Vestibular Vertigo: Possible Causes, Symptoms, Diagnostic Testing, Diagnosis, Correction with Exercise, or Treatment Needed

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

Dizziness is a very unpleasant symptom that interferes not only with normal work and rest, but also with life. The state and sensations of a person at these moments are due to disturbances that are caused by the receipt of sensory information (for example, vestibular or visual) and its processing. What happens in this case? It is difficult for a person to navigate in space, it seems to him that all the objects around him are in motion, and sometimes that he himself rotates relative to fixed surfaces.

There are a lot of reasons for this pathology. For example, vestibular vertigo (VG) can be caused by malfunctions of the apparatus of the same name located in the human ear. It is this analyzer that is responsible for precise movements, a sense of space, vision and balance. And in view of the fact thatSince the vestibular apparatus (VA) is connected directly with the brain, then dizziness can also occur against the background of pressure surges, unrest and pain in the area of the heart muscle.

Why does a person feel dizzy?

Being in a state of balance allows a person to work the brain (in the cortex of which signals from the vestibular system are constantly received), and to be more precise, the impulses emanating from it and reaching the eye and skeletal muscles. In the event of certain failures in the receipt of such signals, a person begins to feel the rotation of the surrounding space, the swaying of not only objects, but also his body.

Vestibular vertigo symptoms

With vertigo, the patient complains that he is smoothly “carried away” to the side, he cannot stand straight (with his eyes closed), the earth simply “leaves from under his feet”, and all surrounding objects rotate in space.

Note! With any turn of the head, walking and standing up, the VG increases significantly.

In addition, there are other manifestations of pathology:

1. "Fog" in the head.
2. Nystagmus. Sudden jerky eye movements interfere with concentration. The patient can neither write nor read.
3. Man loses balance.
4. Sickening condition, sometimes turning into vomiting.
5. Sudden ebb or flow of blood from the skin.
6. Rather uncoordinated movements, manifested in an unsteady gait; inability to climb or descendstairs, as well as take any object in hand. That is, fast and precise movements with vestibular vertigo (vertigo) are simply impossible. The patient feels the fear of falling all the time, so he tries to be less "on his feet" and spend more time in bed.
7. Blood pressure can rise or fall.
8. Profuse sweating (i.e. hyperhidrosis).
9. May faint. The patient, as a rule, feels the approach of a pre-syncope state (that is, the moment of loss of consciousness). This manifests itself in increased sweating, darkening of the eyes, nausea and a feeling of fear.
10. Presence of general symptoms such as headache, changes in pulse and blood pressure, tinnitus and rapid breathing.

Important! If such manifestations are observed not against the background of vertigo, but on their own, then, most likely, this is a signal of the presence of a more serious pathology.

Classification of pathology

There are two types of dizziness:

1. Vestibular. It is also called vertigo, true or systemic. This type of dizziness and the vestibular apparatus are directly related. Violations in the work of the latter lead to vertigo.
2. Not vestibular. Other names for this type are non-systemic or physiological. This type of dizziness includes fainting, pre-syncope, as well as imbalance, which do not have a vestibular origin. They also include the sensations of the incomprehensiblecharacter, which is defined by such a word as "sickness".

Systemic pathology

There are two types of true dizziness (vestibular disorders):

1. Peripheral. Caused solely by pathology of the nerve or middle ear.
2. Central. Vertigo is caused by brain disorders.

Besides this, allocate:

1. Tactile (or tactile) vertigo, the main symptoms of which are sensations of swaying on the waves, unsteadiness of the ground, and lifting and lowering of the body.
2. Proprioceptive. Symptoms - a feeling of slow movement of your body in space.

Possible causes of systemic vestibular vertigo:

1. Vestibular neuronitis.
2. Post-traumatic condition after traumatic brain injury.

Note! Post-traumatic dizziness may not occur immediately, but some time after the injury (for example, after 5-6 days).

1. Ménière's disease.
2. Toxic damage to VA. The cause of this pathology may be the use of aminoglycosides accumulated in the lymph of the vestibular analyzer.
3. Paroxysmal positional vertigo of a benign nature. It can occur with a sharp change in the position of the body or head (that is, when bending forward, backward, and so on). Dizziness does not last long - the duration is a few seconds or about 1 minute. More often occurs in people whose age has exceeded 50. Moreover, in womenmore common than men.
4. Pathologies of the inner and middle ear of a chronic nature (for example, eustachitis, otitis or otosclerosis).
5. Vertebrobasilar insufficiency caused by a malfunction of the brain due to reduced blood flow.
6. Temporal lobe epilepsy. Symptoms of the pathology: nausea, excessive sweating, pain in the temple area; as well as loss of consciousness and even memory. In addition, there may be a disturbance of perception (i.e., taste, smell, touch, and so on) and hallucinations.

