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Myths About Dizziness – The Truth Behind Two of the Most Common
Myth: My head is spinning; I must have had a stroke
Truth: There are many causes of vertigo, and not all of them are life-threatening
Benign positional vertigo (BPV) is the most common cause of vertigo. It occurs when tiny crystals in your inner ear – the ones responsible for balance – break free and float in the inner ear fluids. When the head moves in certain positions, these floaters tickle the balance cells, causing transient dizziness.
There are other causes of dizziness. Labyrinthitis is an inflammation of the inner ear caused by a viral infection or other causes. Its symptoms, which include dizziness, usually last for a few hours and then subside.
Meniere’s disease is another cause of vertigo. Although the causes of this condition vary, symptoms include a buildup of excessive fluid in the inner ear, which causes pressure. This results in hearing loss,
ear congestion and debilitating recurring dizziness that can last for hours.
So how can you tell what’s causing your dizziness? If you have BPV, you are likely to experience spinning-around-the-room dizziness that occurs when you look up, down, or turns over in bed and lasts for a few seconds.
Labyrinthitis is characterized by severe dizziness with nausea and vomiting that lasts for hours. There is usually no hearing loss or other ear symptoms, and the attack may be followed by weeks of unsteadiness or temporary dizziness when tossing and turning in bed.
Meniere’s disease is accompanied by repeated attacks of dizziness, possible nausea and vomiting lasting 30 minutes to hours. Meniere’s disease is usually accompanied by hearing loss, pressure in the ear, and noise or ringing in the ear.
Fortunately, all of these conditions can be successfully treated. BPV is treated in the office, where a vestibular therapist performs a maneuver called the Semont maneuver that moves the crystals away from the balance cells. Ninety percent of patients with vertigo are cured by this treatment, which occasionally needs to be repeated.
Labyrinthitis is treated with oral medications to reduce the feeling of dizziness and with fluid replacement for any associated nausea and vomiting. In severe cases, hospitalization is required to administer drugs intravenously until symptoms subside.
Meniere’s disease is treated with a variety of medications and surgical procedures, all designed to reduce the frequency of vertigo attacks. Among the drugs used to treat Meniere’s disease are diuretics, circulation drugs, sedatives, and steroids
Despite these possible causes of vertigo, a stroke cannot be ruled out, as it is also a cause. A stroke occurs when the blood supply to the brain is interrupted and the brain cells are deprived of oxygen. There are several symptoms of a stroke, including:
o sudden onset of dizziness or vertigo;
o difficulty walking or loss of coordination;
o numbness or weakness of the face, arm or leg;
o speech difficulties; and
o severe headache.
If any of these symptoms appear suddenly, the person should be taken to the emergency room immediately for evaluation and treatment. Every minute that the brain is deprived of oxygen increases the potential for brain damage, so it’s imperative that emergency physicians see stroke cases immediately.
Myth: My balance is bad because I’m getting older and I’ll have to live with it
Truth: Age is not a factor in maintaining healthy balance function
Your balance mechanism works like a tripod. The three arms of the tripod are conduits for inner ear balance, vision, and sensation from the joints and muscles in your legs and feet. Sensory messages from the three sources are sent to the brain, where they are organized into meaningful information. Based on this information, your brain then sends new messages – instructions to your muscles to maintain balance.
There are many causes of dizziness and imbalance. Confused messages, blocked message pathways, or weakness in the brain or tripod limbs can cause imbalance. Other possible reasons include:
o lack of circulation in the area of the brain for balance,
o drop in blood pressure when you go from sitting to standing (orthostatic hypotension),
o disorders of the inner ear,
about vision problems,
about bone and joint disease,
o side effects of drugs and
about drug interactions.
In addition, irregular heartbeat or heart conditions and neurological diseases can cause lightheadedness, dizziness, or imbalance.
But most balance problems result from dysfunction of the balance channels of the inner ear. And the dysfunction of two arms of the tripod at the same time makes it even more difficult to maintain balance.
In order to correctly diagnose the cause of your vertigo, you should see an ENT doctor. This evaluation includes specialized tests that measure inner ear and balance function. In some cases, it may be necessary to consult a neurologist or other medical specialist.
You can notice some basic symptoms yourself and share them with your doctor, helping in the diagnosis process:
o If your imbalance occurs only briefly when getting out of bed or standing up from a sitting position, this may be due to a transient drop in blood pressure.
o Unsteadiness or imbalance only when walking can be related to problems in the balance center in the brain or the balance channels in the inner ear.
o Vision problems can also be a cause of dizziness or balance disorders.
Sometimes there are multiple causes of vertigo, which may require more specialized treatment. But in most cases, vertigo and imbalance can be treated by starting vestibular rehabilitation (VR).
VR is an individualized program of home exercises and activities designed by a therapist specializing in balance disorders. Before starting VR, your musculoskeletal system will be assessed by testing strength, coordination and range of motion in your arms and legs. The therapist will also observe your balance while walking.
With this information, your therapist can design a program to meet your specific needs. Your progress is then monitored at regular check-ups.
The goal of VR is to reduce dizziness and increase balance function, improving overall daily activity levels. Remember, age is not a factor in maintaining healthy balance function!
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