, severe, and
acute, said Dr. Teixido. “If the patient doesn’t have any previous, trusted
pattern of dysfunction, the vertigo is brand new for them, and they have associated
cardiovascular risk like heart disease, vasculopathy, or uncontrolled hypertension,
or they’re on blood thinners, they should be sent to the ED.”

Referral to otolaryngologists, neurologists, or cardiologists will depend on what
the primary care physician suspects is causing the vertigo or dizziness. But primary
care physicians can and should attempt to treat more benign conditions like migraine
and BPPV, said Dr. Teixido.

“BPPV is so common that internists need to know how to treat it, and then send
the hard cases that don’t respond to treatment to an ENT,” Dr. Teixido said.
“There are plenty of YouTube videos demonstrating the diagnostic Dix-Hallpike
maneuver and the exercises used to move the crystals back into place when their location
is known. Generic Brandt-Daroff exercises are helpful for patients even if the involved
ear and canal are not known so primary care physicians can confidently show patients
how to do the exercises themselves. “

Likewise, referral is necessary if the suspected cause is viral and the patient doesn’t
respond to treatment, said Dr. Samuels. “If the patient doesn’t follow the
natural history you expect and is still having symptoms after a three-week course
of medication, there are new symptoms, or symptoms get worse, that would require a
referral to a neurologist. If there is hearing loss, the patient needs to see an ENT.”

Additional reading

Evren C, Demirbilek N, Elbistanli MS, Köktürk F, Çelik M. Diagnostic value of repeated Dix-Hallpike and roll maneuvers in benign paroxysmal
positional vertigo. Braz J Otorhinolaryngol. 2016. [PMID: 27170347] doi:10.1016/j.bjorl.2016.03.007

Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor
examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009;40:3504-10. [PMID: 19762709] doi:10.1161/STROKEAHA.109.551234

Newman-Toker DE, Curthoys IS, Halmagyi GM. Diagnosing stroke in acute vertigo: the HINTS family of eye movement tests and the
future of the “eye ECG”. Semin Neurol. 2015;35:506-21. [PMID: 26444396] doi:10.1055/s-0035-1564298

Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010;82:361-8, 369. [PMID: 20704166]

von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res. 2015;25:105-17. [PMID: 26756126] doi:10.3233/VES-150553

What Causes Dizzy Spells? 11 Things That Can Cause Sudden Dizzy Spells

Sudden dizzy spells have an amazing ability to make you realize how much you take for granted not feeling like you’re going to fall over at any moment. But what causes dizzy spells? It’s a good question, because they can leave you wondering what the heck is going on with your body.

The good news: There are many things that could make you dizzy, and most of them are minor and nothing to worry about, Catherine Cho, M.D., clinical associate professor in the departments of neurology and otolaryngology at NYU Langone Medical Center, tells SELF. The bad news: You’re still unsteady on your feet.

But knowing the many causes of dizzy spells can help you identify what’s no big deal and what’s a sign of something more serious. Here are some of the most common causes to keep in mind the next time you’re struggling with the spins.

What Is a Dizzy Spell?

Dizzy spell is another term for vertigo, a condition that can make you feel like the room is spinning, per the U.S. National Library of Medicine. It causes an “illusion of movement,” Dr. Cho explains. Vertigo is caused by a disconnect between your ears and your brain, which results in a spinning sensation.

Benign paroxysmal positional vertigo (BPPV), which is the most common form of vertigo, can lead to brief episodes of mild to intense dizziness, says the Mayo Clinic. While these dizzy spells can feel freaky, they’re rarely serious, except when it comes to an increased risk of falls.

What Causes Dizzy Spells?

There are a bunch of different things that could be behind your dizzy spells.

1. You moved your head too quickly.

Let’s start off small. If you’re dealing with BPPV, the reason for your dizzy spells could be the way you move. BPPV is caused by a rapid change in head movement, such as turning over in bed, sitting up too quickly, or spinning around. In most cases, BPPV resolves on its own, the Mayo Clinic says.

2. You have an inner ear problem.

With inner ear disorders, your brain receives signals from the inner ear that aren’t consistent with what your eyes and sensory nerves are receiving. Vertigo is what results as your brain works to sort out the confusion. Like we just talked about, that can happen when you move too quickly, but there are other inner ear issues that cause more intense or constant vertigo.

The first possibility is an infection of the vestibular nerve, called vestibular neuritis, according to the Mayo Clinic. When this nerve becomes inflamed thanks to the infection, it can cause a serious spinning or swaying sensation. If you also have sudden hearing loss on top of this vertigo, it’s possible you have another infection, called labyrinthitis.

According to the Mayo Clinic, another possibility is Meniere’s disease, which involves the excessive buildup of fluid in your inner ear. Vertigo associated with Meniere’s disease comes on suddenly and lasts as long as several hours. You might also experience hearing loss that comes and goes, ringing in your ears, or feeling like your ears are plugged up.

