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It may be the result of a sudden change in body position or fatigue. However, if the vertigo persists, it is better to find out what is causing it. This requires both general and specialized diagnostic tests.
About 20 percent complain of dizziness at least once a month. people of productive age, and 1/3 of them have been struggling with this problem for at least several years. Age plays a quite important role here, as this ailment increases with time. Among patients over 65, dizziness is the third most common reason for visiting a doctor.
Some of the patients (5-7%) report this problem to their family doctors. 10-12 percent seek advice from an otolaryngologist for advice on vertigo and imbalances.
Many diseases, many causes
Why do we feel dizzy? There may be many reasons for this. And so: over 50 percent. vertigo is associated with the inner ear. In turn, half of them are so-called dizziness, resulting from prolonged stay in an unnatural position, e.g. when tilting your head during a visit to the dentist’s. In 18 percent this ailment is a consequence of Méniere’s disease (excessive secretion or impaired absorption of the endothelium leading to hydrocele), in about 14% – inflammation of the vestibular or labyrinthine neuron. Other causes are much less common and include, among others, autoimmune disease of the inner ear, otitis media, bilateral damage to the vestibular organ.
As research shows, also neurological causes, approximately 5%, are the basis of dizziness. In this case, they most often include: stroke, transient ischemic attacks (TIA), migraine, epilepsy, multiple sclerosis, cerebellar degeneration, Parkinson’s disease, Arnold-Chiari malformation, lithium poisoning or vitamin B12 deficiency.
Dizziness in 5% cases are also associated with cardiovascular diseases, which include mainly orthostatic (i.e. standing) drops in blood pressure, arrhythmias and side effects of medications, e.g. for high blood pressure.
This ailment can also be caused by motion sickness and mental illnesses (neurosis, phobia, simulation – approx. 15%). There are also known post-traumatic and drug-induced dizziness (mainly as a result of taking antiepileptic drugs, antihistamines, barbiturates and hydantoin).
As you can see, there can be many reasons. Unfortunately, it is not always possible to diagnose them – in about 1/4 of the cases they remain unknown.
General and specialist examinations
One thing is certain – “dizziness” should not be taken lightly, especially if its episodes are repeated. To start with, it’s best to visit your GP, who will take a detailed history, conduct a general examination and order a blood test to rule out general causes, such as anemia or hypoglycaemia (low blood glucose). The physician should receive answers to questions about the circumstances and nature of the onset of the dizziness (sudden or gradual, attacks or constant disturbances) and the symptoms that accompany it. Other diseases that patients suffer from (injuries, hypertension, infections, cardiovascular and eye diseases), medication intake, previous treatments and the current status (frequency and duration of dizziness, provoking factors) are also of great importance.
Various tests may be necessary to make a correct diagnosis. These can be: otoscopic examinations (examination of the inside of the ear), acumetric examination of hearing (consisting in repeating words spoken by the doctor in a whisper), examination for nystagmus (in the so-called Frenzl glasses, equipped with two cameras), as well as tests for coordination, analysis posture, gait and handwriting, Hallpike maneuver (an attempt to induce nystagmus under the influence of bending and twisting the head).
The absence of abnormalities in these tests does not yet mean that everything is okay. The doctor may order further specialist diagnostics – e.g. audiometry (tonal and impedance), electro- and videonystagmography, examination of auditory potentials from the brainstem, static and dynamic posturography (examination of objective imbalances), as well as radiological examinations (computed tomography or magnetic resonance imaging) , studies of the flow in the cranial arteries, serological tests for Lyme disease, syphilis and herpes.
How is vertigo treated? It all depends on the cause that causes them. As it is known that there are many reasons for this, the decision is made by a specialist. The therapy includes both pharmacotherapy, surgery (if the cause are disturbances in the inner or middle ear) and rehabilitation, and in some cases also psychotherapy.
Medical classification
The very term “dizziness”, which we usually use to describe ailments, is inaccurate. There is a medical classification that distinguishes:
• True dizziness (Latin vertigo) – manifested by the illusion of whirling motion (rocking, spinning, less often floating) of the environment in relation to the body or body in relation to the environment. They can be caused by dysfunction of the peripheral vestibular organ in the inner ear or disorders of the central nervous system.
• Balance disturbance – feeling unstable when walking, especially at height (for example, when climbing a stool). It can accompany true dizziness or stand alone. The cause of the imbalance may be paresis or ataxia, caused e.g. by a stroke or the so-called multisensory involution, i.e. impairment of fitness, including gait, due to old age.
• Lightheadedness (no Polish definition) – a group of symptoms that is difficult to define and is associated with disturbances in the blood supply to the central nervous system or with emotional causes. It includes, among others feeling light-headed, blackout, collapsing, confused, “heavy head” and fear of falling.
• Presyncope (no Polish term) – signs of impending fainting: spots or darkness in front of the eyes, narrowed field of vision, feeling of “cotton wool” legs, ringing in the ears, sweating, nausea, paleness. Cause of the symptoms is a reduction in blood flow to the brain, e.g. due to a sharp drop in blood pressure or due to emotional reasons.
Consultation: Małgorzata Grzesik, MD, PhD, laryngologist – Damian Medical Center, Warsaw, ul. Wałbrzyska 46, tel. 0 22 566 22 22
Source: Let’s live longer