Causes, symptoms and treatment of systemic vertigo

In this article we will look at the symptoms and treatment of systemic vertigo.

Numerous manifestations of this pathology require precise classification. This is explained by the fact that people understand dizziness as different sensations, often very subjective ones; not in all cases there are informative descriptions. According to the generally accepted classification, there are two types of illness: systemic (vestibular, true) and non-systemic (that is, non-vestibular). This article will discuss systemic vertigo and its features.

How does dizziness feel?

Anyone who has experienced dizziness knows exactly how it manifests itself - it is very reminiscent of what a heavily drunk person experiences. Suddenly you get the feeling that you’ve been spun around by a tornado; everything around you seems to start spinning and losing its outline, blurring.

The person is disoriented, cannot stand on his feet, and may even feel nauseous. In medicine, this condition has a scientific name - vertigo. It is caused by a disorder of the vestibular system, but what causes this disorder remains to be seen.

Causes of dizziness and loss of balance

Since these sensations are just symptoms, you need to know what diseases they may be accompanied by.

Here are the main assumptions that a doctor is likely to have:

Concussions and head contusions, even those received a very long time ago, which can remind you of themselves for many years with dizziness. Injuries to the eardrum, also barotrauma (that is, caused by increased pressure in the ears, for example, when coughing or deep immersion in water). Viral and cold diseases in the acute stage and previously suffered, after which sluggish inflammation in the middle part of the ear canal could remain. Such causes of dizziness are called labyrinthitis. Intoxication of the body due to poisoning with heavy metals, chemicals, food, alcohol, drugs. Benign positional paroxysmal vertigo (BPPV) occurs equally in children and adults and manifests itself when the head tilts or the body position changes. Brain tumors. Meniere's disease is an accumulation of fluid (endolymph) in the cavity of the inner ear. Pathologies of the cervical spine (osteochandrosis, spondylosis). Paroxysmal conditions (migraine, epilepsy). Diabetes. Diseases of the heart and blood vessels, as a result of which normal blood flow is disrupted, including hypertension, ischemia and pre-stroke condition.

These are the most likely causes, which are accompanied by dizziness (vertigo) and balance disorder (ataxia).

Dizziness as a symptom of heart disease

The heart is a very important organ. It pumps oxygenated blood and delivers necessary substances to the liver, lungs, kidneys, and brain. Thanks to the good functioning of the heart, the entire body can function without failure. Therefore, it is so important to diagnose problems in the functioning of this organ in a timely manner.

Dizziness and loss of balance are often the first sign that your heart needs attention. The presence of the described signs may indicate vascular disease, cardiac arrhythmia or developing heart failure. They cannot be ignored, as these pathologies are fraught with disability.

If the blood pumped by the heart does not flow well to the brain stem, causing dizziness and disorientation, there is a danger that a brain stem stroke will develop.

Depending on the type of lesion, it can be hemorrhagic or ischemic. In a large percentage of cases, ischemic stroke is fatal. It develops against the background of atherosclerosis, a chronic disease of the arteries caused by metabolic disorders.

Arrhythmia is another serious cardiac disorder that manifests itself as an increase in heart rate. The heart either stops or beats furiously, then dizziness appears and control over balance is lost, even to the point of fainting.

Vertigo and ataxia may indicate the presence of other abnormalities in the heart, such as bradycardia, tachycardia, pericarditis, angina pectoris and extrasystole, as well as myocardial infarction. We can say that almost all cardiovascular diseases at various stages are accompanied by dizziness and loss of coordination.

Diagnosis of dizziness

If you often experience a feeling of dizziness, you need to contact a neurologist or therapist who, depending on the identified cause, will refer you to an appropriate specialist, for example, an otorhinolaryngologist or endocrinologist.

The neurologist mainly prescribes vestibular tests (caloric test, rotational tests), as well as posturography - a study of the interaction of the visual, vestibular and muscular systems in ensuring balance.

To diagnose a possible disease of the hearing aid, pure tone threshold audiometry and acoustic impedance measurements may be needed.

To find out the condition of the blood vessels, computed tomography or ultrasound examination is prescribed.

Electroencephalography (EEG) may also be prescribed.

Diagnosis - how to determine the cause of dizziness and loss of balance

Only a doctor can correctly identify heart disease that causes dizziness. You can start with a therapist. He has at his disposal a whole arsenal of studies that will help to see the picture of the disease not only by external symptoms, but also by those signs that are not visible at first glance.

Based on his assumptions, the doctor may prescribe you:

ECG, X-ray, CT of the heart, MRI of the heart, angiogram (examination of blood vessels using a contrast agent), additional special tests.

You should not be afraid of the examination - it is painless, but after it you will not have to doubt why your head is spinning. If necessary, the doctor will additionally refer you to his fellow specialists.

Prevention

To get rid of frequently occurring systemic and non-systemic dizziness, you need to follow the following recommendations from professionals:

• Do not smoke and give up alcoholic beverages.
• Eliminate table salt from your diet.
• Minimally reduce your daily caffeine intake.
• Do daily exercises, especially when working sedentarily.
• It is best to work in moderation and relax in nature, especially near bodies of water.
• Eat foods that contain many vitamins.
• Avoid stressful situations.
• Do not move your neck or head abruptly.
• If you travel frequently and experience motion sickness in transport, you can use special means.
• If possible, purchase an orthopedic mattress that has an anatomical effect, since the body completely relaxes on it during sleep, rest becomes more complete. It should be noted that thanks to such mattresses, pinching and bending of blood vessels is prevented.

Treatment

Since these signs are only symptoms of heart disease, treatment should be aimed at combating their cause. Having made a diagnosis, the doctor will recommend treatment that is right for you. Naturally, it will differ in each individual case.

To improve your well-being, the doctor may prescribe sedatives (Sedavit, Andaksin), antihistamines (diphenhydramine, pipolfen), and, if necessary, anti-nausea medications (cerucal, metronidazole).

If you experience severe dizziness, you need to lie down in bed, let fresh air into the room, you can take 10 drops of a 0.1% atropine solution.