3. You’re having a migraine.

If your dizziness feels like your head is spinning (not the room), it could mean you have migraines without even knowing it, Dr. Cho says. Some people don’t realize their headaches are actually migraines if they don’t also see flashing lights or auras—but those symptoms are not always necessary, the Mayo Clinic says. Migraine can cause symptoms of dizziness and vertigo—vestibular migraines are a thing too. 

4. You’re dehydrated.

You’re probably aware that you don’t feel great when you don’t drink enough water. That’s because when you don’t take in more water than you use or lose, your body doesn’t have enough water to carry out its normal functions. “Especially in the summer months, people forget to drink more. You don’t have to be dripping sweat to become dehydrated,” Dr. Cho says. Dizziness is a common symptom of dehydration.

5. Your workout is a little intense.

Exercise without replenishing your fluids is an easy way to get dehydrated, so it’s worth calling it out too. It may not seem like a big deal, but if you’re constantly feeling this way during physical activity, focus on hydrating more to see if the problem stops. Getting dizzy in the gym or out on a run is a good way to fall and injure yourself.

90,000 10 causes of dizziness – a: care

Dizziness is not an independent disease, but a symptom or, if you like, a kind of SOS signal from our body. There are over 80 diseases in the world that cause dizziness, and the symptoms of many of them are very similar. [1] That is why it is so important to consult a specialist in time: only a doctor can diagnose the true cause of dizziness and prescribe treatment!

The most common causes of vertigo are:

• Benign paroxysmal positional vertigo (BPPV) can occur after traumatic brain injury or otitis media, as well as during intoxication and viral infections.With BPPV, vertigo attacks occur most often when the position of the head and body changes and last from a few seconds to several minutes (usually, the dizziness disappears when you change the position). [2] In most cases, special gymnastics can help cope with BPPV
• Vertebrobasilar insufficiency (VBI) is a reversible dysfunction of the brain that occurs due to a violation of blood supply in the vertebrobasilar basin. With VBI, dizziness occurs for no apparent reason and is accompanied by nausea, loss of balance, double vision, speech disorders, etc.e. VBI is usually short-term, therefore, if symptoms recur, it is worth looking for the cause in something else. [3]
• Meniere’s disease is the cause of vertigo in about 6% of cases. [3] It is characterized by an increase in fluid in the inner ear cavity, which causes severe dizziness, accompanied by tinnitus, nausea, vomiting, a feeling of fullness in the ear, and hearing loss. As a rule, treatment of Meniere’s disease consists of arresting and preventing seizures [4], but in some cases, surgery may be required.
• Vestibular neuronitis most often occurs as a complication after a viral infection, but drug intoxication can also be its cause. The disease is accompanied by sudden attacks of dizziness, nausea, vomiting, lightheadedness, etc. Symptoms are worse with head movement. [4]
• Migraine-associated vertigo is the term used to refer to all forms of the relationship between migraine and vertigo. [5] Typically, dizziness and other symptoms (eg, nausea, blurred vision, confusion, weakness, increased sensitivity to light or sounds, etc.)e) occur earlier than the headache and form the so-called “aura” – a kind of premonition, a premonition of an impending migraine. Migraine vertigo can be positional, i. E. increase or decrease with a change in the position of the head. [4]

These are the most common causes, but the situation can be much more serious if your dizziness is due to a less common condition. Of course, competent prevention can help to cope with dizziness, but it is equally important to consult a specialist on time, follow all his recommendations and know emergency measures for dizziness.

• Labyrinthitis (inflammation of the inner ear) is most often a complication of another illness (eg flu, cold, otitis media) or injury. [6] Labyrinthitis is accompanied by prolonged attacks of dizziness, hearing impairment (up to deafness), nausea and fever. For the treatment of labyrinthitis, antibiotics are most often prescribed, however, even after recovery, dizziness may persist for another 5-6 weeks. [7]
• Chronic cerebrovascular insufficiency occurs when blood circulation in the brain is impaired (for example, due to diabetes mellitus or hypertension).As a result, small arteries narrow and ischemia develops, which is accompanied by headaches, tinnitus, dizziness, etc. Alcoholism, smoking and obesity also contribute to the development of cerebrovascular insufficiency, [8] therefore, the correct lifestyle and diet are of great importance in case of dizziness.
• Brain injuries can also cause dizziness. It occurs as a result of a violation of the blood supply to the brain (due to the development of edema, compression or damage to blood vessels) or in cases where the substance of the brain itself is damaged.Dizziness due to brain injury may be accompanied by nausea, vomiting, headaches, etc. Often in a person those functions of the body that were controlled by the damaged part of the brain stop working. [9]
• In brain tumors, dizziness is most often manifested in the form of seizures (their duration and frequency are related to the size of the tumor). In addition, headaches, nausea and vomiting appear, balance and coordination are disturbed, and sensitivity often decreases.This is due to the fact that the tumor compresses certain parts of the brain, disrupting their work and blood supply.
• Otitis media is an inflammatory process in the ear, which is usually accompanied by headache, constant aching pain in the ear, weakness, fever and dizziness. If you do not see a doctor in time, otitis media can become a chronic disease, leading to hearing loss, meningitis, and even a brain abscess. [6]

List of used literature:

1.Manvelov L. Do you feel dizzy? // Science and life. – 2012. – No. 10. – S. 56-61.

