DizzinessDizziness is a disturbance of the sense of balance – it is a symptom, not a diagnosis.
The organ of balance is located near the inner ear. The 3 arcades are filled with fluid that moves back and forth when the head is moved. The displacement of the fluid can register sensory cilia. Correspondingly transmit signals to the brain. When the eyes are open, the brain also uses the visual impression to "determine" the position of the body in space.
Vestibular organ and nerves in the inner ear
Various diseases can lead to dizziness, but often no cause can be found. Often it is not possible to clearly distinguish between vertigo and a feeling of insecurity due to other causes. With the term dizziness, those affected sometimes also mean weakness, lack of strength or impending unconsciousness.
Vertigo is a perception in which it feels as if the environment or you yourself are turning (spinning vertigo) or the ground is swaying (swaying vertigo) or moving. Uncertainty of gait and dizziness also fall under the term dizziness.
Frequency
Dizziness is relatively common, and the incidence increases with age. In the age group over 70, nearly one-third suffer temporarily from dizzy spells that limit everyday activities.
Short attacks or episodes of vertigo are still considered tolerable. Severe seizures, however, can be dangerous and affect the lives of those with the condition. Prolonged dizziness is very uncomfortable. In family practices, vertigo is the reason for the visit in about 2-5% of cases. Dizziness is also a symptom of other diseases.
What can be the cause?
Vertigo in young people is often triggered by anxiety or restlessness, but can also be the result of a viral infection in the inner ear. Vertigo in the elderly is usually caused by impaired blood supply to the brain, possibly in combination with other ailments of old age. The blood supply to the vestibular organ comes from the basilar artery, which originates from the vertebral artery in the spinal region. Therefore, dizziness is a possible consequence of circulatory disorders also in the area of the cervical spine.
Cervical vertebra with blood vessel
Basically, dizziness can be caused by a malfunction of the following organs or. arise due to the following causes: Organ of equilibrium, brain (migraine, hemorrhage, infection), eyes (visual disturbances), ears, cardiovascular system (restricted blood flow), dysfunction of peripheral nerves (z. B. in the area of the feet) or also psychologically triggered dizziness.
Common causes
– Vertigo due to psychological causes – z. B. Anxiety – occurs frequently. – Patients often feel groggy and have the sensation of fainting. Other symptoms such as fatigue and abdominal or chest pain usually occur as well.
– In many diseases, there may be a lack of blood due to hemorrhage or decreased production of red blood cells. – Symptoms depend on the severity and progression of the anemia. Typical symptoms include fatigue, tiredness, reduced physical performance, ringing in the ears and shortness of breath. In addition, there is paleness, palpitations and often dizziness.
– Certain forms of migraine can also cause dizziness.
– A stiff neck is often a sign of stress. – The neck muscles cramp up when we are tense. This leads to symptoms such as headaches, dizziness, tenderness and pain in the neck muscles.
– The causes can be manifold. – Possible causes include blocked ears, low blood prere when standing up (orthostatic hypotension), medication, cardiac arrhythmia or hypersensitivity in the carotid sinus (a prere-sensitive area in the region of the carotid artery).
Viral infection in the organ of equilibrium
– The trigger may be a viral infection in the upper respiratory tract that has spread to the vestibular system. – Symptoms occur suddenly and include balance problems, dizziness (everything spins), uncontrollable rhythmic movements of the eye (nystagmus), nausea and vomiting. – Symptoms may be severe in the first few days and then gradually become less severe.
Inflammation of the vestibular nerve (neuritis vestibularis)
– Persistent spinning dizziness for days to weeks – Unsteady gait, noticeable eye movements, nausea and vomiting – Self-curing in about 50 % after a few weeks
– The dizziness is triggered by certain positions or head movements. – This is caused by a malfunction of the equilibrium organ in the inner ear. – Spinning dizziness, which can last from 30 seconds to about 2 minutes, usually occurs when lying down or standing up.
– The disease manifests itself as rotary vertigo, hearing loss and ringing in the ears resp. a ringing in the ears (tinnitus), nausea and vomiting. Patients usually have to lie down; the attacks often last 1-2 hours. – The disease usually appears between the age of 30. and 50. first appears in the first year of life. In 90 % of cases, only one side is affected at first, but later 30-60 % experience symptoms on both sides. – Over time, there is an almost constant, low-frequency, rushing ringing in the ears (tinnitus) as well as hearing loss.