At home, the following will help relieve “lightheadedness” from dizziness:

Ginkgo biloba tincture. Juices from pomegranate, carrots or beets. Tea with lemon, ginger, linden, mint, lemon balm. You can grind parsley seeds, pour 1 teaspoon of boiling water into a 200-gram glass, leave for at least 6 hours and take a couple of sips throughout the day. You can buy seaweed powder at the pharmacy. The trace elements contained in it will help improve the functioning of the vestibular apparatus.

If you experience frequent dizziness, it is important to find your own saving method. In addition, you should completely reconsider your regime and your physical activity.

In any case, dizziness and its treatment should not be left to chance. The above are the auxiliary remedies, and to eliminate the cause, visit a doctor.

Folk remedies for dizziness

Treatment of dizziness with folk remedies is often not inferior to, and sometimes even superior to, traditional medicines, because they have minimal side effects, unlike medications. But even here it is worth mentioning that even taking traditional medicine must be done after consultation with your doctor.

Read also Vitamin B5 (Pantothenic acid). Functions, sources and uses of pantothenic acid

Consider folk remedies for dizziness:

Carrots and beets. You should take carrot and beet juices on an empty stomach.

Parsley. 1 tsp. Pour 200 ml of water into the ground parsley seeds. Leave the product to infuse for 6-8 hours. Consume in small portions throughout the day.

Clover. 1 tbsp. l. Pour 200 ml of boiling water over clover inflorescences. Drink after lunch and dinner.

Pomegranate. Pomegranate perfectly raises hemoglobin levels, thereby improving blood circulation, and as a result, eliminates or minimizes the manifestations of dizziness.

Linden, mint and lemon balm. 1 tbsp. l. a collection of linden inflorescences, mint and lemon balm, pour 200 ml of boiling water. The product helps to calm frequent dizziness. Drink after lunch and dinner.

Sea kale. Sea kale powder (sold in pharmacies) is excellent as a preventive remedy for dizziness, as well as for frequent occurrences of it. It will saturate the body with microelements responsible for the normal functioning of the vestibular apparatus - iodine, phosphorus, etc. Sea kale can also be purchased in grocery stores.

Ginger tea. In addition, traditional healers recommend taking ginger tea for dizziness.

Dizziness itself is not life-threatening, but it can indicate serious health problems. Therefore, if such attacks and headaches begin abruptly and are accompanied by speech disturbances, weakness and numbness of the limbs, then it is necessary to immediately call an ambulance.

Risk factors and prevention

Factors contributing to the development of heart and vascular diseases may include:

Congenital heart defects. Hereditary diseases of the cardiovascular system. Sedentary-lying lifestyle, low physical activity. Adverse habits such as alcohol and nicotine addiction, overeating and poor nutrition, lack of sleep. Stress loads. Colds and viral diseases suffered “on your feet”.

To prevent such heart pathologies, you should lead a correct lifestyle:

Avoid alcohol abuse, smoking, drugs, drug addiction. Exercise. Watch your diet: it should be balanced. Sleep consistently 8 hours a day. Visit your doctor promptly if you experience dizziness with loss of coordination and other symptoms. Avoid stress and overwork. Spend a lot of time outdoors.

When can you do without the help of a doctor?

You can do without the help of a doctor only if you regularly monitor your health, take a general blood test, monitor your blood pressure numbers, and know for sure that nothing threatens your life (as is the case with oncological causes of dizziness). You also eat right, and regularly engage in moderate exercise, walking in the fresh air, and in general, lead a healthy lifestyle, which normalizes periodic dizziness. In this case, the person knows about the true causes of dizziness, and he can cope with them by going to a massage therapist or taking a course of iron supplements, for example. If dizziness does not go away, then perhaps it would be unnecessary to talk about the need for urgent consultation with a doctor, this is already understandable.

Serious physical exercises, including breathing exercises, massage can be beneficial for dizziness, but it is also necessary to remember that they can be dangerous in case of high blood pressure, previous myocardial infarction, glaucoma, high degree of myopia, high temperature, in the acute stage any disease. If you have these conditions, then urgent consultation with a specialist is necessary.

We also recommend: Exercise therapy for osteochondrosis

When physical activity and the normalization of work and rest do not help you much, then you need to remember about drug treatment for dizziness. Self-medication is very dangerous here; you should consult a doctor to prescribe medications.

Forecast

Unfortunately, sometimes dizziness and loss of balance remain with a person for life. Of course, there is nothing pleasant about this, but it is possible to learn to live with such symptoms. Each person's body is individual, but everyone can adapt.

In most cases, once the cause is eliminated, the symptoms go away.

Remember a few takeaways:

Dizziness is not a disease, but a symptom of a disease. Self-medication is unacceptable; it is important to consult a doctor. There is no need to listen to friends and grandmothers on the bench, because these signs accompany several dozen diseases. Only a specialist can help you. Prevention is something you can do ahead of time, without consulting your doctor. This is the best protection against heart disease. Take care of your health, and your head will only spin with happiness!

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Sudden dizziness is a condition characterized by a false sensation of rotation of one’s body or objects around, as well as the illusion of losing one’s point of support. It is often accompanied by weakness, imbalance, nausea, darkening of the eyes, and slowing (increasing) heart rate.

The reasons for this phenomenon lie in a failure in the system for controlling the position of the body in the surrounding space. It consists of the vestibular apparatus, visual analyzer and muscle receptors. Its functioning is coordinated by the brain.

There are many types of dizziness. But to understand its premises, the most significant is the classification into peripheral and central . The first is associated with diseases of the vestibular apparatus, and the second with pathologies of the brain and systemic ailments. In addition, there are a number of physiological reasons that lead to a short-term feeling of weightlessness.

How I cured dizziness: after many years of ordeal, forty minutes was enough

To begin with, coming out. I get dizzy from time to time. Quite a long time ago, about twenty-five years. It spins when you tilt it up. Or, conversely, when you look down. Or in a dream, when you roll over to the other side.

This kind of bullshit comes on unexpectedly and lasts from several days to a month. Gradually the dizziness stops and may not occur again for a whole year. Or two years. Or three. There is no system in her behavior. I don't know why it starts and why it stops.

