Dizziness is a feeling of an imaginary movement or rotation of a body in space or an incorrect definition of one's body in the surrounding space. Patients describe the dizziness in completely different ways: swimming or rocking the head, impaired coordination, rotation inside the head, weakness in the legs, instability, unsteadiness in walking, etc. Vertigo is a proven symptom of more than eighty somatic and neurological diseases. In addition, this condition can be observed in cardiovascular diseases, blood diseases, mental illnesses and pathologies of the ear and eye. Vertigo is an extremely unpleasant subjective symptom that significantly reduces the quality of life of a person
Dizziness - Causes
The function of maintaining equilibrium directly depends on the surface-sensory, proprioceptive, vestibular and visual information and is provided by a very complex unique mechanism called the vestibular apparatus. All incoming sensory information is processed in the central nervous system and modeled by the activity of the extrapyramidal system, the reticular formation, the cerebellum, and the cerebral cortex. Simultaneously, the vestibular receptors control the position of the head, determine the change in the force of gravity, change the angular and linear acceleration, and translate all this accumulated information into brain-processing electrical impulses.
The vestibular apparatus is located in the pyramid (in the stony part) of the temporal bone and in its structure looks like consisting of three cavities (anterior bone snail, central cavity with spherical and elliptical sac, vestibular posterior chamber, three semicircular bone canals) bone labyrinth. Blood vestibular apparatus is supplied with branches of basilar and anterior cerebral arteries, internal auditory artery. In the absence of any pathologies, vestibular activity occurs at a subconscious level, with lightning recognition of any changes in patterns of sensory influences. Not one person does not think about keeping a balance for running and walking, about the position of the eyes when jumping, bending and moving the head. All this for him instantly makes the vestibular apparatus. In the event of any dysfunction of modulation, generation or integration in this complex mechanism, there is an imbalance, dizziness, and perhaps nausea and even vomiting.
In its current, dizziness can be a transient and insignificant, or a persistent growing symptom of a person's serious pathological changes or disorders
Causes of dizziness are the damaged connections with the vestibular nuclei with the cerebellum, in the trunk, with the medial longitudinal fascicle, the cortex of the brain, the muscles of the body and neck, the nuclei of the eye muscles, and pathological changes in the vestibular part of the inner ear.
Allocate non-systemic and systemic (true) dizziness
– ощущение неустойчивости и чувство нестабильности окружающего пространства. Inconsistent dizziness is a sense of instability and a sense of instability in the surrounding space. This type of dizziness occurs in cerebellar and emotional disorders, damage to the visual analyzer, with pre-occlusive conditions
– иллюзия движения окружающих предметов или непосредственно самого тела человека в окружающем пространстве. Systemic (true) dizziness is an illusion of movement of surrounding objects or directly of the human body itself in the surrounding space. Systemic dizziness is accompanied by anxiety, increased sweating, blanching of the skin, nausea and vomiting. The true form is associated with the stimulation of certain regions of the vestibular analyzers, and is subdivided depending on the degree of damage to the central and peripheral vertigo (dizziness). The most common reasons for the development of true dizziness: various intoxications, degenerative and inflammatory processes of the organs of balance and hearing; disturbed blood supply to the inner ear, brain.