2. Bestuzheva NV, Parfenov VA, Antonenko LM Diagnostics and treatment of benign paroxysmal positional vertigo in outpatient practice // Neurology, neuropsychiatry, psychosomatics. – 2014. – No. 4. – P.26-30.

3. Drapkina O.M., Chaparkina S.M., Ivashkin V.T. Dizziness in the practice of an internist // Cardiovascular therapy and prevention. – 2007. – No. 6 (4).- S. 107-114.

4. Zamergrad MV Vestibular disorders in neurological and general medical practice // Modern therapy in psychiatry and neurology. – 2012. – No. 2. – S. 20-26.

5. Zamergrad M.V. Migraine-associated dizziness // Medical Council. – 2013. – No. 4. – S. 24-28.

6. Kryukov AI, Kunelskaya NL, Turovsky AB, Sidorina OG Complications of acute otitis media // Medicine. – 2007. – No. 4. – P. 3-9

7.Labyrinthitis // Medical encyclopedia appteka.ru – https://appteka.ru/zabol/zabol_l/labirintit.html (access date: 24.06.2016)

8. Kamchatnov P.R., Chugunov A.V., Glushkov K.S., Li V.A., Radysh B.B. Chronic cerebrovascular disorders in patients with arterial hypertension // Farmateka. – 2007. – No. 20.

9. Grigoryan AS, Kruglyakov PV Cell therapy for brain injury // Genes and cells. – 2009. – T.4. – No. 1. – P. 35-42.

Co-author, editor and medical expert:

Volobueva Irina Vladimirovna

Born on 17.09.1992.

Education:

2015 – Sumy State University, specialization “General Medicine”.

2017 – Graduated from an internship in the specialty “Family Medicine” and also defended her master’s work on the topic “Features of the development of antibiotic-associated diarrhea in children of different age groups.”

90,000 Are you dizzy? | Science and Life

A slight dizziness when spinning in a dance or riding a carousel is familiar to everyone, and it can be attributed, rather, to a pleasant sensation.But in other situations, dizziness is a symptom of the disease, and even the doctor does not always immediately understand which one, and in order to find out, a full-fledged medical examination is required.

Osteochondrosis of the cervical spine is a very common pathology. With sudden movements, this condition provokes dizziness.

Science and Life // Illustrations

Magnetic resonance imaging data. Cerebellar infarction (1), brain stem tumor (2), blockage of the vertebral artery (3) are accompanied by dizziness.

Doppler ultrasound data. Bending of the vertebral artery in its initial section (top) causes dizziness, as does atherosclerotic plaque in the orifice of the vertebral artery, leading to stenosis (bottom).

Science and Life // Illustrations

Science and Life // Illustrations

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Among the complaints with which patients turn to medical institutions, dizziness occurs very often and is second only to headaches and back pain.According to our data, based on an extensive survey of the population aged 35-60 years, dizziness was noted in almost 15% of cases. Moreover, many do not consider it necessary to consult a doctor for such a seemingly “trifling”, but in fact – a very serious matter.

One symptom, different diseases

Dizziness is not a disease, but a symptom that can accompany more than eight dozen diseases. Here are just a few of them: defeat of the ear labyrinth; insufficient blood supply to the brain in cardiovascular diseases; osteochondrosis of the cervical spine; infectious diseases, including syphilis and HIV infection; brain tumors; traumatic brain injury; neuroses; drug intoxication.

Various methods help to identify the causes of dizziness: computed and magnetic resonance imaging, ultrasound, radiological, radioisotope, biochemical and other studies. But first of all, the doctor must find out what the patient means when he complains of dizziness.

It is not uncommon for dizziness to be mistaken for visual disturbances, flashing “flies”, fog or a veil in front of the eyes.

The unpleasant sensations that occur when the vehicle flickers in front of the eyes also do not belong to dizziness – they are characteristic of vestibular dysfunction.

Real dizziness manifests itself in a different way – as an imaginary rotation of objects or one’s own body, as a feeling of “rotation inside the head”, unsteadiness, instability, imbalance.

a vestibular analyzer helps a person maintain orientation in space and balance. It includes the vestibular apparatus located in the inner ear and the vestibular nuclei of the brain.

