Dizziness (Vertigo): About the causes, diagnosis and treatment

21 October 2017

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Do you know that? They lie in bed in the morning, then stand on relatively quickly and suddenly you dizzy. You have the feeling that the whole world around you would rotate. You need to sit down again. Sometimes nausea and dizziness is added in addition to dizziness.

Then you are not alone: ​​The unpleasant feeling of dizziness probably know most from personal experience. The dizziness can occur in different ways. Some complain, for example, especially when lying down or standing up about sudden vertigo attacks, others it is constantly dizzy.

The causes of dizziness are diverse and can be quite harmless: Especially children know and love as the momentary dizziness after a carousel ride - which results every now and then even to the point of nausea. Also tensions come as a cause of dizziness in question, often accompanied by back or neck pain. 

About 60 percent of vertigo can be Not attributed to a disease and disappear after some time by itself but it can also happen that the dizziness signs of disease are -. at about Meniere's disease or a Inflammation of the vestibular nerve. If you constantly dizzy, you should seek medical attention. 

Dizziness is not a disease in itself, but "just" Symptom. Dizziness - fachsprachlich Vertigo - is when the person perceives apparent movement between themselves and the environment.

The term dizziness is often found also in the wider sense Use: So many people say that they did dizzy when they

If those concerned here, however, perceive any apparent movement - the main feature of vertigo - it is not a true vertigo, but a so-called Pseudovertigo (Greek. Pseudo = false).

In vertigo it can on the one hand a normal response of the body act - for example when driving carousel or has excessively drunk a lot of alcohol - on the other hand dizziness can also The context of a disease occurrence.

Therefore, as causes of dizziness or vertigo many different triggers are eligible, such as

Generally speaking arises dizziness, when the eyes, the receptors in the muscles and the organ of balance perceive different stimuli in the inner ear. About such inconsistencies arises in the brain the information that something out of the "balance" is. 

An example: During a rapid carousel ride our eyes follow the scurrying objects - that is, the visual system detects rotation and reports it to the brain. The balance organ in the inner ear, however, finds no change in motion at a constant rotation. Due to this discrepancy leads to dizziness.

In addition, the psyche or the brain itself can produce such misinformation, for example, damage to the balance nerve.

Some patients complain about especially in the morning when getting up, turning the head or the Up or Down Look short vertigo, the rarely last more than a minute. the violent vertigo is often accompanied by nausea to vomiting. This harmless, though extremely unpleasant form of fraud is called in medicine Benign paroxysmal positional vertigoThe reasons for this are probably small crystals that irritate the sensory cells in the semicircular canals of the inner ear.

Even in pregnancy (especially in the first six months) may from time to time come to circulatory problems and dizziness again. This is due to the hormone progesterone, which causes that dilate the blood vessels and blood pressure drops.

Especially at the beginning of pregnancy some women may occasionally be dizzy. This is because falls faster by changing blood flow and hormonal changes in blood pressure. © iStock

Especially at the beginning of pregnancy some women may occasionally be dizzy. This is because falls faster by changing blood flow and hormonal changes in blood pressure.

Depending on whether related causes for fraud with the organ of balance or not, a distinction

When vestibular vertigo causes directly or indirectly to the Equilibrium system together. This can both the organ of balance in the ear (the inner ear or labyrinth) and the center of equilibrium or balance nerve in the brain relate. 

Vestibular vertigo with peripheral causes occurs most frequently to as:

A vestibular vertigo with central causes is, for example, at a particular form of migraine attacks (so-called. vestibular migraine) in front. Often, vascular, inflammatory or degenerative (that is, with degradation or loss of function associated) diseases of the brain behind a Vertigo: For example, circulatory disorders in the brain (for example, by atherosclerosis or stroke), multiple sclerosis, Parkinson's disease and tumors cause dizziness. In addition, a vestibular dizziness can occur as a result of accidents (e.g. during traumatic brain injury).

But not only for diseases and injuries vestibular vertigo occurs. As causes of dizziness and some come drugs being: Thus, for example remedy for high blood pressure, depression, epilepsy and migraine, tranquilizers (sedatives), and certain antibiotics (from the group of so-called aminoglycosides.) Vertigo as a side effect cause. In addition, alcohol and drugs can temporarily paralyze the central control of balance and so cause those affected dizzy.

As dizziness causes disturbances are suitable which nothing to do with the balance system have: Such non-vestibular vertigo can its causes in the variety of diseases have - for example:

Also, a low blood sugar (or sugar) may cause dizziness - Possible reasons for this insufficient food intake or diabetes mellitus be. Furthermore, can result in a non-vestibular vertigo, for example, due to insufficient liquid absorption, high fever, and inadequate oxygen supply.