Many times I tried to find out why she was spinning and how to treat her. I went to different specialists. I can’t remember all the doctors I’ve visited in my life. But those whom I have worked with over the past five or six years have definitely been good professionals.

All of them conducted consultations in public and commercial clinics and medical centers. Real doctors, not paramedics. Someone was recommended to me. Having saved up money, I went to someone myself, deciding that I could trust him since he worked in an expensive and prestigious medical institution, because they wouldn’t hire a bad specialist there.

I do not mention the names of medical centers here so as not to create anti-advertising for them. But, believe me, they are all very worthy, famous and have been working in Moscow for many years.

If you feel dizzy, you need to go to a neurologist - this is what I was told in any clinic. And the therapist also always referred me to a neurologist. That's why I went to neurologists.

Neurologists examined me very carefully. They tapped me with hammers, laid me down, kneaded me, sent me for an ultrasound of the neck vessels, an MRI of the brain and upper spine, and demanded that I take all sorts of tricky blood tests.

According to the results of the research, on which I spent about ten thousand each time, if not more, it turned out that I, of course, had osteochondrosis. The vertebrae in the neck are misaligned from computer work or perhaps from a birth injury. Because of this, some vessels in the neck are pinched and the blood supply to the brain is disrupted. And my head is spinning.

Neurologists wrote terrible diagnoses in their reports. And some kind of encephalopathy, and something vascular, and something vegetative-vascular.

I was upset, of course. “Unfortunately, the vertebrae cannot be moved back,” the kind neurologists reassured, “it will get worse with age. High blood pressure, stroke, you are at risk. But now we will treat you, and you will feel better. In general, you need to sit at the computer less, sleep more, walk, relax, therapeutic exercises and the pool, swimming is very useful for you.”

The treatment from all the doctors was the same - ten days of drips with some kind of blood-strengthening drugs, plus massage, chiropractor, acupuncture, physiotherapy and therapeutic exercises. Either all together, or something to choose from. But in any case it cost a lot of money.

One time I decided to limit myself to IVs. After a month, my head really stopped spinning, but before it stopped even without IVs, so I didn’t have much faith in such treatment.

Another time, I had fat insurance that paid not only for IVs, but also for procedures. “Any whim for your money,” said the neurologist, writing out a thick stack of referrals, and for three weeks I went to this medical center as if it were work. Dropper, electrophoresis, magnets, massage, unscrewing the head with a manual, needles. The dizziness, however, became even more dizzy and only stopped after my treatment stopped and about a month passed again.

I must say that a long time ago - probably ten years ago - I casually told my friend about the head. She graduated from a medical institute in Moscow back in Soviet times. Then she went abroad and works there as an ordinary general practitioner. “How do you get dizzy—like on a ship or like on a carousel?” - she asked immediately. I said it was more like a carousel. “Go to the earworm,” she advised. In our youth, the otolaryngologist was called “Ear-throat-nosed”. A friend explained that the dizziness was due to the crystals in her ears. Somewhere I found them in the wrong place, and the earworm will return them to the right place with basic manipulations. They can do it, it's not difficult.

While hanging around neurologists, I sometimes remembered this strange advice and one day I decided to follow it. I went to see an otolaryngologist of the highest qualifications, in a paid reputable clinic with an excellent reputation.

Here, I say, my head is spinning. Put the crystals in my ears back in their place.

A highly qualified otolaryngologist looked at me like I was a fool who had fallen from the sky. She had never even heard of crystals. “With dizziness, see a neurologist. You came to me in vain.”

This is where my relationship with the “ear-throated noses” ended. And the progress with neurologists continued to be sluggish.

***

A couple of months ago - at the beginning of summer - I didn’t feel dizzy at all. And I haven’t been spinning for so long that I forgot to even think about it.

Without any connection with my head, I decided to fulfill an old dream - I signed up for “easy swimming” courses in order to learn how to swim long distances in open water and eventually swim across the Volga at its widest point, or even the English Channel.

Contrary to the assurances of neurologists of the exceptional benefits of swimming for osteochondrosis, after the third lesson my head began to feel dangerously dizzy. I didn’t give up and continued my studies. Don’t throw it away once it’s paid for.

I studied until the end of the course. But my head spun so much that it had never spun in my life.

She behaved well only if she looked straight ahead. But from turns and tilts to the right, left, up, down, a rapid rotation of everything in the field of vision began.

I could only sleep sitting. To brush my teeth, I had to undress and get into the bathtub, because it was impossible to bend over to the sink. My head was starting to feel so dizzy that I could easily hit my forehead against this sink. While driving, you only had to look straight ahead and park using the mirrors, under no circumstances turning your head sharply. In general, I was in despair, to be honest. Damn neck. My poor brain. He is not supplied with blood at all. What to do? Should I go see a neurologist again? But how can he help if useless IVs and massage are his entire arsenal?

Photo: Gennady Cherkasov

In addition to the headache, I had a toothache. For some reason, an otolaryngologist saw me at the dentist. After leaving the dentist, I went to see him. An absolutely unpretentious specialist. Fortunately there was no queue, no registration. And she told me about the head. And about crystals.

The diagnosis was made instantly: benign positional vertigo. “You need to see an otoneurologist,” said the otolaryngologist. - He will manipulate you. There is only one specialist in Moscow who can do this correctly, and he has all the necessary equipment. If you go, then go to him.”

And I went to him. And everything worked out. Three weeks of torment and many years of feeling depressed due to “poor blood supply to the brain” ended in forty minutes.

The otoneurologist put special glasses on me, laid me on the couch and began to somehow cunningly and carefully turn me. At first, my head was spinning mercilessly with every turn. It was sickening, disgusting, I wanted to sit down immediately to stop the rotation. But by the fourth series of turns everything somehow got better. I rolled over both on my left side and on my right and looked forward to sleeping lying down - forgotten happiness! - already tonight.

***

Benign positional vertigo occurs due to disorders in the vestibular system. Osteochondrosis, narrowed blood vessels and poor blood supply to the brain have nothing to do with it. This is all from a completely different story.

In the human inner ear there are two receptors - auditory and vestibular, which are directly involved in the balance system. The inner ear (ear labyrinth) contains calcium crystals. They lie there in so-called bags and provide a sense of gravity.

