A balance disorder causes a feeling of lightheadedness or vertigo:
- If you are standing, sitting, or lying down, but still still, it may appear that you are moving, spinning, or floating.
- If you are walking, you may suddenly feel like you are rolling over.
The occasional brief dizziness happens to everyone, but the word vertigo can mean different things to different people: for some people vertigo can mean a passing feeling of fainting, while for others it can be an intense spinning sensation (the real vertigo) that lasts overtime.
This symptom is one of the main ailments for which adults go to the doctor. Frequent and/or constant episodes can significantly affect an individual's life, but they are only rarely signs of serious and/or life-threatening conditions.
The possible underlying causes of the symptom are varied and may include:
- systemic diseases,
- drugs,
- ear disorders,
- nervous system disorders.
Treatment depends on the cause and symptoms - it usually works, but the problem can reoccur and reoccur.
The constant presence of dizziness, whatever the triggering cause, often has a very strong impact both emotionally and psychologically and it is therefore recommended to never underestimate or neglect the symptom.
Dizziness and dizziness when tired: The causes
Two forms of vertigo can be distinguished:
- Subjective vertigo, the patient appears to be moving even though they are actually immobile (they could however sway slightly as a result of the symptom).
- Objective dizziness, one has the feeling that the surrounding environment is moving.
On the basis of the structure concerned, one can rather operate a macro-classification by:
- Peripheral vertigo: They are caused by lesions that can be placed in the vestibular apparatus of the ear, seat of the sense of balance; they usually have a sudden and violent onset and tend to persist more or less constantly over time. The patient describes the sensation as spinning a rapidly spinning carousel, thus also causing nausea and vomiting, and often unable to stand.
- Central vertigo: In this case, the patient feels the sensation of a lateral oscillation, but the effect is milder and undergoes changes in intensity over time. They do not cause nausea.
Peripheral vertigo
Benign positional vertigo
It is one of the most common forms of vertigo; the symptom is felt after a change in the position of the head (lying down, turning over in bed, looking up, bending over, etc.).
It is often accompanied by nausea and, more rarely, vomiting, lasts about 30 seconds and disappears when the head is still. There may also be nystagmus (the eye moves involuntarily).
It is due to a displaced otolith crystal entering one of the semicircular equilibrium canals. Benign positional vertigo most commonly affects adults and older people, with most cases occurring in people over 50; it may have no apparent cause, or it may be the result of:
- ear infection,
- ear surgery,
- a head injury,
- prolonged bed rest, for example during recovery from illness.
It can last for days, weeks or months. The “repositioning” treatment (Epley maneuver), carried out by an otolaryngologist, is generally curative.
Trauma
A skull fracture that also damages the inner ear produces intense and disabling vertigo, with nausea and hearing loss. Symptoms of vertigo can last for several weeks and slowly improve as the other (normal) ear takes over. Benign paroxysmal vertigo is a common consequence of head trauma.
In the event of dizziness following a trauma, it is essential to consult a doctor immediately to assess all the possible damage.
Labyrinthitis
Labyrinthitis is an infection or inflammation of the inner ear that causes dizziness and loss of balance. it is often associated with an upper respiratory infection, such as the flu or a cold.
It can be accompanied by nausea, vomiting, hearing loss, tinnitus, and sometimes fever and pain.
vestibular neuritis
Vestibular neuritis is a condition of the inner ear that causes inflammation of the nerve that connects the labyrinth (a structure in the ear that controls balance) to the brain. In some cases, even the labyrinth itself can be inflamed.
The cause is usually a viral infection, it appears suddenly and can cause other symptoms such as
- instability,
- nausea and vomiting,
- not feeling well.
Hearing impairment usually does not occur.
It can last from a few hours to several days, in some cases up to six weeks.
Meniere's syndrome
It is a disorder characterized by attacks of vertigo that last for hours, nausea and/or vomiting, and unpleasant sensations of tinnitus (tinnitus) in the ear, which often feels closed or full. Usually, a hearing impairment also coexists.
The cause of Ménière's syndrome is unknown, but the symptoms can usually be controlled with diet and medication.
