Dizziness is a disorder that occurs with an incorrect sensation of position or movement of the subject with respect to the space in which it is located. Vertigo or dizziness is opposed to
the state of well-being and awareness of one’s position and relationship in the space defined as equilibrium. Maintaining balance, i.e. what allows us to stand and move, is implemented by a multisensory system consisting of factors that work in synergy with each other:
- sight : the eyes allow us to look at the surrounding space;
- position receptors (called proprioceptors) and movement located in muscles, tendons and joints: which allow our brain to understand the position we are assuming in space;
- hearing :which provides information on the orientation from which a sound source comes, and most of all the vestibular system , an organ located in the inner ear which also takes the name of “organ of balance” due to its unique function.
After having outlined the phenomenon and described what are the main anatomical structures that are involved in the case of vertigo, let’s move on to analyze the different types that can occur.
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If you suffer from this symptom with a fairly high frequency, our advice before going into the illustration of the problem is to make an appointment with your doctor who will analyze your situation and direct you towards more right therapeutic choices. for your specific case. How many types of vertigo
exist
Dizziness , or dizziness if you prefer, are generally distinguished as follows: Duration
According to the duration, different forms are distinguished:
- Paroxysmal : they are the most common and their duration is limited from a few seconds to a few minutes;
- Acute : the duration of which can range from a few hours to a few days;
- Subcontinuous : the duration of which is extended to several days, even if discontinuously;
- Chronic : the manifestation of which tends to recur several times.
Number of episodes
In these cases we distinguish single seizure forms (in the case of an acute lesion of the vestibule) and episodic forms (in the event of an exacerbation of a pre-existing pathology).
What is benign paroxysmal positional vertigo Benign paroxysmal positional vertigo
also called cupolithiasis or BPPV is one of the most common forms of vertigo that can affect the population. It is a particular condition that manifests itself with violent sudden onset crises that tend to recur with a certain frequency.
Specifically, this particular form of vertigo tends to have some associated symptoms such as severe nauseaand balance crises that can occur as much if you are at rest (with the sensation of the room spinning) as well as if you are standing or doing any activity. If you suffer from benign paroxysmal positional vertigo
with a certain frequency, there are a series of actions that can be taken to avoid exacerbating the problem:
- get into a comfortable position;
- get your blood pressure checked;
- perform very slow movements without jerking (getting out of bed in three to four steps);
- use a specific orthopedic pillow for the neck ;
- never sleep without a pillow;
- try to sleep on your back and not on your side.
Let’s now analyze, on the next page, what are the symptoms that are generally felt when suffering from vertigo .
What are the symptoms associated with vertigo
Often other pathological manifestations can be added to vertigo such as :
- hypoacusis : hearing loss, therefore there is a temporary lowering of the hearing threshold for which it is difficult to perceive low intensity sounds;
- tinnitus : annoying and persistent noises perceived by one ear or both,
- visual symptoms : which cause temporary difficulty in focusing on objects when moving;
- motor symptoms : in the event that vertigo is due to neurological damage, paralysis of the facial muscles, coordination and swallowing disorders occur);
- headache .
The symptoms most frequently associated with this disorder are those of an autonomic nature which include nausea , vomiting and tachycardia.
Based on the symptoms felt, it is possible to create a further classification of vertigo in:
- objective vertigo: it is an asymmetry of the functioning of the two vestibular organs and the symptomatology is characterized by the sensation of rotation of the surrounding environment with respect to the individual. Objective vertigo is almost always peripheral in nature, therefore, except in some cases, it does not concern the central nervous system (CNS);
- subjective vertigo when the direction of rotation is relative to the head of the affected subject.
Balance disturbances differ from these two forms, leading to instability and imbalance but are of lesser intensity.
What are the causes of vertigo?
With regard to the possible causes at the origin of vertigo , we can distinguish transient triggering factors linked above all to head movements ( paroxysmal positional vertigo ) and vascular factors linked to states of hypotension ( vertigo from orthostatic hypotension ), typical of when one passes from a bent position to an upright position, thus standing up, and again to head trauma. Causes
are also distinguishedneurological in nature including multiple sclerosis, nervous system cancers and syphilis. There are also purely psychological causes linked to anxious states, and which are often associated with panic attacks.