Vestibular dizziness (it is also called true, systemic) is characteristic of damage to both the peripheral and central parts of the vestibular analyzer.With such dizziness, there is a feeling of rotation of one’s own body or movement of objects, or both at the same time. It is often accompanied by nausea and vomiting, sweating, impaired hearing and balance, a false sensation of “support” movement under the feet. It seems to a person that his body either collapses or rises, sways back and forth, left and right, up and down, that he walks over bumps, through a swamp. Vestibular vertigo is aggravated by a change in the position of the head and body.

Non-vestibular (non-systemic) dizziness is described differently – as a feeling of intoxication, impending loss of consciousness, lightness in the head, instability when walking.These symptoms can be caused by diseases of the hematopoietic systems, cardiovascular, endocrine and others. Complaints about “fog”, heaviness in the head, a feeling of intoxication, faintness are typical for those suffering from neuroses.

Central, peripheral … How to distinguish?

Vestibular (systemic) vertigo is of two types: peripheral, associated with damage to the structures of the inner ear, and central, manifested when certain areas of the brain are damaged.Distinguishing between the two is very important because the treatment is not the same, although the symptoms may be similar. For example, in diseases of the inner ear, the nature of dizziness is similar to dizziness in brain lesions caused by vascular problems: arterial hypertension and atherosclerosis, transient (temporary) cerebrovascular accident or its chronic insufficiency. The appearance of dizziness can be associated with neuroses and depression, heart disease, increased blood viscosity.

The connection between dizziness and pathology of the inner ear was first discovered by the French physician Prosper Ménière. His name was subsequently given to a disease, the main symptom of which is attacks of dizziness. Meniere’s disease is characterized by sharp attacks of dizziness, combined with unilateral hearing impairment, and the presence of vascular diseases (while maintaining blood flow through the vertebral arteries).

The auditory and vestibular pathways are closely related.When dizziness is accompanied by hearing loss, noise in the ear, a feeling of stuffiness in it, or double perception of sound, this indicates a peripheral lesion of the vestibular analyzer.

If a person has suffered from an inner ear disease in the past, then dizziness may occur due to an untreated inflammatory process in the ear labyrinth.

Head injuries, even minor ones, can also cause dizziness, such as damage to otoliths – ear stones that are found in the inner ear.Fissures of the temporal bone are fraught with damage to the auditory nerve. Dizziness attacks often appear many years after the injury.

If such violations occur only with a certain position of the head and body (on the side in bed or when the head is thrown back) and are accompanied by nausea, vomiting, fear, this may also indicate the pathology of the ear labyrinth.

The most severe vertigo occurs when there is an acute circulatory disorder in the inner ear.The roots of the auditory and facial nerves and the inner ear – the cochlea and labyrinth – supply blood to the internal auditory artery. It is the only artery that feeds the inner ear, and a circulatory disturbance in it can lead to a labyrinth infarction. The disease begins with a feeling of stuffiness and noise in the ear. Dizziness and one-sided deafness develop rapidly, balance is disturbed.

Peripheral vertigo attacks are accompanied by palpitations, fluctuations in blood pressure, sweating, and other autonomic symptoms.It is often preceded by a feeling of noise and stuffiness in one ear. The attack usually lasts about three hours. If such conditions are frequent, then it is necessary to examine the patient using computed tomography or magnetic resonance imaging. With peripheral dizziness, the functions of the central parts of the vestibular analyzer are preserved, therefore, recovery after an attack occurs rather quickly.

Central vertigo also begins unexpectedly, and its manifestations are very similar to peripheral vertigo.However, after an acute period, walking instability and imbalance persist for a long time. Central dizziness is more often non-systemic, lasts several days, or even weeks, followed by a long-term imbalance or short-term – a few seconds or minutes. Sometimes dizziness is preceded by a headache, accompanied by vomiting, loss of balance. At the same time, hearing is not impaired or is impaired only slightly. Repeated seizures can be accompanied by symptoms indicating brain damage: sensitivity disorder on one side of the face, trunk and limbs, double vision, speech impairment, weakness in the limbs on the left or right side.Patients with vascular diseases of the brain are characterized by central hearing impairments, which may not bother them, but are detected during additional examination.

Central vestibular disorders occur with an acute decrease in cerebral circulation, tumors, encephalitis and a number of other brain diseases. Their character is unpredictable – they can wake up at night, suddenly throw to the side on the street, or they appear only when the position of the head and body changes. All this significantly impairs the quality of life, reduces activity and efficiency.

Dizziness “inside the head”, reminiscent of the state of “intoxication”, is characteristic of neuroses and depression. The list of complaints with neuroses can be quite impressive: irritability, poor sleep, pain and discomfort in various organs. As a rule, such conditions require treatment, but in some cases the expression is true: “It is not the one who does not hurt anything, but the one who hurts in a different place every time.”

Dizziness also occurs with such a widespread disease as osteochondrosis of the cervical spine, especially with sudden and awkward movements.Such dizziness is short-lived. They can be accompanied by imbalance, slight staggering. Their main cause is irritation of the nerve plexus, muscles and ligaments of the neck.