Dizziness occurs not only in physical Disturbances, but can also psychological causes have: Such psychogenic dizziness may be caused for example by stress, conflict or anxiety. is a typical example of emotionally induced Vertigo phobic postural vertigo: This (V. A. in younger adults spread) Schwindelart arises primarily in certain situations - like driving a car, while running over a bridge or a wide area, climbing stairs, you enter an empty space or by special social and communication requirements (for example, if one is to make a speech in front of many people).

This real vertigo solves almost always accompanying symptoms from: The perceived illusory movements result in a full-blown vertigo attack to the fact that those affected unsure when standing and walking are plus tend to fall. Other possible symptoms of vertigo are

Sufferers are often pale and sweating. In addition, a fraud can with a Trembling of the eyes be connected, in which the eyeballs twitching spontaneously and rapidly in succession due to impaired function of the eye muscles (so-called. nystagmus).

are in the various forms of dizziness not all symptoms equally pronounced. Dizziness may both temporarily (Episodic) and occur ongoing show (chronic) gradients. In this case, the individual vertigo attacks either by itself (spontaneous) or arise by appropriate stimuli.

Value suffers frequent dizzy, you should definitely see a doctor. The doctor can determine if the dizziness was caused for example by a brain disorder caused by damage of the vestibular system in the ear or some other disease.

Depending on how the person concerned is itself carrying out the fraud and how long the symptoms can be various forms of vertigo differ. This distinction is important for the doctor so that he can find out the cause of the dizziness. The question of strengthening the dizziness what factors, helps the physician in the diagnosis.

The most important diagnostic criteria for vertigo are:

Prerequisite for the proper treatment is a correct diagnosis. Only when the doctor knows what causes are responsible exactly for fraud, he can take appropriate action.

For example, if infected sickness behind the dizziness, it is often sufficient, at regular intervals take a break. In the long term it can also help if you gently repeated at short intervals expose the appropriate stimuli then. However, this habituation effect only temporary and for certain movement sequences. Therefore, an acquired insensitivity to the driving, for example, does not protect against seasickness.

In addition, are used to treat a certain sickness Medicines for Vertigo (Or antivertiginous) suitable: These help against dizziness and against the often simultaneous nausea. are used

Even if an example Meniere's disease or one Inflammation of the vestibular nerve (Vestibular neuritis) is behind your dizziness, can for therapy temporarily antivertiginous are used to reduce nausea and vomiting. But because mend only the symptoms - the causes the balance disorder characterized disappear Not.

Important: These preparations should not more than three days are given. In many forms of vertigo antivertiginous are also completely unsuitable for treatment - especially for long-term treatment.

Depending on the cause of the dizziness but can other medicines help: For example, if a vestibular migraine is responsible for your dizziness, are for therapy Remedy for migraines and migraine prevention suitable. As a preventive drug of first choice beta blockers apply (such as metoprolol succinate), which are to take about six months.

Often are physiotherapy an important part of dizziness therapy. So heal example, a persistent dizziness in inflamed balance nerve and a benign (benign) paroxysmal positional vertigo by physiotherapy exercises much faster. The exercises solving attitude uncertainties and thus require corrective movements: the physiotherapy is thus aimed at improving your balance reactions by constantly causing stance and gait uncertainties yours.

If the vertigo attacks especially frequently or for years occur while your hearing restricted , may for a surgical treatment come into consideration (the surgeon can remove, for example, the affected organ of equilibrium). However, since many diseases associated with dizziness, have a good prognosis and therapy without cure (which can be promoted by appropriate physical therapy), such operational measures are a exception.

There are several positional maneuver to combat the symptoms of the benign paroxysmal positional vertigo. The crystals to be dissolved in the portico of the inner ear by certain turns of the head and upper body, which are considered cause for this dizziness lying down or getting up. 

Studies have shown that the maneuvers by Epley and Semont maneuvers are most effective. Both techniques can be - even independently perform at home - after careful guidance of a doctor. In this case, repeat the exercise several times a day to freedom from illness sufferers. The success rates are 50 to 90 percent after only one week.

In hoax of course depends on Why it comes to the dizziness. If it is possible, the causes of dizziness caused by an appropriate treatment remove, The prognosis is usually Good. A permanent vertigo that lasts for months or even years, often has a psychological trigger going, and he rarely arises as a result of a disease which is important for the balance organs.

A vertigo you can Not prevention - especially if the dizziness occurs as a side effect of a disease of the nervous system. Preventive measures are limited to to deal with vertigo related diseases according and thus to prevent further attacks of vertigo.

If you in unfamiliar movement situations - such as in a car or on a boat - prone to dizziness, you should try to gradually get used to the new environment.


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