Note! Typically, temporal lobe epilepsy is diagnosed in childhood or adolescence.

1. Malignant neoplasms in the brain. There is an increase in intracranial pressure and, as a result, compression of the nuclei of the brain. As a result, a person experiences severe headaches and dizziness. There is also vomiting.
2. The causes of the development of vestibular vertigo can be diseases such as osteochondrosis and multiple sclerosis, as well as all kinds of neuroses.

Ménière's disease

This is a disease of the inner ear of a non-purulent nature. A characteristic sign of Meniere's disease is an increase in the volume of the endolymph, and, as a result, an increase in pressure inside the labyrinth.

Pathology manifests itself in the form of bouts of dizziness, which can last a few minutes, or maybe a whole day. At the same time, there is a loss of balance, vegetative disorders (they can persist ina few days after the vertigo has ended), noise in the ear, a feeling of increased pressure in it, vomiting and involuntary rhythmic eye movements (this symptom is called nystagmus).

Note! As the pathology develops due to a rupture of the membrane due to edema of the labyrinth (that is, the inner ear), hearing loss occurs (usually on one side). Most often, complete hearing loss is not observed.

Vestibular neuronitis

The disease can occur suddenly (sometimes after a viral or bacterial pathology, especially of the upper respiratory tract), last for several minutes or several hours, up to several days. Patients are quite difficult to tolerate vestibular neuronitis (or neuritis) and stay in bed for several days, as they are simply unable to get up and perform any actions. Pathology is accompanied by severe dizziness, vomiting, loss of balance, nystagmus, pronounced autonomic disorders, congestion in the ear, noise in it, and sometimes a feeling of fear. The rumor usually persists.

Note! Any change in the position of the body and movement of the head contributes to an increase in the manifestations of the pathology. By the way, statistics say that in 50% of cases of vestibular neuritis, attacks of dizziness recur after a few months or years.

Post-traumatic dizziness

As a result of a traumatic brain injury, the bone membranes of the labyrinth, which differspecial fineness, may be damaged. As a consequence, systemic vertigo occurs, accompanied by dizziness, sudden nystagmus, loss of balance and vomiting. Moreover, any sudden movement of the head leads to an increase in symptoms. The reasons for this condition may be:

1. Violation in the functioning of one of the labyrinths.
2. Longitudinal or transverse fracture of the pyramid of the temporal bone, resulting in damage to the eardrum or hemorrhage in the middle ear.

Dizziness of a non-systemic nature

Vestibular vertigo of a physiological nature can be caused by severe stress, motion sickness in vehicles, prolonged rotation, sudden changes in climate, overwork, malnutrition, loud noises or unpleasant odors. The cause of the disease is a mismatch in the activity of the vestibular analyzer at different levels of the nervous system.

Note! If you feel dizzy and nauseous during long car (or bus) trips, that is, you feel sick, then it makes sense to carry a few mints or tablets of a drug like Vestibo with you.

Diagnosis of disturbances in the work of the vestibular analyzer

First of all, to confirm the fact of the presence of vestibular vertigo, the neurologist must carefully listen to the patient, without prompting him with any terminology and without offering it to choose from. During the conversation, the specialist must understand whether we are talking about vertigo or another disease that will alsoreveal.

Next, the patient undergoes a neurological examination, and the doctor sends him for laboratory tests. This refers to a clinical study of blood. If necessary, a neurologist can give a referral for a consultation with such specialists as a vestibulologist or an otoneurologist. You may need an examination of the cervical spine, that is, MRI, X-ray and CT. In some cases, to exclude diseases such as epilepsy or paroxysmal dizziness of a benign nature, an EEG of the brain is prescribed. In addition to all these diagnostic measures, studies of the vestibular analyzer can be carried out, namely stabilography, rotation tests and vestibulometry.

Treatment of dizziness

Treatment of vestibular vertigo should be aimed solely at relieving the patient of neurological disorders and very unpleasant sensations. To do this, they can be assigned:

1. Medications of the histamine mimetic group, for example, Vestibo, which improves blood flow in the brain and properly stabilizes intralabyrinthine pressure. Also, the tool helps to cope with gag reflexes and has a positive effect in terms of the transmission of impulses along the nerves of the vestibular analyzer.
2. Medications of the benzodiazepine group, such as Relanium, after which all the symptoms characteristic of this pathology disappear.

Important! Remember: Relanium is highly addictive. Be careful and takeonly on prescription (as, indeed, all other medications).