Dizziness can also occur when taking medications, in particular antibiotics and narcotic drugs, and in women – oral contraceptives. Some antibiotics can lead not only to vestibular disorders, but also to irreversible changes in hearing. Dizziness is sometimes caused by diuretics, anticonvulsants, aspirin.Most often this occurs in elderly people with haphazard use and overdose of drugs.

How to treat?

First of all, you do not need to endure dizziness, but you need to go to the doctor. Timely diagnosis and proper treatment of the underlying disease are the principles that help get rid of dizziness attacks. If the reason is the defeat of the ear labyrinth, then drugs are prescribed to improve blood supply in the inner ear. One of the most effective medicines is betaserc.It was first used in 1962 to treat headaches, and in 1965 to treat Meniere’s disease. Today betaserc is prescribed to relieve dizziness of any origin. The drug causes the release of histamine and its synthesis, which contributes to the development of recovery processes in the vestibular analyzer. It is inappropriate to prescribe betaserc at the same time as cinnarizine, since the latter weakens the therapeutic effect of betaserc with its antihistamine activity. The mechanism of action of betaserc includes a direct effect on the receptors of the vestibular analyzer, which is especially important in cases where dizziness occurs as a result of uncontrolled changes in the spontaneous activity of these receptors.The drug selectively affects the nerve cells of the inner ear (labyrinth), the vestibular centers of the brain, improves blood circulation in the small vessels of the inner ear. A two-month course of treatment with Betasercom in patients with dizziness in the initial forms of vascular diseases of the brain showed that in the overwhelming majority of patients, seizures and tinnitus disappeared or significantly decreased; improved hearing and general well-being. Observations within six months after treatment proved that the positive effect not only persisted, but also increased.Consequently, betaserc has a universal effect on all systems responsible for the onset of vertigo.

There are many drugs of various pharmacological groups (nootropics, antioxidants, antihypoxants, psychostimulants and others) that regulate adaptive mechanisms. They accelerate the development of compensatory reactions of the central nervous system. In a number of drugs, the regulatory effect is combined with an improvement in energy metabolism in cells and tissues.These include, first of all, nootropics that stimulate brain functions, increasing the resistance of the central nervous system to the action of various damaging factors. They are successfully used for many diseases and injuries of the brain, overwork.

The first nootropic drug was created in 1962 in Belgium. This drug – nootropil (piracetam) – is considered “reference”. Numerous studies have proven that it significantly accelerates the compensation of the impaired function of the vestibular apparatus.In addition, it significantly increases cerebral blood flow and activates oxidative processes in the brain. Nootropil is effective for the elimination of acute vestibular dysfunction of any origin: in vascular diseases, toxic lesions, manifestations of natural aging of the vestibular apparatus, and others. It is actively used in the course of treatment for vestibular disorders in patients not only with severe, but also with initial signs of cerebral circulation insufficiency, with craniocerebral trauma and their consequences.

Widely used vascular agents, such as Cavinton (Vinpocetine) or Stugerone (Cinnarizine), often do not give the desired result in elderly patients due to serious changes in the vessel walls over the years.

Everyone knows: in order to maintain health, first of all, you need to lead a healthy lifestyle. However, the words spoken by the French moralist writer Jean de La Bruyere back in the 17th century have not lost their relevance until now: “There is nothing that people would most like to preserve and least of all take care of than their own health.”Avoid conflicts, stressful situations. Treating people the way you would like to be treated is a sine qua non for your health. From time immemorial came to us the appeal of doctors to their patients: “There are three of us – you, me and the disease. If you are on my side, we will definitely win. ”

The author expresses his gratitude to the candidate of medical sciences R. N. Konovalov and the candidate of medical sciences M. A. Kravuchenko for their help in illustrating the article.

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Exercises for vertigo associated with diseases of the labyrinth

One of the most effective home exercises is the Apple maneuver.It is recommended for moving ear stones – otoliths – to a less sensitive area. Exercise at home before bed for a week.

For the left ear (see picture): perform all exercises on the back for 30 seconds, then sit down for one minute. This cycle takes 2.5 minutes. For the right ear, the exercises are performed in a mirror image. You need to do three cycles for each side.

Brandt-Daroff Exercise

From the original sitting position, move left and right with your head slightly tilted.Remain in each position for 20-30 s. Do the exercise several times a day.

***

Tips for sufferers of vertigo

● Avoid sharp tilts, turns of the head. When you wake up, lie down for a while. Then gently get out of bed. Sleep on a low pillow.

● Heavy physical activity is not for you.

● Do not eat hot spices.

● Be outdoors more often. Hiking is good for you.

● It is dangerous to drive a car, work on moving machinery.

● Attractions with flickering light, strong sound effects can cause an attack.

● Beware of stuffy rooms and direct sunlight.