These crystals are called canalites. They can break down for various reasons. The released crystals can float out of the sacs into the semicircular canals filled with liquid. There are three such semicircular canals in total. Most often, canalites swim into a vertical channel. But they can swim into any.

If they are swam, changing the position of the head can cause the channels to shift, and then the person will have a feeling of rotation. It's very strong. Lasts less than a minute, but causes nausea, imbalance, and these sensations last for hours.

Such dizziness happens to both children and the elderly. No patterns have been identified that would allow us to indicate their cause. Apparently, these are structural features of the vestibular apparatus. Some kind of pathology. But quite common.

In general, your head can feel dizzy for many reasons. But floating crystals are the most common. About 20% of all people suffering from dizziness suffer from it precisely because they have “loosed” their canalitis.

This cannot be treated with medications. Massages and manuals too. The floating crystals just need to be driven back to where they should be. This is exactly what the otoneurologist did with me. With a series of light movements, I moved the floating canalites to the area of ​​the ear labyrinth where they would not harm the balance system.

Someday they may float back into the semicircular canals. Then I will go to him again, and he will drive them back into place. Since this doesn't happen often, it's not a big problem.

***

I wrote about the interesting behavior of crystals on my page on social networks. Those who live in our country responded with comments like “my case, give me the doctor’s contact information, I’ve been suffering from blood vessels and osteochondrosis for many years, I’ve been poisoned by medications, there’s no point.” Those who live abroad were also surprised. But not because there is such a dizziness that is “fixed” by manipulation, but because few people in Russia know about it. “Our physiotherapists do this; they teach such manipulations in the first year,” the Swede wrote. “I had the same thing, but I was immediately referred to an ENT specialist,” wrote the Israeli woman. “In America, this is treated with one session of physical therapy,” the American woman wrote.

The otoneurologist who “fixed” me said that doctors relatively recently learned that positional vertigo is caused by floating crystals. This became known only in 1995 - due to an unsuccessful operation performed by a Canadian surgeon.

Over the past 22 years, foreign medicine has “incorporated” a new disease into its medical care system, defining a clear place for it: how it is diagnosed, by what symptoms, at what stage of the examination, by which specialists, who treats, who is taught to treat.

This did not happen in our health care system.

Yes, many specialists know about positional vertigo. But many people don’t know.

Although if dizziness is referred to neurologists, neurologists should definitely know about it. And it's not easy to know. It should be included in the algorithm of their actions: before looking for vasoconstriction and a brain tumor, it is still necessary to check whether the crystals are causing the patient’s dizziness. Because if it’s because of the crystals, then he should not be sent for hardware tests and IV drips, but referred to another specialist - an otoneurologist.

Otherwise, the medical care system does not work effectively. Patients are not cured, and huge amounts of money are wasted - both by insurance companies and by the patients themselves.

***

Who should we ask why benign positional vertigo is in limbo? Minister of Health? But the minister cannot keep track of all medical news and look for a practical application for each news. This is not the ministry's task. This is the task of the professional medical community.

For clinical practice, clinical recommendations are needed - a specific list of necessary diagnostic and treatment methods for a particular disease. In the West, such recommendations are developed by professional associations of doctors of various specializations. The Association of Surgeons develops for surgeons, the Association of Therapists - for therapists, the Association of Neurologists - for neurologists. Doctors are guided by these clinical recommendations.

It's not like that with us.

There are no clinical recommendations, and they are not being developed, and even Western ones are not translated into Russian, although this would be faster and easier. Gaps in clinical practice are filled haphazardly rather than systematically.

“We’ve been telling everyone about benign positional vertigo for ten years at meetings of the Moscow City Scientific Society of Therapists,” said Professor Pavel Vorobyov, having learned about my ordeal with my head. “It’s a common thing, people are poisoned with meaningless medicines, but the little box opens easily. Yes, there are other causes of dizziness, but the sad thing is that most sufferers can be helped.”

Moscow City Scientific Society of Therapists is a professional association. Okay, she’s doing her job - she’s talking about positional vertigo at meetings. But who hears her? A handful of “living” doctors who are really interested in the profession. There is no point in telling the rest. They need an order from the head physician, which will describe the algorithm, how, when and who should be examined in order to detect positional vertigo. Then they will examine. If there is no order, they won’t.

This is our order - both in public medical institutions and in private ones. Bureaucratic. Reliable, time-tested.

If only it worked, it would be very good.

***

Massage of the collar area, which neurologists first directed me to, turns out to be harmful for positional vertigo. “It will get even worse,” warned the savior-otoneurologist. The neck usually hurts terribly with such dizziness, yes. But it hurts not because of the crooked vertebrae, but because the muscles are constantly trying to hold the head and stop the rotating picture.

And swimming isn't good either. Especially the rabbit. Because the position in which the body is located can provoke a massive “swim” of channelites. This seems to be exactly what happened to me. So the English Channel will have to wait for now.

PS I know very well what will happen after the publication of this article. Various people will start calling and writing to me, who need an otoneurologist to find out where he sees him. People will solve their private problems in this way. And they will decide. But I wrote the article not for the sake of solving specific problems, but in order to highlight a general problem. Systemic. The health care system is not working the way it should. And someone in power must finally understand this. Recognize the problem and take action to solve it.

Functional reasons

Dizziness can occur with a sudden change in body position : when standing up after a long period of lying or sitting, when suddenly turning the head or tilting, and so on. Usually it is not accompanied by unpleasant symptoms, but sometimes there is noise in the ears and darkness before the eyes. This state lasts for a few seconds. It is the result of the redistribution of blood through the vessels.

The causes of sudden dizziness not associated with changes in body position or serious pathologies are considered to be:

overwork, lack of sleep; lack of nutrients during diet; anemia is a decrease in hemoglobin levels, which often occurs during pregnancy, as well as with heavy menstrual flow.

In all these conditions, there is insufficient oxygen supply to the brain. This is why dizziness, weakness, loss of balance, and slow heart rate occur. Treatment consists of normalizing the daily routine, proper rest, and a balanced diet. You may need to take multivitamin complexes, as well as therapy aimed at eliminating the causes of the problem. For example, with heavy menstruation, the doctor prescribes hormonal or herbal remedies.

