Dizziness - Vertigo: causes, symptoms, forms and treatment

Typically, dizziness, loss of balance, and loss of orientation are symptoms of a simple disease that is easily treatable. Much less often, stroke and severe genetic diseases can manifest themselves this way. But even in the first case, if the doctor does not make the correct diagnosis and starts the wrong treatment, the patient’s quality of life will greatly deteriorate. What to do if you feel dizzy?

You can suspect a diagnosis of dizziness based on the description of the symptoms. There are two types of such complaints:

Real dizziness, when there is an illusion that everything around is starting to spin (systemic dizziness, vertigo). In this case, certain head movements provoke dizziness. Nystagmus (involuntary oscillatory eye movements) can also be noticed in a person; sometimes this requires special studies. Vertigo also makes it difficult to stay in a straight, upright position when walking or standing. There are three main diseases, the main symptom of which is systemic dizziness:
benign paroxysmal positional vertigo;
Meniere's disease;
vestibular neuronitis.

Everything else: instability, loss of balance, loss of orientation, feeling of falling, etc. (unsystematic dizziness). It could be a pre-fainting state or depression. hypoglycemia in diabetes mellitus and other conditions. Most often, such disorders occur in older people due to diseases common at this age and the need to take certain medications with such side effects.

In none of these situations, the cause of dizziness can be osteochondrosis of the cervical spine, although often this diagnosis can be heard at a doctor’s appointment. Throughout the civilized world they know that degenerative changes in the intervertebral discs (which, in essence, is osteochondrosis) very rarely cause any symptoms - most often you should look for some other disease. Also in Russia they like to diagnose vertebrobasilar (vascular) insufficiency and call it the cause of dizziness. However, vascular problems actually very rarely cause these symptoms.

Definition and Features

It is necessary to distinguish between true dizziness, in which there is a feeling of objects moving in space. Such symptoms may be normal if they occur after prolonged rotation around its axis (on a carousel), but in other cases they indicate a malfunction of the vestibular apparatus. The difficulty in diagnosing this condition is that the doctor has to rely only on the patient’s testimony. Many people also mean other symptoms by this term: impaired visual acuity, headaches and others. In reality, dizziness should be understood as a feeling of movement of environmental objects in relation to a person, while the body position is felt as stable. Most often these are circular movements (objects rotate around a person’s axis), but they can also be linear (a feeling of falling or rising in height, various shocks).

Situations that require immediate medical attention

If dizziness is aggravated by the following symptoms:

Attacks of nausea and vomiting.
Severe headache.
Loss of consciousness.
Rapid heartbeat, chest pain, trembling in the limbs, sweating, lack of full breath.
A sharp loss of sensitivity. Weakness in half the body, face, arms or legs.

Such manifestations of the disease are highly likely to indicate an emergency condition and the need for urgent treatment.

Anatomy and mechanism of development of pathology

With dizziness, there is a growing lack of coordination of movements and balance. To find out its cause, one must understand how the transmission of nerve impulses that play a role in proprioception occurs. This term refers to a person’s ability to identify and sense the position of parts of his own body relative to each other and objects in the environment. Information is perceived by proprioceptor organs, including muscle tissue, and then moves along peripheral nerves to the spinal cord, from where it enters the brain. The necessary picture is formed in the parietal lobe of the brain after nerve impulses pass through the thalamus.

The inner ear is an organ that is responsible for a person's ability to maintain balance. It has a complex structure and consists of several sections: the vestibule, 3 semicircular canals and the cochlea. The inner ear is protected by bone tissue that forms the temporal lobe of the skull. It is filled with aqueous fluid - it moves when a person tilts and turns his head, and this information is perceived by sensitive cells to identify the position of the body in space.

The nervous system collects information that comes from the visual apparatus, tactile receptors and other sensory organs, as well as from the inner ear, and then analyzes it. The center of balance is located in the cerebral cortex, namely in its temporal region. Along the nerves, impulses reach the vestibular nuclei - clusters of nerve cells capable of perceiving, analyzing and coordinating information received from different areas.