● The use of alcohol and tobacco is unacceptable.

● Avoid stress, conflict, psycho-emotional outbursts. Try to establish a friendly relationship with those around you.

“Dizziness in women, causes” – Yandex.Kew

The feeling of “loss of balance”, “spinning of the surrounding objects” is one of the frequent complaints with which one goes to the doctor.

Dizziness in women can be associated with both physiological changes in the body and with various diseases, for example, arterial hypertension. With a sharp increase in blood pressure, headache and deterioration of health may occur.

What other symptoms can accompany dizziness, why can women feel dizzy and how to cope with this problem?

Symptoms of dizziness

Scientists dealing with the problems of the quality of life after a heart attack say that in general, after the condition has stabilized and an active life resumed, having sex does not pose a direct threat to health.

They also warn: you should neither force things, nor completely give up sex. The most correct option is to ask the doctor about everything. Many patients hesitate to ask the doctor “uncomfortable questions” about sexual relations, experience unnecessary embarrassment, called “a sense of false shame.” But it is the doctor who can tell the optimal time for the resumption of sexual life, the permissible load during it.

Dizziness, or vertigo, is not a disease, but a subjective symptom of various diseases and conditions, which can be described in different ways.

Most often it is perceived as:

• weakness;
• “feeling of nausea”, “lightness in the head”;
• false “sense of rotation”, change in the position of the body in space;
• instability, staggering when walking;
• “loss of balance”.

Typical symptoms may worsen with walking or head movement. Sometimes the main problem is complemented by a number of other symptoms, in particular, nausea, vomiting, sweating, palpitations.

An episode of vertigo may vary in duration. Sometimes it can last for a few seconds, but persistent dizziness is possible for several hours, days, etc.

Dizziness in women: causes of

Most often, dizziness is benign and does not pose a threat to health. It can occur in healthy women at different times in life. Let’s consider the most common reasons.

What should you check with your doctor?

1.Premenstrual period .

Dizziness may be associated with impending menstruation. In some women, dizziness occurs 4-10 days before the onset of critical days. The reason lies in fluctuations in the level of progesterone, estrogen and other hormones. With the onset of menstruation, balance is restored and the problem disappears.

2. Pregnancy.

Expectant mothers may experience slight dizziness due to the increasing level of hormones that promote vasodilation and relaxation.This is necessary for the baby to get enough oxygen and nutrients, but the woman herself may experience a slowdown in blood flow. As a result, blood flow to the brain may be reduced and dizziness may occur6.

Dizziness in the second trimester of pregnancy (from 12 weeks) may be associated with increasing pressure from the enlarging uterus on the blood vessels that carry blood from the lower extremities to the heart. In addition, blood sugar levels can rise during pregnancy.This condition is called gestational diabetes. It can also be accompanied by dizziness 6.

3. Menopause.

Menopause can cause dizziness in menopausal women. The exact mechanism underlying this condition is unknown. Scientists suggest that middle-aged women develop vertigo due to a deficiency of the sex hormone estrogen.

4. Decrease in blood glucose levels.

Glucose is an energy source for all cells.With low blood glucose, hypoglycemia, all organs and systems, including the brain, experience a lack of energy. This can lead to weakness and dizziness.

Hypoglycemia can develop in patients with diabetes mellitus taking too high a dose of antidiabetic drugs. Occasionally, glucose levels can decrease in people with normal carbohydrate metabolism during fasting, a poor diet8.

5. Migraine.

Headaches and dizziness can occur with migraine, a common condition that is two to three times more common in women than in men.It is known that vertigo occurs in 30-50% of cases in the midst of an attack. This form of the disease is called vestibular migraine. According to statistics, it occurs in 1% of the population.

6. Dehydration.

If there is a loss of fluid in the body, for example, when overheating, against the background of digestive disorders, respiratory infections, the water-salt balance may change and dehydration may develop. It leads to a decrease in blood volume, a drop in blood pressure.In such conditions, the brain does not receive enough oxygen, which leads to dizziness and lethargy.

Arterial hypertension and dizziness

Frequent dizziness in women can become a sign of various pathologies. So, it is experienced in about half of cases of one of the most common diseases in the world, arterial hypertension.

The main cause of dizziness in hypertension is the narrowing of the vessels that feed the brain and inner ear.This leads to a lack of oxygen and disruption of the vestibular apparatus.

Scientists dealing with the problems of the quality of life after a heart attack say that, in general, after stabilization of the state and the resumption of an active life, having sex does not pose a direct threat to health1-5. They also warn against pushing things forward or giving up sex entirely.

The most correct option is to ask the doctor about everything. Many patients hesitate to ask the doctor “uncomfortable questions” about sexual relations, experience unnecessary embarrassment, called “a sense of false shame.”But it is the doctor who can tell the optimal time for the resumption of sexual life, the permissible load during it.