A feeling of weightlessness can occur with serious food or chemical poisoning. It is accompanied by nausea, vomiting, and diarrhea. In this condition, you urgently need to cleanse the body of toxins using gastric lavage, take enterosorbents and rehydration solutions. In difficult situations, you should seek medical help.

Dizziness in women

The described symptom occurs in representatives of both sexes, and occurs under the same pathological conditions of the body.

For reference. However, dizziness and its causes in women often have a direct connection with physiological characteristics. The work of any organism, regardless of gender, is regulated by hormones.

While men's hormonal levels are fairly stable, women experience changes every month.

In addition, the occurrence of dizziness is characteristic of pregnancy and menopause. This is usually due to a deficiency of estrogen, which affects vascular tone and the rheological properties of the blood.

Arterial pressure

Changes in blood pressure negatively affect the blood supply to the brain, which is why dizziness occurs. Along with it, symptoms such as:

When the pressure drops:

weakness, pallor; feeling of lack of air; increased sweating; darkening, “floaters” before the eyes; aching headaches.

When pressure increases:

pain and throbbing in the temples; headache in the back of the head or behind the sternum; facial redness and feeling of heat; loss of balance.

General signs:

nausea, sometimes vomiting; noise in ears; change in heart rhythm.

Treatment of hypo- or hypertension is complex and long-term. If pressure surges occur very rarely due to overwork, malnutrition or stress, then to eliminate dizziness it is enough to drink sweet tea (for hypotension) or take a sedative (for hypertension).

Mechanism of symptom development

Dizziness is a person's feeling of uncertainty about the position of his body in space. It is often accompanied by additional unpleasant sensations:

• there is a feeling that objects or the human body itself begins to rotate;
• there is a feeling that surrounding objects are beginning to blur;
• the ground disappears from under your feet;
• a person loses the ability to control his body;
• spots flash before your eyes;
• arms and legs may go numb;
• sweating increases;
• an attack of nausea and sometimes vomiting appears.

Types of dizziness

Dizziness can occur at any age. This symptom is usually divided into 2 large groups depending on the nature of the lesion:

1. Central vertigo. It occurs due to brain damage. The causes are traumatic brain injuries, infections and neoplasms in the skull.
2. Peripheral dizziness. It develops as a result of damage to organs and structures of the peripheral system (for example, the vestibular nerve, inner ear).

Systemic and non-systemic dizziness are also distinguished. They have some differences:

• Non-systemic dizziness - occurs due to physiological reasons. Among them:

• 
  stress;

psycho-emotional shocks;

• glucose deficiency (cause - strict diets, fasting);
• motion sickness on carousels or in transport;
• seasickness. Dizziness can also occur in a person who looks down at high altitudes. At the same time, he feels nauseous and feels weak in his legs. For such dizziness, treatment is not necessary. It is enough to get rid of the irritant, and the symptom will disappear on its own.

Systemic vertigo is often called true or vestibular, since it occurs against the background of disorders that entail a malfunction of the vestibular apparatus. Such disturbances may occur in one of the systems that are responsible for orientation in space:

• the vestibular apparatus itself;

visual apparatus;

musculoskeletal system.

Depending on the nature of the manifestation of the symptom, a distinction is made between paroxysmal (short attacks appear from time to time) and constant vestibular dizziness.

Most often, dizziness in the head occurs in the form of a short-term attack. If systemic dizziness is a constant concern, then most likely the vestibular apparatus is affected by toxic substances or the integrity of the labyrinth of vestibular fibers is impaired.

This occurs due to infection, as well as injuries to the skull or spine. This type of dizziness is dangerous, since its appearance is provoked by one or another pathology. Therefore, careful diagnosis is required to identify the cause of its development in humans.

Diseases of the vestibular apparatus and ears

The main causes of peripheral dizziness:

Otitis is an inflammation of the middle ear . Symptoms are ear pain and discharge, fever, hearing loss. Treatment is local and systemic antibiotics. Vestibular neuritis is inflammation of the vestibulocochlear nerve. Signs: nausea, vomiting. A feature of this disease is very severe dizziness without hearing loss. Therapy – drugs to eliminate dizziness and nausea. The disease goes away on its own. Meniere's disease is a lesion of the inner ear. Symptoms: ringing, tinnitus, temporary hearing impairment. Treatment is relief of discomfort; in severe cases, surgery on the inner ear. The disease cannot be completely cured.

There are several other pathologies associated with the ears and vestibular system that lead to dizziness. Among them: labyrinthitis, acoustic neuroma, damage to the eardrum, defects of the capsule of the inner ear, and so on. They are rare.

You can suspect problems with the ENT organs if sudden dizziness is not accompanied by lethargy, headache, heart rhythm disturbances and other systemic symptoms.

Dizziness in old age

Age characteristics of the body in both women and men are also taken into account during examination and diagnosis.

For example, degenerative processes associated with aging most often lead to the development of benign paroxysmal positional vertigo, Meniere's disease. If there are characteristic complaints, these diseases are suspected by the attending physician at the initial appointment.

Problems with blood vessels that are typical for older people are also taken into account, especially after a stroke, against the background of atherosclerosis or diabetes. In female patients, the most common cause of dizziness is usually menopause.

Brain diseases and injuries

The main causes of central vertigo:

A tumor in the brain compressing the eighth cranial nerve. Symptoms: unilateral hearing loss, headaches. Treatment is surgical removal, chemotherapy. Migraine. Signs: headache that occurs after dizziness. Therapy – painkillers. Epilepsy . Symptoms include confusion, convulsions, and heart rhythm disturbances. Treatment is a course of antiepileptic medications throughout life. Cervical osteochondrosis is a disease that affects the discs in the cervical region. It leads to infringement of the vertebral artery and disruption of blood supply to the brain. Signs: discomfort in the cervical spine, crunching when turning the head, headaches, nausea, angina pectoris, increased heart rate. Therapy - exercises, massage, anti-inflammatory drugs, analgesics, chondroprotectors and so on. Multiple sclerosis is damage to the nerve fibers of the brain and spinal cord. Early symptoms include double vision, muscle weakness, loss of balance and coordination, numbness in the fingers, and tingling sensation in the limbs. Treatment: corticosteroids, plasmapheresis. Traumatic brain injuries and congenital deformities . Symptoms are pain, nausea, vomiting, fast or slow heart rate.