1. Treatment of vestibular vertigo involves mandatory control of blood pressure levels.
2. Taking nootropics, antiplatelet agents, vasodilators and venotonics.
3. Anti-epileptic drugs if needed.
4. Medicines of the antihistamine group (for example, Meclozine or Promethazine) give a good effect.
5. To reduce feelings of fear and general anxiety, tranquilizers are prescribed (for example, Lorazepam or Diazepam).
6. Metoclopramide relieves the exhausting nausea.
7. How to treat vestibular vertigo in Meniere's disease? A good result is obtained by taking a drug such as Betahistine, which promotes the expansion of the vessels of the inner ear and improves its microcirculation. If taking this drug (or some others of this group) does not give positive results and vertigo continues, then the option of surgical intervention is not ruled out. By the way, in the presence of Meniere's disease, patients are recommended to limit the use of coffee and s alt, as well as completely stop smoking.

Important! Betahistine is generally well tolerated. But remember: those who have diseases such as stomach ulcers, bronchial asthma or pheochromocytoma should treat it with caution. Under no circumstances should this drug be used by pregnant women.

1. If necessary, antiviral drugscharacter.
2. If a patient has paroxysmal positional vertigo of a benign nature, the use of any drugs that affect the activity of the vestibular apparatus depressingly, experts consider it inappropriate. But taking drugs that irritate VA can give good results in therapy.
3. For pathologies in children, drugs such as Betahistine or Cinnarizine can be prescribed.
4. Do not forget about non-drug treatment, with which you can restore normal coordination of movements. The therapy is carried out in collaboration with a psychotherapist. Sometimes anticonvulsants and antidepressants are prescribed.

Important! Do not self-medicate. Only a doctor, after a thorough examination of the patient, can prescribe the correct and adequate treatment.

Traditional medicine in the fight against vertigo

In folk medicine, there are many recipes for dealing with vestibular vertigo. Here are some of them:

An excellent recipe that helps cleanse blood vessels and improve blood circulation in the brain. We put a handful of fresh needles in a thermos (by the way, you can even with twigs), pour boiling water (1 liter) into it, close it and leave it to infuse overnight. In the morning we filter, add chopped lemon and insist another 2-3 hours. The entire infusion should be drunk during the day (the next day we prepare a new mixture). Moreover, it is necessary to take a healing drink either 60 minutes before a meal, or 1 hour after a meal. The course of therapy is 10 days

1. Tea with leavesmint and chopped ginger root. You have to take it twice a day. The course of therapy - until the disappearance of the disease. We prepare tea as follows: pour mint leaves (10 g) and ginger root (20 g) with boiling water (200 ml), leave for 10 minutes and drink warm.
2. Tincture of meadow clover inflorescences. Helps to deal with disorders of the vestibular apparatus (dizziness in particular). Pour clover flowers (40 g) with alcohol (you can also use vodka), insist 7-8 days in a dark place. Take three times a day, 1 teaspoon (after meals).
3. A good result is given by seaweed, which should be consumed every day, 1 teaspoon.
4. Decoction of meadow clover. Pour the flowers of the plant (1 teaspoon) with boiling water (1 cup), close the lid and boil over low heat for about 5 minutes. Then remove, cool, filter and drink 4 times a day for a tablespoon.
5. Infusion of dry leaves of the Siberian prince plant. Pour dry raw materials (5-6 g) with boiling water (1 cup), insist for 60 minutes, filter and take ½ cup 2-3 times a day.
6. You can breathe in peppermint, rosemary or camphor oil for 5-7 minutes to reduce vertigo, and sometimes even get rid of it.
7. Eat more phosphorus foods. These are walnuts, fish, eggs, cheese, cucumbers, peas or radishes.

Important! Folk recipes can give positive results if the pathology is caused by functional disorders that are rare and short-lived. Ifthe disease is organic in nature, then you should consult a doctor. Only he can conduct a competent diagnosis and determine the cause of the disease. Do not self-medicate. You may lose precious time.

Exercise for vestibular disorders

Sometimes, with dizziness, gymnastics for the vestibular apparatus can give positive results in the fight against the disease:

1. In the morning, immediately after sleep, we perform torso tilts to the left, right, back and forth. We do about 14 approaches, alternately with open eyes, then with closed ones. In order for vestibular gymnastics with dizziness to give tangible results, it must be done every 2-3 hours.
2. Trying to look in different directions. Such actions help to concentrate visual attention and to some extent cope with nystagmus.
3. Draw lines (for example, on the ground). They can be straight or curved. We try to walk through them first with our eyes open, and then with our eyes closed. Similar exercises for vestibular vertigo help to significantly reduce the manifestations of the disease.
4. We take a tennis ball and throw it from hand to hand (eyes are open). We do this for about 5 minutes. We repeat the exercise, but with our eyes closed.

Note! Along with vestibular gymnastics, with dizziness, you can perform a massage of a point located at a distance of 2/3 from the upper lip to the nose. Massage it with your thumb, lightly pressing. These actions will help alleviate your condition.