Vertige cervical
The importance of the cervical region in the management of balance has been known and studied for some time, as well as the associated disorders induced by traumas or pathologies of the neck.
In these patients, we speak of cervicogenic (or cervical) vertigo, a disorder characterized by dizziness, difficulty with balance and neck pain.
This type of vertigo mainly occurs as a result of neck movements and can also affect the ability to concentrate.
pharmaceuticals
Dizziness is a typical side effect of many medications. in case of occurrence when taking a new drug, it is recommended to immediately contact your doctor.
Among the most commonly associated with the development of the disease are:
- aminoglycosides (a class of antibiotics),
- anti-inflammatory,
- phosphodiesterase type 5 inhibitors (the best known is certainly Viagra®),
- furosemide (a diuretic)
- ...
Central vertigo
Circulation
Dizziness is felt when not enough blood reaches the brain.
This has happened to virtually everyone occasionally when rising quickly from a lying position (orthostatic hypotension), but some people (especially the elderly) have this feeling frequently or chronically due to poor circulation.
This may be due to atherosclerosis of the arteries and is commonly seen in patients with high blood pressure, diabetes, or high levels of fats (cholesterol) in the blood; it is also sometimes found in patients with heart failure, hypoglycemia (low blood sugar), or anemia (from iron deficiency).
Migraine
Some people with a history of classic migraine may have bouts of vertigo and dizziness similar to Ménière's syndrome. Headaches are usually but not always felt.
It is a common form among young people.
Neurological diseases
Various neurological diseases, such as multiple sclerosis, syphilis, tumors, ..., can also have effects on balance. These are uncommon causes, but your doctor may want to run tests to investigate them.
Acoustic neuroma
Acoustic neuroma is a rare benign tumor that affects the acoustic nerve, the one responsible for balance control.
Ischemia
A transient ischemic attack or a complete stroke can cause dizziness accompanied by vertigo due to the sudden reduction in blood supply to the brain.
Anxiety
Anxiety can be a cause of dizziness and lightheadedness.
Unconsciously too frequent breathing (hyperventilation) may be perceived as overt panic or mild dizziness with tingling in the hands, feet or face. It may be necessary to teach the person how to breathe properly.
Allergies
Some people experience dizziness or difficulty with balance when exposed to food or airborne particles (dust, pollen, animal hair, etc.) to which they are allergic.
Other causes
Among the many other possible causes of vertigo and dizziness are also:
- stress,
- hypoglycemia,
- dehydration,
- heatstroke ,
- alcohol abuse,
- substances of abuse,
- atrial fibrillation ,
- carbon monoxide poisoning,
- dizziness in the cervical vertebrae.
Risk factors
Factors that can increase the risk of suffering from vertigo and dizziness are:
- Age: Older people are more likely to have conditions that cause seizures, particularly seen as loss of balance. They are also more likely to take medications that can cause dizziness.
- Familiarity for vertiginous episodes.
- Previous episode: If you have suffered from it in the past, the probability of new attacks increases.
SYMPTOMS
A balance disorder can cause a wobbly gait or cause the person to wobble or fall when standing up. Other symptoms are possible, such as:
- a sensation of rotation, that is to say of vertigo proper,
- falls or the feeling of falling,
- dizziness, fuzziness, floating sensation,
- blurred vision ,
- confusion or disorientation.
These may be associated with nausea and vomiting, diarrhea, changes in heart rate and blood pressure, and fear, anxiety, or panic. Symptoms can come and go for short periods or last a long time, and can also cause fatigue and depression.
Dizziness and nausea
The presence of nausea in balance disorders is usually associated with a disorder causing true vertigo (typically related to ear diseases), while in simple vertigo the patient does not experience nausea or vomiting. .
WHEN TO CALL THE DOCTOR?
Dial 17 or go to the emergency room if you experience dizziness associated with:
- a sudden or severe headache,
- persistent vomiting,
- sudden changes in speech, vision, or hearing
- unsteady stride or difficulty walking,
- fainting,
- chest pain or irregular heartbeat,
- numbness or weakness
- shortness of breath,
- high fever,
- very stiff neck,
- head injury,
- convulsions .