Dizziness

G

dizziness is one of the symptoms most often encountered in medical practice. Among the reasons for visiting doctors of all specialties, it accounts for 2–5% [12].

The cause of dizziness is an imbalance of sensory information coming from the main afferent systems that provide spatial orientation - vestibular, visual and proprioceptive. Disturbances in central information processing and the efferent part of the motor act are also of great importance. In addition, pathology of the musculoskeletal system plays a certain role [2,4,8, 9,11,12,16,14].

In most cases, dizziness is caused by one of the following conditions:

: peripheral vestibular disorders, multiple sensory deficits, psychogenic causes, circulatory disorders in the brain stem, other diseases of the central nervous system, cardiovascular diseases. A combination of several reasons is possible [12,14].

Patients can describe a wide variety of sensations as “dizziness,” so the primary diagnostic task is to clarify the nature of the patient’s complaints. Typically, they can be classified into one of four clinical types of dizziness [1,2,4,9,11,12,14,16].

Systemic or vestibular vertigo

– a feeling of rotating, falling, tilting or swaying of one’s own body or surrounding objects. Often accompanied by nausea, vomiting, hyperhidrosis, impaired hearing and balance, as well as oscillopsia (the illusion of rapid small-amplitude vibrations of surrounding objects). Systemic vertigo is characteristic of damage to the vestibular system - both its peripheral and central parts.

Presyncope

. Patients note a feeling of lightheadedness, impending loss of consciousness, and “lightness” in the head. Often combined with pallor of the skin, palpitations, a feeling of fear, darkening of the eyes, nausea, and increased sweating. The most common causes are heart disease and orthostatic hypotension.

In some cases, by “dizziness”, patients mean imbalance

. There is instability, unsteadiness when walking, and a “drunk” gait. It is characterized by a combination with paresis, sensitivity disorders, incoordination and oscillopsia. Symptoms caused by imbalance are observed during standing and walking and are absent in sitting and lying positions [1,4,12,16,14].

For psychogenic dizziness

, observed, in particular, within the framework of anxiety, conversion disorders or depression, is characterized by difficult-to-describe sensations that do not correspond to the previous types of dizziness [1,12]. Patients may complain of “fog,” “heaviness” in the head, a feeling of intoxication, and lightheadedness. It should be noted that similar vague symptoms can occur in the early stages or during the atypical course of organic diseases [12].

Along with the clinical type of dizziness, its course, the presence of provoking factors and accompanying symptoms are of diagnostic importance [4,11]. A single episode of systemic vertigo is most often caused by a brainstem or cerebellar stroke. Repeated attacks of dizziness can develop either for no apparent reason or due to certain provoking factors. Spontaneous attacks of dizziness, not provoked by sudden movements of the head, usually serve as a manifestation of arrhythmias, transient ischemic attacks (TIA) in the vertebrobasilar region, Meniere's disease or epileptic seizures. Recurrent attacks of dizziness, in which provoking factors are identified (changes in body position, turning the head), are most often caused by benign paroxysmal positional vertigo (BPPV) or fainting, in particular orthostatic.

Systemic dizziness

The most common cause of systemic dizziness is BPPV [4,8,12,14]. The disease usually develops after middle ear infections, traumatic brain injury, or otological surgery. Characteristic are short-term (no more than 1 minute) attacks of systemic dizziness that occur when changing body position. In the pathogenesis of BPPV, the leading role is played by cupulolithiasis - the formation of a clot of calcium carbonate crystals in the cavity of the semicircular tubule, which leads to an increase in the sensitivity of the receptors of the semicircular tubules. To detect positional vertigo, the Nilen-Barany

. From a sitting position, the patient quickly lies on his back, with his head tilted back 45° and turned to the side 45°. The position is maintained for 30–40 seconds. The test is repeated with the head positioned along the midline and when turned in the opposite direction. The development of positional vertigo and nystagmus confirms the diagnosis. Isolated positional nystagmus also speaks in favor of BPPV - when the eyeballs are fixed in the middle position, the nystagmus is vertical-rotatory, with a fast phase directed upward and towards the underlying ear. When looking towards the underlying ear, the fast phase of nystagmus is directed in the same direction, horizontal-rotatory nystagmus, when looking in the opposite direction - vertical, beating upward. There is a characteristic latent period (30–40 seconds) between the start of the test and the onset of nystagmus. The nystagmus fades when the test is repeated. Positional nystagmus is observed inconsistently, more often during an exacerbation [10]. BPPV must be differentiated from central positional vertigo and nystagmus, the most common causes of which include spinocerebellar degenerations, brainstem tumors, Arnold-Chiari malformation, and multiple sclerosis. Central positional nystagmus has no latent period, its duration exceeds 1 minute, the direction of nystagmus can vary, often vertical nystagmus does not fade with repeated examination. To treat BPPV, exercises are used to move calcium carbonate crystals from the semicircular tubule into the cavity of the elliptical sac. Repeated provocation of dizziness is also effective, which leads to its gradual regression due to central compensation.

The combination of systemic dizziness with focal neurological symptoms is characteristic of circulatory disorders in the vertebrobasilar system, as well as tumors of the cerebellopontine angle and posterior cranial fossa [4, 5, 12, 14]. With vertebrobasilar insufficiency, dizziness, as a rule, develops suddenly and persists for several minutes, often accompanied by nausea and vomiting. As a rule, it is combined with other symptoms of ischemia in the vertebrobasilar region [10]. Early stages of vertebrobasilar insufficiency can manifest as episodes of isolated systemic dizziness [15]. Longer episodes of isolated systemic vertigo suggest other diseases, particularly peripheral vestibular disorders. Along with systemic dizziness, TIAs and strokes in the vertebrobasilar region can also manifest as imbalance.

Systemic dizziness, nausea and vomiting are the earliest symptoms of ischemia in the anterior inferior cerebellar artery.