In the world neurological practice most often dizziness occurs with various emotional disorders, pathologies of the cervical spine and cerebrovascular diseases
. Emotional disorders . , различные невротические расстройства, простое переутомление и недомогание могут имитировать практически любую симптоматику болезней тела. Depression , various neurotic disorders, mild overwork and malaise can mimic virtually any symptomatology of the body's disease. In some cases, the only symptom is dizziness, noise / ringing in the ear, noise in the head. With these diseases, dizziness is accompanied by a pronounced fatigue, a continuous fixation of attention on your poor health, sleep and appetite disorders, increased anxiety combined with tearfulness and bad mood
. Pathologies of the cervical spine . On the shortage of blood supply, the vestibular system reacts quite sharply. Vestibular centers of the brain and the inner ear feed on blood from the system of vertebral arteries that run through narrow canals of the cervical spine. , травма или нестабильность шейных позвонков зачастую приводят к сдавливанию этих артерий, что ведет к дефициту кровотока и соответственно головокружению. Osteochondrosis , trauma or instability of the cervical vertebra often leads to squeezing of these arteries, which leads to a shortage of blood flow and, accordingly, dizziness. The main symptomatology for these diseases: shakiness and dizziness, which are intensified when the head tilts and turns; Reduced vision in the dark, ripples and / or "flies" in the eyes; discomfort and tension in the temples, lower back and neck; irritability and fatigue; accompanied by nausea, and sometimes vomiting, increased blood pressure
. Vascular lesions of the brain . With these pathologies, dizziness may occur as a consequence of atherosclerotic lesions of the arteries, or due to hypertensive disease. With a prolonged increase in arterial pressure, the small arteries of the brain are damaged, they become inelastic and narrow. As a result of such changes, the inflow to the brain of a person enriched with oxygen (arterial) blood decreases, leading to dizziness, noise / ringing in the ears and head. характеризуется отложением на внутренних стенках артерий выпуклостей – бляшек, которые постепенно перекрывают ток крови. Atherosclerosis is characterized by the deposition on the inner walls of the arteries of bulges - plaques, which gradually block the flow of blood. The most dangerous is the formation of such plaques in the arteries of the brain. In the case of cerebral circulation, dizziness is sometimes the first and only complaint
Dizziness occurs with the following diseases and processes:
, сифилис височной кости - Infectious diseases , syphilis of the temporal bone
- Diseases of the ear: otitis (chronic or acute inflammation of the middle ear), cholesteatoma, otosclerosis, neurinoma of the auditory nerve and the like
- Cerebrovascular diseases
- Craniocerebral trauma, trauma of the temporal bone
- Diseases of the cerebellum: a tumor, degeneration
- Diseases of the nervous system: Parkinson's disease, syringomyelia, multiple sclerosis
- Diseases of the cervical spine, Paget's disease
- Various intoxications: drugs, mercury, drugs, industrial solvents, alcohol
, анемии, злокачественные опухоли , метаболические нарушения, язвенная болезнь - Somatic diseases: atherosclerosis, hypertension, stroke, rheumatism, ischemic heart disease , anemia, malignant tumors , metabolic disorders, peptic ulcer disease
- Mental diseases
Diagnosis of dizziness
Since the list of disease states and disorders with vertigo is truly huge, to determine the exact cause of vestibular disorders, a comprehensive examination is required. First of all, the patient is shown the consultation of a neurologist and an otolaryngologist; if necessary, a therapist, a cardiologist, a vascular surgeon, an infectious disease specialist, and an oculist. The neurologist, in addition to an external examination for specific neurological symptoms, often assigns X-ray of the temporal bone, cervical spine, dopplerography of the main vessels, CT and MRI. The otolaryngologist examines directly the auditory and vestibular apparatus. Laboratory diagnosis is purely individual and is assigned on the basis of detected somatic diseases. Vertigo is a concomitant symptom of a very large number of diseases, so very often even after comprehensive examinations, its cause remains unclarified
Vertigo - treatment
Treatment of dizziness primarily depends on the underlying cause of the disease, and only after its diagnosis is the appropriate choice of treatment strategy. In case of occurrence of a giddiness on a background of a proceeding somatic disease, it is necessary to treat it first of all. Antihistamines (Diprazin, Cinnarizine), Phenobarbital, Metherazine, Torekan, Diazepines, Belloid, vasodilators (nicotinic acid, Tionikol) and diuretics are prescribed. In the presence of concomitant vertigo vomiting, injectively appoint Elenium or Seduxen. In the case of prolonged severe dizziness, the administration of neuroleptics (haloperidol) is indicated. To improve blood circulation, the reception of such vascular drugs as: Memoplant, Cavinton, Sermion
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