Emotional experiences and unfavorable meteorological factors can also contribute to the development of dizziness.

In case of arterial hypertension, there may be complaints about:

• dizziness, headache;
• feeling of “fullness in the head”;
• impairment of memory, attention;
• sleep disorder;
• irritability;
• imbalance, unsteadiness when walking;
• flashing “flies” before the eyes.

Dizziness with arterial hypertension may appear when the pressure drops too sharply after taking antihypertensive drugs (for example, in case of an overdose of the drug).

Feeling of dizziness and “unsteadiness” can also occur with hypertension with concomitant heart rhythm disturbances.

Why dizzy: pathological causes

Frequent dizziness can occur with some other diseases …

1. Anemia

A number of clinical conditions associated with a decrease in hemoglobin levels. Can often occur during pregnancy due to iron deficiency. May be accompanied by fatigue, pale skin, taste perversion, impaired appetite, palpitations, and other symptoms. A typical complaint of women with anemia is dizziness and weakness.

3. Psychogenic diseases

Neurotic disorders associated with stress, schizophrenia, depression, panic attacks.

How to deal with the problem?

In case of a sharp, sudden dizziness, the help of a doctor may be required.

Warning signs are:

• increased dizziness compared to previous attacks;
• chest pain, difficulty breathing;
• loss of consciousness;
• impairment of vision, speech, hearing;
• numbness of the limbs.

When these signs appear, you need to call an ambulance.

If dizziness occurs infrequently, there is most likely no cause for alarm. To alleviate the condition, you can take a horizontal position, in a room with dim light and close your eyes.

To find out the cause of recurrent or regular dizziness, you need to see a doctor.

Original article:

https://helpheart.ru/arterialnoe-davlenie/riski-prichiny-i-posledstviya/golovokruzhenie-u-zhenschin/

90,000 Why is my head spinning and which doctor should I go to?

whole list

Dizziness is one of the most common reasons for patients seeking medical attention.Currently, there are about 80 diseases and conditions that can be accompanied by a feeling of dizziness. These include: diseases of the cardiovascular, endocrine, nervous systems, pathology of the organ of vision, blood diseases, head and neck injuries, malnutrition, poisoning, stress, depression, as well as pathology of the middle and inner ear.

Regardless of the root cause, dizziness leads to a deterioration in the general physical condition and performance (up to complete disability), can lead to depression, fear of falls; some patients stop leaving the house, limit their life activity – all this, of course, ultimately affects the quality of life.

Thus, it is very important to timely identify the cause of dizziness and start treatment on time.

Numerous studies have shown that the most common cause of dizziness is the pathology of the vestibular system at its peripheral level, in other words, outside the central nervous system. It is the peripheral vestibular (and auditory) disorders that the otoneurologist deals with.

Frequently asked questions at the otoneurologist’s appointment:

It is possible in advance ( but not necessarily before consultation ) to undergo an audiological examination and consult a neurologist.No other special studies are needed in advance, since there are a large number of diseases accompanied by dizziness, and it is impractical to carry out all the studies in a row to identify the root cause. After the examination, the otoneurologist will determine the range of necessary additional examinations.

Why do I need additional testing if dizziness is untreated?

Additional studies are needed to make an accurate diagnosis; when the pathology is known exactly, it can be influenced.In some diseases of the vestibular apparatus, we can achieve almost complete absence of symptoms, in some diseases there is a relapsing course, however, the treatment carried out can have a significant positive effect on the course of the disease.

My head is spinning, but the “dizziness” pills do not help me. What to do?

Dizziness is a symptom, that is, a manifestation of some kind of disease. Treating the symptom rather than the disease is usually ineffective.Therefore, of course, it is necessary to identify the nature of the disorder and, depending on this, select a course of treatment.

I suffer from periodic dizziness, maybe I should immediately do an MRI of the brain?

This is not necessary before the consultation, unless you have been prescribed an MRI of the brain by a doctor of another specialty (for example, a neurologist). After a detailed questioning (about the nature, duration of dizziness attacks, about provoking factors, etc.) and an otoneurological examination, it will be clear whether there is a need for this additional examination, i.e.it is not indicated for all patients.

Dizziness occurs when the position of the body or head changes, can this be due to a “problem spine”?

Of course, it is impossible to answer this question without examination, but it is important to emphasize that the most common cause of positional vertigo is a disease of the vestibular apparatus with the long name “benign paroxysmal positional vertigo”. Treatment of such dizziness quickly enough has a positive effect.

Why do I need an audiological examination if I am not complaining of hearing?

An audiological examination (audiometry and tympanometry) is mandatory for patients with dizziness and imbalance, even if the patient has no complaints of hearing loss. This will allow the correct diagnosis to be established.

If you need an examination, you can make an appointment with an otoneurologist by phone: +7 (495) 544-10-60, +7 (495) 544-10-80

90,000 Dizziness: causes, treatment Rostov-on-Don

Dizziness is not a disease, it is a symptom.Quite often, when describing their condition, patients complain about dizziness, which tells the professional about the presence of a certain disease in the patient, the symptom of which is just dizziness.