, leading to the development of infarction of the caudal parts of the tegmentum of the pons (lateral inferior pontine syndrome, Gasperini syndrome). Similar symptoms are observed with cerebellar infarction [19,23]. Such symptoms require a differential diagnosis with peripheral vestibular disorders. With damage to the cerebellum, in contrast to damage to the labyrinth, the fast component of nystagmus is directed towards the lesion. Its direction changes depending on the direction of gaze, but nystagmus is most pronounced when looking in the direction of the lesion. Fixing the gaze on any object does not affect nystagmus and dizziness. In addition, there is discoordination in the limbs, which is absent when the labyrinth is affected [6,9,14].

Acute systemic dizziness, both isolated and in combination with suddenly developed deafness, is characteristic of labyrinthine infarction

. Deafness caused by labyrinthine infarction is usually irreversible, while the severity of vestibular disorders gradually decreases. A combination of labyrinth and brainstem infarction is possible [6,19,23].

Systemic dizziness is a cardinal symptom of peripheral vestibular disorders

. The most important sign that makes it possible to differentiate peripheral vestibular disorders from central ones is nystagmus - most often horizontal, directed in the direction opposite to the lesion and intensifying when looking in the same direction. In contrast to central lesions, gaze fixation reduces nystagmus and vertigo [4–6,9,12,24,16,14].

Acute development of systemic dizziness in combination with nausea and vomiting is characteristic of viral neurolabyrinthitis

(vestibular neuronitis, vestibular neuritis). Symptoms usually regress within a few days, in severe cases - after 1-2 weeks. Typically, symptoms develop 1–2 weeks after a respiratory infection [4,5,12,14].

Meniere's disease

manifests itself as repeated episodes of severe systemic dizziness, accompanied by decreased hearing, a feeling of fullness and noise in the ear, nausea and vomiting. Within a few minutes, the dizziness reaches its maximum and gradually, over the course of several hours, goes away. Hearing impairment in the early stages of the disease regresses completely and then becomes irreversible. Balance problems may occur for several days after an attack of Meniere's disease. The first attacks of the disease may manifest as isolated systemic dizziness. To confirm the diagnosis, audiometry is performed. A hearing loss of more than 10 dB at two different frequencies is typical. The cause of Meniere's disease is recurrent swelling of the labyrinth, which develops as a result of rupture of the membrane separating the endolymph from the perilymph [1,4,14].

Treatment

Treatment of systemic dizziness is largely determined by its cause; in addition, symptomatic therapy plays an important role. Specific treatment for systemic vertigo is known only for a limited range of diseases. Dizziness as part of vertebrobasilar insufficiency requires the prescription of antiplatelet agents

(acetylsalicylic acid 75–330 mg/day, ticlopidine 500 mg/day), and if symptoms increase,
anticoagulants
[6]. For viral neurolabyrinthitis, symptomatic therapy is carried out. The effectiveness of antiviral drugs and glucocorticoids has not been proven [4,5,8,12,14].

Treatment of attacks of Meniere's disease is symptomatic. Betahistine is the most effective

[1,3]. For prevention, a low-salt diet and diuretics are prescribed [4,8].

For the symptomatic treatment of systemic dizziness, vestibulolytic agents are used that act on vestibular receptors or on central vestibular structures, mainly the vestibular nuclei. The first include antihistamines

: meclozine is prescribed 12.5–25 mg orally 4 times a day, promethazine – 25–50 mg orally, intramuscularly or rectally 4–6 times a day.
Benzodiazepines
have a central vestibulolytic effect : oxazepam - 10-15 mg orally 4 times a day, diazepam - 5-10 mg orally, IM or IV 4-6 times a day. Also used is the histamine receptor stimulator betahistine - 8-16 mg orally 2-3 times a day, calcium antagonists (cinnarizine 25-50 mg orally or intramuscularly 4 times a day, flunarizine 10 mg per day in the afternoon) [3, 8,13,18].

An effective treatment for dizziness is the combination drug Phezam

, containing 400 mg of piracetam and 25 mg of cinnarizine. The effect of the drug is complex, including vasoactive and metabolic effects [7,20]. The combination of two components in the drug leads to an increase in their therapeutic effect without increasing toxicity. In addition, Phezam was noted to be more effective and tolerable compared to separate administration of its components [17,19].

A number of double-blind, placebo-controlled studies have shown the high effectiveness of Phezam in systemic vertigo caused by both central and peripheral vestibular disorders [17,19]. The drug also reduced the severity of dizziness during the presyncope state. Fezam is effective in patients with chronic cerebrovascular insufficiency, who showed significant improvement in cognitive functions during treatment. The drug is prescribed 2 capsules 3 times a day for 3–6 weeks.

To relieve nausea and vomiting

Prescribe prochlorperazine 5-10 mg orally or intramuscularly 4 times a day, 25 mg rectally once a day or metoclopramide - 5-50 mg orally, intramuscularly or intravenously 4-6 times a day. Thiethylperazine has a central vestibulolytic and antiemetic effect. Prescribe 6.5 mg orally, rectally, subcutaneously, intramuscularly or intravenously 1–3 times a day [5,6,12,16,18]. A combination of antihistamines and benzodiazepines is effective. To reduce the sedative effect of vestibulolytic drugs, it is recommended to prescribe methylphenidate hydrochloride 5 mg orally 2 times a day (in the first half of the day) [12]. Vestibulolytic agents should be prescribed only for acute systemic dizziness. Their use should be as short as possible, since long-term use slows down the process of central compensation of the defect [6,12,16,18].

The main principle of rehabilitation for peripheral vestibular disorders is the stimulation of central compensation

by repeated stimulation of vestibular receptors. It is necessary to start rehabilitation as early as possible. With damage to the central vestibular structures, rehabilitation is much less effective [5,6,8,16].