Another important cause is consequent to an inflammatory or bacterial process that leads to the destruction of the inner ear and this condition takes the generic name of labyrinthitis .
Promoting factors are then identified, the presence of which increases the possibility that a dizzying crisis may occur :
- exposure to ototoxic (toxic to the ear) substances such as toluene;
- consumption of salt in one’s diet, excessive consumption can lead to an accumulation of liquids that exert pressure on the structures of the ear;
- taking medications such as aminoglucosides:
- head or neck trauma;
- barotrauma, a condition more frequent in subjects who carry out deep scuba diving;
- infectious processes affecting the upper airways (nose, paranasal sinuses);
Cervical vertigo: what it is Often cervical
sufferers also experience associated vertigo . The causes that can lead to such a condition are many, among them we have:
- causes of degenerative origin such as cervical arthosis, a pathology characterized by the degeneration of the intervertebral discs;
- trauma such as a car accident, whiplash;
- poor posture leading to inflammation and joint and tendon stiffness.
The latter cause affects subjects who spend many hours sitting at the PC for study or work, assuming an incorrect position for a long period of time that favors the formation of hernias and muscle stiffness.
So if you want to heal from the frequent cervical vertigo it is necessary to think about relying on a serious rehabilitation process to understand first of all what is the right position to take in order not to burden this joint and then perform specific exercises for mobilization of the spine.
How to diagnose vertigo
Before going on to illustrate the ways of diagnosing vertigo , please note that in order to correctly assess the entity and the causestriggering dizziness, it is necessary to go to otolaryngology specialists, able to carry out all the tests and analyzes necessary to treat the problem with the necessary attention.
Often the tests to be performed include diagnostic tests of the head and neck area, hearing tests, electronystagmography (which evaluates the involuntary movements of the eyes and their muscles) and blood tests.
To these are also added the maneuvers carried out by the specialist doctor on the patient’s body and head such as:
- the Romberg maneuver performed with the patient with his eyes closed in an upright position and with his arms at his sides. The maintenance of the equilibrium in these conditions is evaluated;
- the Dix-Hallpike maneuver which lead the patient to sit and lie down on one side with speed;
- Head Shaking Test a maneuver performed by shaking the patient’s head while wearing lenses that prevent objects called Frenzel lenses from focusing.
What therapies exist for vertigo
It is good to clarify, from now on, that the right therapy for you is closely linked to the triggering cause of vertigo , to the presence of concomitant pathologies and to the extent of the problem itself.
Therefore, it must be indicated and prescribed exclusively by an otolaryngology specialist after having carried out all the necessary investigations and having reached a precise diagnosis.
Having ascertained the exclusivity of the therapeutic choice to the doctor, we now pass to illustrate some of the most used and effective therapies available.
Some subjects are treated without pharmacological aid but only through maneuvers (such asEpley maneuver ) which allow the vestibular structures to be rebalanced and which can be resolved in a single session, or if the entity is more persistent, by means of cyclic sessions whenever the disturbance recurs.
The patient is advised to observe some lifestyle and dietary changes such as: reducing the intake of salt in the diet, quitting smoking, avoiding exposure to too bright lights, reading or straining the eyes when experiencing symptoms or avoid too abrupt movements of the head.
It is also recommended to lead a healthy and active lifestyle, sleeping a sufficient number of hours, practicing outdoor sports and relaxation techniques such as yoga, pilatesand meditation.
In some rare cases there is no effective therapeutic strategy, and in these patients through psychological sessions they are taught to live with the problem.
The drug therapies used include the administration of drugs that act by counteracting the vertiginous attacks and the resulting nausea . These are drugs that can induce drowsiness and slow reflexes therefore it will be necessary to follow the doctor’s instructions on the suitability or otherwise of the subject to drive vehicles, to use dangerous tools and to perform particular tasks.
In severe cases, surgery on the vestibular organs is necessary, but this must be carefully evaluated by the specialist.
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