Dizziness is a disturbance in the sense of balance. Anatomically, it can occur at several levels:

peripheral - in case of disturbance of impulse conduction at the level of the vestibular nerve or inner ear (organ of balance);
intermediate - the pathological process is localized at the stage of transmitting information from the inner ear to the central nervous system;
central - associated with diseases of the brain, in which it is unable to analyze the information received.

Clinical signs of dizziness of different origins do not differ. The patient experiences a feeling of disorientation in space and abnormal movement of environmental objects. However, short-term loss of balance cannot be a consequence of serious diseases of the cerebral cortex. Such dizziness is accompanied by a number of additional symptoms and occurs after injury or certain diseases. To diagnose the cause and mechanism of development of this symptom, doctors at the Clinical Institute of the Brain carry out a comprehensive examination to determine accompanying symptoms.

Forms of dizziness

To more accurately determine the cause of dizziness, there are several classifications of this symptom. This distribution is necessary to understand the danger of the disease and to prescribe an effective treatment regimen. Various types of therapy can be carried out by doctors of different specialties. Thus, the first classification distinguishes two types of dizziness: systemic and non-systemic.

Systemic dizziness is a more dangerous type, which in any case indicates pathology. It is associated with a violation of nerve conduction at the level of the vestibular apparatus (inner ear, vestibular nerve, parts of the cerebral cortex). Systemic dizziness can be central, intermediate or peripheral, depending on the location of the pathological process.
Non-systemic dizziness is also called physiological. It manifests itself in the absence of pathological changes in the vestibular apparatus, but may be a consequence of its excessive irritation. Thus, non-systemic dizziness is one of the clinical signs of motion sickness syndrome, and also occurs after a long and monotonous rotation around its axis.

Symptoms of dizziness may vary. In this regard, it is also customary to distinguish several of its varieties:

tactile - the patient experiences a sensation of loss of support under his feet, instability, as on a ship;
proprioceptive - associated with a change in the identification of the body in space, with a feeling that the body is rotating around an axis, and the surrounding objects remain in their places;
visual - visually the human body remains motionless, and the environment begins to move in different projections.

It is worth understanding that systemic dizziness manifests itself in a more vivid clinical picture. It is associated with damage to neural connections, so symptoms appear and remain even without an apparent reason. In addition, loss of balance is accompanied by other characteristic manifestations of damage to the nervous system or analyzer systems. Non-systemic dizziness is temporary and can go away spontaneously as soon as the vestibular system adapts to environmental changes. The second case does not pose a danger to humans.

What is BPPV?

BPPV (benign paroxysmal positional vertigo) is one of the most common types of vertigo. Most people have encountered this condition. It occurs when quickly raising the head, throwing the head back or bending forward.

BPPV usually lasts no more than a minute and always goes away on its own, so it does not require the intervention of medical professionals.

It is known that people after 50 years of age are more likely to experience benign paroxysmal positional vertigo. Women are more susceptible to developing BPPV when they suddenly change body position (standing up) or move their head.

Main causes of the symptom

Dizziness can be a symptom of a number of diseases and pathological conditions that lead to disruption of the vestibular apparatus. These are congenital or acquired disorders of varying severity, with different mechanisms of development and characteristics of clinical manifestations. Among the most common groups of causes of this symptom are the following:

inflammatory diseases of the inner ear and vestibular nerve - can be of infectious or non-infectious origin;
intoxication and poisoning, which lead to disruption of the vestibular apparatus;
traumatic brain injuries - when certain areas of the cerebral cortex are damaged, dizziness may appear after a long time;
metabolic disorders, including diabetes.

Impaired balance and coordination of movements in space can also be a variant of the norm. In some cases, intense irritation of the vestibular apparatus occurs (on a carousel, during a long stay on a ship or on another unstable support), after which the nervous system needs time to recover. It is impossible to determine the cause of dizziness at home, especially if it is a consequence of organic lesions of the central nervous system.

Clinical picture of different types of dizziness

The main clinical manifestation of dizziness is a feeling of loss of balance and imaginary movement of the body in space. However, this symptom may indicate a number of different disorders, the symptoms of which will differ. At the Clinical Brain Institute, you can undergo a full examination using laboratory and instrumental techniques that will allow you to detect all possible diseases that cause dizziness. However, even an initial examination and medical history will clarify the picture and make a preliminary diagnosis. Systemic dizziness, as a manifestation of functional disorders of the vestibular apparatus, should be considered separately from non-systemic dizziness, which does not pose a danger and can even be considered a variant of the norm.

