Vertigo (dizziness) and balance disorderWhen people are plagued by vertigo, they feel like the ground is swaying, everything is spinning, or the ground is sagging out from under them. According to the descriptions of those affected, vertigo is usually accompanied by the sensation of disturbed balance and insecurity and can be perceived, for example, as staggering vertigo or also rather diffusely. The causes and the accompanying symptoms of vertigo are manifold. The spontaneous onset, seizure-like or persistent dizziness does not always have its cause in the sense of balance. Other causes of vertigo are usually benign. Easily accessible to various forms of therapy.
The most important facts about vertigo
– Dizziness can have many causes besides a disturbance of the sense of balance. – Vertigo can be spontaneous, seizure-like, or persistent. – dizziness is the second most frequently mentioned symptom by patients. – There are different forms of vertigo. – Through avoidance or. Treatment of the causes may disappear dizziness.
Types of vertigo
Vertigo is usually classified according to different criteria, for example
– according to subjective perception, – according to duration, – according to trigger – or according to origin of the complaints.
Of course, the symptoms are not always so clearly distinguished from each other in practice, mixed forms and transitions occur quite often. The different forms of vertigo are defined by their causes and the specific way in which it manifests itself in the affected person.
The following forms of vertigo are called systematic vertigo. Systematic vertigo is usually caused by a disturbance or irritation of the sense of balance:
– spinning dizziness Do you know the feeling you have, for example, when you get off after a fast ride on a merry-go-round? This is how spinning dizziness feels. – Swaying vertigo The term swaying vertigo is used when the ground seems to move under the feet, as occurs physiologically after long boat rides. – Elevator vertigo In this case, the affected person has the feeling of an upward and downward movement of the environment, as known from rides in elevators.
In unsystematic vertigo, the apparent movements of the environment are less clear. The generic term diffuse vertigo includes various sensations, such as:
– Feeling of emptiness and spinning in the head, – blurred vision, – flickering and blackening of the eyes, – attacks of nausea, – unsteady gait, – attacks of weakness, – imminent fainting or dizziness – and a feeling of unreality.
It usually occurs with vertigo that originates outside the organ of balance.
In addition to the described perceptions, there are often tendencies to fall in one direction, eye tremors (nystagmus) and a number of vegetative symptoms such as nausea and vomiting, sweating, palpitations and anxiety. Due to the multitude of additional symptoms, it is referred to as vertigo syndrome.
Whether the cause of the dizziness lies in the inner ear can be determined in an ENT practice. (Image: Supak/fotolia.com)
Causes and triggers
In order to orient ourselves with our body in space, the central nervous system must constantly process and coordinate sensory stimuli, which come in from the vestibular apparatus in the inner ear, from the eyes and receptors of the muscles and tendons and are adapted to the respective requirements (rest, movement, change of position). Many people are quite familiar with the effects of irritation of this processing as motion sickness (motion sickness) or altitude vertigo. The symptoms can also occur as a side effect of medication, alcohol or drug use. Last but not least, organic and functional disorders in circumscribed areas lead to dizziness, as do stress, anxiety and psychological imbalance.
Cause in the vestibular apparatus
The organ of balance in the inner ear consists of the atrial labyrinth, the arcuate apparatus and the vestibular part of the VIII cranial nerve (vestibular nerve). For a number of vertigo syndromes, the cause is considered to be a disturbed sense of balance. If peripheral parts of the labyrinth or a nerve are damaged and the dizziness is triggered by head movements or changes in position, the symptoms may be a sign of common but benign positional vertigo (BPPV) or a symptom of Meniere's disease, a disorder associated with dizziness and ringing in the ears (tinnitus), for example. But also bacterial or viral inflammations, for example of the structures of the inner ear (labyrinthitis) or of the vestibular nerve (neuritis), herpes zoster infection in the ear as well as an infarction in the labyrinth are possible causes. Lesions of central nerves or the cerebral cortex can also lead to (especially systematic) vertigo. Furthermore, dizziness can occur in the context of migraine, multiple sclerosis, acute circulatory disturbances in the brain (TIA), poisoning or tumor diseases (acoustic neuroma).
A special form of motion sickness is VR-sickness or VR-motion sickness. There are modern PC, console and cell phone games, but also professional applications, in which the action is not perceived on a conventional monitor, but by means of virtual reality goggles, or VR goggles for short. This enables users to act virtually in a 3D environment. Some people experience symptoms such as dizziness, nausea and disorientation as a result. These symptoms disappear on their own after a short time.
It is believed that these symptoms are triggered by the discrepancy between the movements that are visually communicated to the brain, but not by the sense of balance. As a result, VR disease takes on a special role. Although the sense of balance is partly responsible for the symptoms, there is no disturbance of it. Many get used to the VR world after some time. The symptoms of VR disease subside. For others, these symptoms arise anew every time they are used.
Vertigo can also be the triggered by the use of VR glasses (Image:adam121/fotolia.com)
Cause outside the sense of balance
In vertigo with cause outside the sense of balance (non-vestibular vertigo), the origin can lie in various organs and functional areas. In the case of anemia, for example, there is an undersupply of oxygen, which can lead to dizziness. Besides, vitamin deficiency, hypoglycemia, hyperventilation as well as a low blood prere with dizziness symptoms directly after getting up and possible weather sensitivity are to be considered causally.
In the area of the head, disorders of vision, such as latent strabismus, reduced cerebral blood flow due to calcification processes, epilepsy or head injuries are also possible. Cervical vertigo, which originates in the cervical spine, certainly plays an important role.
Vertigo and cervical spine
In the case of so-called cervical vertigo, there is a presumption of a connection between vertigo and the cervical spine. If other structural causes have been ruled out, conventional medicine now often refers to other procedures such as osteopathy, chiropractic or Rolfing, which include tie qualities and the use of the body in everyday life in diagnosis and treatment.