Heart disease, z. B.:
In rare cases, dizziness can be a sign of a stroke (bleeding or impaired blood flow to the brain).
– Especially if the vertigo is sudden – Usually there are other symptoms at the same time, such as nausea, speech, gait, coordination, or vision problems.
Other chronic conditions
– An underactive thyroid (hypothyroidism) as well as liver or kidney dysfunction can also cause dizzy spells in some cases.
Various medications (as well as drugs, toxins, alcohol) can also either directly damage the vestibular nerve or indirectly lead to dizziness as a side effect. Some patients with a severe allergic reaction also report dizziness.
Rare causes
– This is a benign tumor in the vestibular nerve that occurs in one out of 100.000 people a year are diagnosed with dizziness. – There is a unilateral, increasing hearing loss, which mainly affects high-pitched sounds. – Other symptoms are nonspecific; dizziness and ringing in the ears are usually not very pronounced.
– The disease usually appears between the age of 20. and 40. year of life. – Initial symptoms may include acute dizziness, double vision, unilateral optic nerve damage, clumsiness, sensory disturbances, and a strong urge to urinate.
– First signs are epileptic seizures, slowly progressive paralysis and speech disorders, depending on the location of the tumor; headaches are rare in the early stages. – Typical other symptoms include nausea, vomiting, dizziness, and paralysis of facial muscles.
When should you seek medical advice?
In most cases, these are short-lasting mild attacks of dizziness without further complaints. Particularly in the case of older people, they should be carefully examined when they first experience dizziness, in order to avoid a possible. Underlying disease not to be overlooked. Often, however, no cause can be found.
Sudden onset and severe vertigo should be evaluated by a physician as soon as possible. Especially if there are other symptoms at the same time (fever, gait disturbance, visual disturbance, etc.).), this can be an indication of a disease that needs to be treated quickly. Hospitalization may be necessary.
If dizziness persists, you should also see a doctor to find out the cause.
What does the doctor do??
Medical history
You will probably be asked the following questions:
– How long have you been suffering from dizziness? – Do you suffer from dizziness all the time or does it occur in fits and starts?? – How long does a seizure last?
– Have the feeling that everything is spinning (spinning dizziness)? – Have the sensation that the floor is moving (staggering vertigo)? – Does the dizziness occur in the head or do you rather "just" feel it? unsteady on your feet (gait unsteadiness)? – Do you feel dizzy or. as if they might faint?
– Suffer from nausea, vomiting, unsteadiness during movements or visual disturbances (even with new, unfamiliar glasses)? ? or hearing loss? , Shortness of breath? , Heart palpitations? – Paralysis? – Numbness? – Other symptoms?
– Head movements? Anxiety? Stress?
Medical examination
In most cases, the doctor will perform a general physical examination, focusing on blood prere, pulse, heart, and ears. A careful examination of the nervous system, including possible abnormal eye movements, is also important.
Various tests are used to determine whether the cause of the dizziness is more likely to be in the vestibular system (peripheral) or the brain (central).
If positional vertigo is suspected, the doctor will perform a special test called the Dix-Hallpike maneuver (certain positional changes that can cause vertigo).
Other examinations
Some blood tests may be performed.
If a specific disease is suspected, imaging techniques may be used, e.g., a hearing aid may be needed. B. X-ray, computer tomography, etc. or an electrocardiogram performed.
Referral to a specialist or hospital
If a definite diagnosis cannot be made or if special procedures are necessary, you will be referred to a specialist (usually neurology or ENT).
Treatment options
Is the dizziness the result of a curable disease (z. B. infection, cardiac arrhythmia, hypothyroidism) or side effect of medications, it will subside when the condition is treated or. the medication has been discontinued. However, if the vertigo is caused by a chronic disease or if no cause can be found, it is useless to avoid the situations in which the vertigo occurs. Rather, affected persons must learn to cope with it: There are training programs in which the brain is trained, so to speak, to no longer perceive the dizziness so strongly.
Positional vertigo can usually be alleviated or cured with certain positioning maneuvers by an experienced physician. In case of very severe dizziness and nausea, anti-nausea medications or other agents sometimes help in the beginning; in some situations, temporary medications for mental illnesses or.