Systemic dizziness

Systemic dizziness includes a number of diseases associated with various disorders of the conduction of nerve impulses to the cerebral cortex. The pathological process can be located at any level, and therefore the symptoms will differ. Thus, each pathology that may underlie the mechanism of development of dizziness should be considered separately. Systemic types occur in no more than a third of patients and require more detailed examination.

Benign paroxysmal positional vertigo (BPPV) is the main cause of systemic varieties. The process is associated with the formation and deposition of crystals of calcium carbonate salts on the tissues of the semicircular canals of the inner ear. This is an acquired chronic disease, the leading clinical sign of which is short-term dizziness and loss of orientation in space. The attacks last no more than 1 minute, with no additional symptoms (headache, tinnitus).
Inflammation of the vestibular nerve (vestibular neuronitis) is a dangerous condition that often develops against the background of a bacterial or viral infection. Its reproduction with damage to the nervous system causes a characteristic set of symptoms, which includes dizziness. The duration of their manifestation ranges from several hours to several days, and their intensity remains high or even intensifies. Hearing is preserved in vetibular neuritis.
Post-traumatic dizziness is complete or partial disorientation that develops immediately after a traumatic brain injury. The process is associated with damage to areas of the cerebral cortex responsible for transmitting information about the position of the human body in space. Clinical signs may vary in intensity and persist until the tissue has completely healed, and in some cases they appear several days after the injury.
Intoxication is another cause of dysfunction of the vestibular apparatus. Toxins, including aminoglycosides, can accumulate in peri- and endolymph, the fluid that fills the structures of the inner ear.
Meniere's disease is a disease in which there is an increase in the amount of endolymph (hydrops). The fluid is located in the lumen of the labyrinth of the inner ear, and an increase in its volume leads to excess pressure on its walls. The disease occurs in attacks, the interval between which can range from several days to several months. The duration of one attack is from several hours to a day, and the symptoms are very pronounced. The patient experiences acute disorientation in space, dizziness and headaches. The disease progresses and causes gradual deterioration of hearing (usually a unilateral phenomenon), but complete loss does not occur.
Temporal lobe epilepsy is a pathological condition that is manifested by a periodically manifested complex of autonomic disorders (dizziness, headache, low blood pressure, and others). The patient's condition deteriorates suddenly, for no apparent reason, and the attack may be accompanied by deterioration of vision.
Lipotymic conditions are a set of symptoms that precede fainting. The patient experiences severe dizziness, weakness, his skin and mucous membranes turn pale, and his heartbeat becomes less frequent. An attack can occur for many reasons, including diseases of the cardiovascular system, a decrease in blood glucose concentration, an increase or decrease in blood pressure.

Systemic dizziness most often occurs in old age, but can also occur in young people. The development of the disease should be monitored over time, taking into account the frequency and intensity of attacks. It is also important to monitor the occurrence of additional signs: hearing and vision impairment, fainting, nausea, migraines. These data will make it possible to determine the severity of violations even before specific analyzes are carried out.

Non-system varieties

One of the most characteristic signs of non-systemic dizziness is that its clinical manifestations intensify if you close your eyes. The causes of this condition may be various dysfunctions of the cerebellum and other structures that regulate motor activity and coordination of movements. Additional clinical signs include general weakness and drowsiness, decreased visual acuity, deterioration of memory and attention. Similar symptoms may occur with systemic use of certain groups of drugs (benzodiazepines). The patient's condition in such cases improves by adjusting the dosage of medications.

Providing assistance at home

If dizziness bothers you regularly, you need to contact a neurologist who will find out the cause of the problem and help eliminate it. Before visiting a doctor, you can try to get rid of dizziness during sleep using several traditional medicine methods. These include:

light massage of the neck and scalp;
performing regular breathing exercises for two minutes (to do this, place a hand on your stomach and begin breathing slowly through your mouth, while you need to inflate your stomach as much as possible when you inhale and draw it in when you exhale);
pressing the center of the forehead with your fingertips for several seconds (about ten);
ventilation of the apartment;
getting rid of tight clothes (they should be unbuttoned or removed);
Avoid sudden body movements, including sudden turns of the head. You need to take a vertical position carefully, without rushing.