In osteopathy it is amed that in the muscles at the back of the head there could be balance receptors, which can be pinched off and cause dizziness when these muscles are hard-stretched. In Rolfing, the statics of the entire organism are taken into account in order to ensure adequate symptom-free function without dizziness. The basis of these concepts is that balance for the human organism can also be the relationship of the head to the body. If this is disturbed or inharmonious, it can consequently lead to complaints. Therefore, the diagnoses also ask for symptoms that are not necessarily recognizable as being related to the vertigo, such as:
– or headache at the back of the head. Structural representatives from the medical profession suspect behind the connection between cervical spine. Vertigo more likely to be caused by degenerative processes in the cervical vertebrae. These are said to cause movement restrictions, blood undersupply and nerve conduction problems and thus functional restrictions of vestibular organs.
Dizziness caused by head movement
According to statistics, the occurrence of vertigo most often occurs in the context of a so-called benign paroxysmal positional vertigo (BPPV). Spontaneous attacks of spinning dizziness can occur during certain movements or changes of position, which are very unpleasant but harmless in themselves. This is caused by small stones that are located in the inner ear and sometimes clump together to form larger structures. During certain movements, especially of the head, these can now reach unfavorable positions with the lymph fluid and lead to vertigo attacks. Various positioning exercises help to prevent the complaints or to stop them at an early stage after they have started. Alternative medical practitioners see a possible connection with the diet of those affected. More about this in the section on nutrition as a trigger.
Stress can also lead to dizziness. (Image: Henrie/fotolia.com)
Dizziness can occur in the context of many psychological disorders, for example in the depressive syndrome, pyschoses and especially in anxiety disorders. Fear of heights and other specific phobias such as agoraphobia with or without panic attacks are often accompanied by vertigo, which is usually described as diffuse and unsystematic dizziness. It often takes a long time for a psychogenic cause to be accepted by sufferers. After all organic causes have been excluded, the medical diagnosis of "phobic vertigo" often leads to the recommendation of psychotherapy.
The probability of suffering from vertigo increases significantly with age. There are indications that between 40 and 50 percent of people over the age of 75 are affected. Very often, no clear organic cause is found for the occurrence of dizziness in old age. Presumably, various age-related factors come together that promote vertigo symptoms. This includes for example
– cardiac insufficiency, and cardiac arrhythmias, – blood prere fluctuations, (especially of the brain and ears), – disorders of vision, – ear diseases, – anemia, – severe fluctuations in blood sugar levels – and exsiccosis.
Older people usually feel less and less thirst, drink too little and are thus at risk of internal dehydration. Aging is a process, so that older people do not want to acknowledge and ignore their limitations, for example due to dizziness. Therefore, to avoid falls, a suitable aid, such as a walker, is useful. Regular balance exercises, an alkaline diet rich in vitamins and sufficient fluid intake can stop the development of dizziness. From the naturopathy preparations from Ginkgo biloba as well as physical water applications, as for example face castings, are recommended.
Vertigo can have organic or psychological causes. (Image: pathdoc/fotolia.com)
Diet as a trigger
In alternative medicine, nutrition is also discussed as a trigger or important factor in the development of vertigo syndromes. Electrolytes, especially common salt, potassium, calcium, magnesium, and phosphate, are thought to play a role. The endolymph, a fluid that performs important tasks in the ear canals, can be altered in its mineral composition through nutrition and, under certain circumstances, impair the function of the sense of balance. In addition, food intolerances and food allergies are suspected of triggering dizziness, because the symptoms improved with individual omission attempts or the omission of the suspected allergens. As a preventive measure, an alkaline diet should be preferred, especially if symptoms already exist.
Complaints that persist for a long time or keep recurring should first be clarified by a doctor – and by a specialist, for example in an ear, nose and throat (ENT), neurology or cardiology practice. In case of a severe vertigo attack, emergency medical help is advisable, not least because of the possibility of a stroke.
Conventionally, after anamnesis and diagnosis, the focus is on drug treatment for the therapy of the underlying disease and for symptomatic relief of the vertigo, for example with dimenhydrinate or pentoxyfylline. In the case of positional vertigo, however, various positioning exercises, such as the positioning maneuvers according to Epley and Semont, show better results. Psychotherapeutic work is usually initially carried out with behavioral therapy or depth psychological methods, which can be supplemented by alternative methods after consultation.
Self-help through avoidance
If the cause of the dizziness is known, such as a food allergen, alcohol or drugs, it is important to avoid these substances. Anyone who is prone to prolonged dizziness on merry-go-round rides should not use such rides. Likewise, the use of VR glasses should be limited if this leads to dizziness.
Especially in case of chronic complaints, natural remedies can bring about improvement. Depending on the cause of the dizziness, acupuncture, ear candles (which also help with colds and stress) and procedures according to Kneipp are used. If the cervical spine is involved, manual therapies, Rolfing, osteopathy or craniosacral therapy are appropriate.
Craniosacral therapy can help resolve causes of vertigo in cervical vertebrae. (Image: SENTELLO/fotolia.com)
In the case of stress and psychogenic cause, for example:
– meditation, , , – psychokinesiology, – or autogenic training
Provide relief so that sufferers can regain "solid ground" and "find their footing" again.
Especially for senile vertigo, phytotherapeutics with ginkgo extracts are often used. Dizziness caused by motion sickness can be treated with ear acupuncture. homeopathically prepared cocculus grains (Cocculus) treat. Bach flowers can also be used and other homeopathic remedies are in use, such as Aurum, Viscum album and Tabaccum, the use of which should ideally be preceded by an individual professional history. (jvs, ok)
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