What is it? Dizziness is a condition when a person has the feeling that objects are starting to move around him. This false movement has a number of different accompanying symptoms:

• weakness and sweating;
• vomiting and nausea;
• tinnitus and headache.

Only a doctor can determine the cause of the dizziness. Therefore, for this you need to undergo a comprehensive diagnosis, according to the results of which a specialist will diagnose and prescribe the necessary treatment.

Causes of dizziness

This problem occurs in people of all ages. Although in the main risk group, patients are 45-60 years old.

The head can be dizzy for various reasons and in different situations: if you change your position abruptly (squatted down or got up quickly), when your head is thrown back for a long time (you are looking for a book on the top shelf for a long time).Such attacks last about 1-3 minutes and may be repeated.

There are various causes of dizziness:

• violation of the blood supply to the brain;
• inflammation of the hearing organs;
• vasospasm;
• low pressure;
• lowered glucose level;
• heart failure;
• disorders of the cervical spine.
• anemia.

In addition, dizziness often occurs with excessive emotional experience, with tension of the muscles of vision, when you follow moving objects for a long time.

Treatment of vertigo in the medical center “BioDynamics”

Manual therapy is an effective way to treat vertigo caused by changes in the cervical spine, as well as other diseases of the spine.

This branch of medicine makes it possible to solve this health problem without the use of drugs.Chiropractors in their practice use the following methods of treating vertigo:

• acupuncture;
• massage;
• craniosacral osteopathy.

The patient immediately after several procedures of manual therapy gets rid of dizziness, insomnia and irritability. In addition, with the help of manual therapy, complexion and vision can be improved.

90,000 Dizziness in the elderly. 5 Most Common Reasons | Healthy life | Health

For a person of age, this is a serious test.For fear of falling, elderly patients are sometimes afraid to leave the house. However, this problem can be dealt with if you know the true causes of dizziness.

Word – Professor of the Department of Neurology, RMANPO, Senior Researcher of the Laboratory of the Russian Gerontological Research and Clinical Center of the Russian National Research Medical University named after V.I. NI Pirogov, Doctor of Medical Sciences Maxim Zamergrad .

Among the many varieties of vertigo in the elderly, there are:

Benign paroxysmal positional vertigo

Why it happens. This type of vestibular dizziness is associated with the fact that, due to various reasons (as a result of injury, lack of vitamin D, prolonged bed rest), microscopic crystals – otoliths located in one part of the vestibular analyzer, fall into another, thereby causing attacks of severe dizziness, provoked by a change in head position.

How it manifests itself. In contrast to young and middle-aged people, in an elderly person, benign paroxysmal positional vertigo can manifest itself only in a feeling of instability and loss of balance when walking.

How is it treated. With the help of a special procedure, during which an experienced otoneurologist, in a certain sequence, changing the position of the patient’s head, promotes the return of the otoliths to their original place.

Meniere’s disease

Why it happens. This chronic condition of the inner ear leads to an increase in the amount of fluid in the inner ear, paroxysmal dizziness and progressive hearing loss.

How it manifests itself. Attacks of rotational dizziness, the frequency of which in elderly patients decreases with hearing loss. But instability often becomes almost constant.

How is it treated. In most cases, drugs. If they do not help, a labyrintectomy is possible – a procedure in which the affected vestibular apparatus of the inner ear is removed or “turned off”. After that, the patient undergoes a mandatory course of vestibular rehabilitation (a special version of vestibular gymnastics).

Vestibular neuronitis

Why it happens. The cause of the disease is considered to be an inflammatory process (probably of viral origin), selectively affecting the vestibular nerve.

How it manifests itself. A single attack of dizziness, the intensity of which increases with changes in posture and may decrease when the patient tries to remain motionless and fix his gaze at one point.

How is it treated. In the acute period with the help of symptomatic therapy aimed at relieving dizziness, in the recovery period with the help of vestibular gymnastics.

Vestibular migraine

Why it happens. According to one theory, during a migraine attack, changes in the activity of neurons in the cerebral cortex can reach the parietotemporal region, where the centers responsible for the sense of balance are located. According to another theory, during a migraine attack, biologically active substances are released in those areas of the brain stem that are related to the vestibular system.

How appears. An attack of rotational dizziness. In this case, there may not be a headache.

How is it treated. Antidepressants, anticonvulsants, beta-blockers.

Central vertigo

Why it happens. The cause of such dizziness may be a violation of the blood supply to the vestibular centers of the brain in stroke or transient ischemic attack.

How it manifests itself. An attack of dizziness or sudden instability, which is usually accompanied by other neurological disorders: weakness, speech disorders, double vision.

How is it treated. Same as stroke or ischemic attack.

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