Changing your lifestyle can significantly improve the patient’s condition and even cure dizziness. That is why experts advise normalizing your diet, following a daily routine (it is very important to distinguish between rest and sleep time), taking active walks in the fresh air for at least an hour every day, and conducting therapeutic exercises.

These measures have a therapeutic effect for any pathologies that provoke dizziness. Their regular adherence will help a person prevent the progression of the disease and reduce the symptoms of vertigo.

If, despite following all the advice of a specialist, the head continues to feel dizzy, leading to further deterioration of the patient’s condition, it is necessary to immediately call an ambulance.

Diagnostic methods

The Clinical Brain Institute has all the conditions for a full diagnosis of dizziness. The process is carried out by analyzing the work of the vestibular apparatus and the brain, after which the localization of the pathological process and its stage can be detected. During the initial examination, it is important to conduct a detailed interview with the patient and obtain a detailed description of the complaints. At this stage, it is possible to differentiate true dizziness from other conditions that are also often called by this term. Next, specialists will select an individual diagnostic scheme, which may include the following steps:

examination of the spinal column (analysis of X-rays, CT or MRI) to identify osteochondrosis, vertebral displacements and other pathologies that cause impaired blood supply to parts of the brain;
examination by a neurologist, which includes determination of nystagmus, various tests and assessment of the ability to coordinate movements;
examination of the state of the brain using MRI or CT - carried out to exclude tumors and other diseases leading to demyelination of nerve fibers;
electroencephalography is a way of assessing brain activity by capturing the signals it produces;
study of the functioning of the vestibular apparatus - may include rotational tests, vestibulometry and other tests.

Instrumental techniques are prescribed after a general examination. Based on the data obtained, the doctor can determine what examinations need to be performed in order to conduct a differential diagnosis and exclude possible causes of dizziness. Thus, if Meniere's disease is suspected, patients are offered a test to detect low-frequency sound signals.

Treatment and prognosis

Specialists at the Clinical Brain Institute will select the most effective treatment regimen, depending on the diagnostic results. In most cases, dizziness does not pose a threat to the life and health of the patient and is easily corrected with general measures and medication. Thus, the following methods of treating the causes and clinical signs of this condition may be recommended:

constant monitoring of blood pressure indicators, if necessary, taking antihypertensive drugs;
preventing the appearance of edema - limiting salt intake, prescribing diuretics (diuretics);
taking vestibulics - drugs to eliminate the symptoms of dizziness;
if necessary - antihistamines, anti-epileptic drugs;
restoration of movement coordination with special exercises.

Dizziness is not a disease, but one of the symptoms of a dysfunction of the vestibular apparatus. It is impossible to determine its cause at home, so if it occurs, it is worth undergoing a comprehensive diagnosis at the Clinical Brain Institute. It employs broad and specialized specialists who regularly examine and treat patients with similar symptoms. The medical center also has the opportunity to undergo complex examinations using high-quality equipment necessary to make a diagnosis. Despite the fact that dizziness alone is not a dangerous symptom and cannot threaten the patient’s life, it can indicate serious problems with the vestibular system and organic lesions of the central nervous system in the early stages. It is impossible to cure these pathologies on your own, but an integrated and competent approach in a hospital setting will eliminate both the causes and manifestations of dizziness.

Preventive measures

To reduce your risk of dizziness, follow these tips:

watch your diet, give up exhausting diets and hunger strikes;
choose comfortable clothes without tight collars, which can compress blood vessels;
if you have heart or vascular diseases, monitor your blood pressure;
if you get motion sickness in transport, take special tablets or mints;
try not to stand up suddenly or make sudden movements of your head;
eat foods rich in iron.

Dizziness can occur for various reasons, but only a doctor can determine the true cause and prescribe effective treatment. Do not self-medicate. Remember that vertigo may indicate the development of serious diseases of the brain or spinal cord.