Consult your doctor in case of:
- recurrent, sudden and severe dizziness,
- prolonged episodes of dizziness, faintness or dizziness,
- feeling of instability,
- sensation that the room is rotating around the patient (objective vertigo),
- falls due to dizziness,
- Blurred vision,
- feeling of disorientation.
Associated HAZARDS
Dizziness and vertigo can increase the risk of falling and injury.
An attack while driving a car or operating heavy machinery can increase the likelihood of an accident. There can also be long-term consequences if the underlying health condition is left untreated.
DIAGNOSIS
Diagnosing the presence of vertigo is as simple as it can be difficult to trace the cause; if necessary, the doctor can suggest a visit to otolaryngology (otolaryngology is a medical-surgical specialty of diseases and conditions of the ears, nose and throat).
The otolaryngologist may request
- hearing test,
- blood tests,
- electronystagmography (a test that measures the movements of the eye and its muscles),
- head and brain imaging tests.
Another possible examination is posturography. In this exam, you stand on a special moving platform in front of a patterned screen. Doctors measure the body's response to platform movement, screen patterns, or both.
TREATMENT AND THERAPY
If the balance disorder is dependent on another health condition or medication, the goal is to treat the condition or change/reduce the dosage of the medication.
If you have benign paroxysmal positional vertigo, your doctor may recommend a series of easy movements, such as the Epley maneuver, which can help move the otoliths out of the semicircular canal. In many cases, one session is enough; in others, several sessions will also be necessary to eliminate the symptom.
In the case of Ménière's syndrome, your doctor may suggest changing your diet and quitting smoking if you smoke. Anti-dizziness or anti-nausea medications can relieve symptoms, but they can also make you drowsy. Other medications, such as gentamicin (an antibiotic) or corticosteroids, may be used.
Although gentamicin can reduce symptoms better than corticosteroids, it sometimes causes permanent hearing loss. In some severe cases of Ménière's syndrome, surgery on the vestibular organs may be necessary.
Some people with balance disorders may not fully recover and will need to find a way to coexist with the symptoms. A vestibular rehabilitation therapist can help develop an individualized treatment plan.
You should consult your doctor to find out if it is safe to drive and if there are ways to reduce the risk of falls and injury during daily activities (for example, going up or down stairs, using the bathroom, Sport).
Avoiding walking in the dark can help reduce the risk of injury during new episodes. It will also be necessary to use low-heeled shoes or, outside, walking shoes. If necessary, you will have to use a cane or a walker and intervene on the furniture of the house or the work environment, for example by adding guardrails.
Lifestyle and home remedies
To prevent aggravation, it is useful:
- avoid sudden movements or changes of position,
- stay calm in case of symptoms,
- avoiding bright lights, television and reading in case of symptoms,
- slowly increase your activity when you feel better by having someone help you walk in case you lose your balance.
An acute and sudden episode during certain activities can be dangerous, so it is advisable to wait a week after the resolution of a severe episode before activities such as climbing, driving, using heavy machinery; if not, ask your doctor.
Chronic dizziness or lightheadedness can cause stress, in which case making healthy lifestyle choices can help you tolerate symptoms better:
- get enough sleep,
- follow a healthy and balanced diet do not overeat,
- if possible exercise regularly ,
- learn and practice relaxation techniques, such as progressive muscle relaxation, yoga, tai chi, meditation.
PREVENTION
- Avoid sudden changes in position.
- Get up from bed or from a sitting position slowly and gradually.
- Avoid rapid movements of the head (especially turning or turning it).
- In the case of objects placed on high shelves, use a ladder and avoid hyperextension of the neck.
- Stop smoking.
- Eliminate or reduce the use of substances that reduce circulation, such as tobacco, alcohol, caffeine and salt.
- Minimize stress and avoid exposure to substances to which you are allergic.
- Drink enough fluids.
- Treat infections, including ear infections (otitis), colds, flu, sinus congestion (sinusitis), and other respiratory infections.