Balance imbalance

One of the causes of imbalance is chronic vestibular dysfunction. Characteristically, symptoms intensify in the dark, when it is impossible to compensate for the defect with the help of vision. Oscillopsia is often observed, possibly combined with hearing impairment. The most common cause of chronic bilateral labyrinthine lesions is the use of ototoxic drugs. Worsening imbalance in the dark is also characteristic of deep sensitivity disorders. The most pronounced imbalances develop in cerebellar disorders. Visual control does not affect the severity of symptoms. With damage to the flocculonodular parts of the cerebellum, oscillopsia is often observed, as well as nystagmus, depending on the direction of gaze. One of the mechanisms of imbalance is also disorders of cervical proprioception. The causes of imbalance caused by changes in the efferent part of the motor act include multiple subcortical infarctions, normal pressure hydrocephalus, Parkinson's disease, chronic subdural hematoma, tumors of the frontal lobes, as well as a number of medications - anticonvulsants (difenin, phenobarbital, finlepsin), benzodiazepines, antipsychotics ( phenothiazines, haloperidol), lithium preparations. Impaired balance is a characteristic symptom of tumors of the cerebellopontine angle, temporal bone and posterior cranial fossa. Systemic dizziness is observed much less frequently with this pathology. In the vast majority of cases, concomitant neurological symptoms are detected. In addition, one of the causes of imbalance, observed mainly in the elderly, is multiple sensory insufficiency - a combination of moderate disorders of several sensory functions. Disturbances in the central integration of sensory information play a certain role in its development [4,8,9,11,12,16,14].

Psychogenic dizziness

Psychogenic dizziness most often occurs as part of agoraphobia, depression and panic attacks, and also, usually in the form of a presyncope, serves as a manifestation of hyperventilation syndrome [4,12,14]. With dizziness of an organic nature, it is also possible to develop restrictive behavior, in particular, secondary agoraphobia or reactive depression. In some cases, there is a combination of episodes of organic and psychogenic dizziness, as well as the development of dizziness of mixed origin [14]. Treatment is determined by the nature of the underlying disorder. Psychotherapy is of great importance. It is necessary to explain to the patient the essence of his existing disorders, since often an additional psychotraumatic factor is the belief that he has a life-threatening disease [4,8,12,16].

The list of references can be found on the website https://www.rmj.ru

Piracetam + Cinnarizine –

Fezam (trade name)

(Balkanpharma)
Literature:
1. Weiss G. Dizziness // Neurology Edited by M Samuels - M, Practice, 1997–P 94–120.

2. Lavrov A.Yu., Shtulman D.R., Yakhno N.N. Dizziness in the elderly // Neurological journal – 2000 – T 5, N 5 – P 39–47.

3 Lavrov A.Yu. Application of betaserc in neurological practice // Ibid –2001 –T6.N2–C35–38.

4. Baloh RW Dizziness in older people//J Am Genatr Soc–1992–Vol 40, N 7 –P 713–721.

5. Baloh RW Dizziness and verigo // Office of practice of neurology Eds MA Samuels, S Feske – New York, 1996 – P 83–91.

6. Baloh RW Vertigo //Lancet –1998 –Vol 3 52 –P 1841–1846..

7. Ban T. Psychopharmacology fot the aged – Basel, Karger, 1980.

8. Brandt T. Vertigo // Neurological disorders Course and treatment Eds T Brandt, LP Caplani, J Dichgans et al – San Diago, 1996 – P 117–134.

9. Daroff R.V., Martin JB Dizziness and vertigo // Harrison's principles of internal medicine Eds Fauci AS, Braunwald E., Isselbacher KJ et al – 14th ed – New York, 1998 – P 104–107.

10. Davies RA Disorders of balance // Handbook of vestibular rehabilitation Eds LM Luxon, RA Davies – London, 1997 – P 31–40.

11. Derebery MJ The diagnosis and treatment of dizziness // Med Clin North Am –1999–Vol 83,N 1–P 163–176.

12. Drachman DA A 69–year–old man with chronic dizziness // JAMA –1998 –Vol 290, N 24–Р21П–2118.

13. Fraysse V., Bebear JP, Dubreuil S. et al Betahistine dihydrochloride versus flunarizine A double–blind study on recurrent vertigo with or without cochlear syndrome typical of Memere's disease // Acta Otolaryngol (Stockh) – 1991 – Suppi 490 – P 1 -10.

14 Furman JM, Jacob RG Psychiatric dizziness // Neurology–1997–Vol 48, N 5–P 1161–1166.

15 Gomez S.R. , Cruz-Flores S., Malkoff MD et al. Isolated vertigo as a manifestation ofvertebrobasilar ischemia // Neurology –1996 –Vol 47 –P 94–97.

16. Hollander J. Dizziness//Semin Neurol–1987–Vol 7, N 4–P 317–334.

17. Konstantinov K., Yordanov Y. Clinical and experimental–psychological studies in cerebral atherosclerosis //MBI–1988–Vol 6–P 12–17.

18. Luxon LM. Modes of treatment of vestibular symptomatology // Handbook of ves–tibular rehabilitation Eds LM Luxon, RA Davies – London, 1997 – P 53–63.

19.Popov G., Ivanov V., Dimova G. et al Phezam - clinical and psychoogical study // MBI-1986-Vol 4-P3-6.

20. Temkov I. Yordanov Y., Konstantinov K. et al. Clinical and experimental–psuchological studies of the Bulgarian drug pyramem // Savr Med–1980–Vol 31, N9–P 467–474.

21. Troost T.V. Dizziness and vertigo // Neurology in clinical practice Eds WG Bradley, R.V. Daroff, G.M. Fenichel, S.D. Marsden 2nd ed – Boston, 1996 – P 219–232.

Diseases of the heart, blood vessels and other pathologies

Other causes of spinning and loss of balance include:

Atherosclerosis of cerebral vessels is the deposition of cholesterol on the walls of blood vessels, causing poor circulation. Symptoms are weakening of memory and attention, decreased intelligence, fatigue. Therapy – diet, vasodilators, vitamins. Stroke is an acute disruption of the blood supply to the brain. Signs are loss, stunned consciousness, impaired speech and coordination of movements, slowing and then increasing heart rate, breathing problems, facial asymmetry, and so on. This condition is extremely life-threatening. The first thing to do is call an ambulance. The patient should be placed with his head elevated and air flow should be ensured. Balance problems may occur during rehabilitation after a stroke. Gastrointestinal diseases - gastritis, hepatitis, gallbladder pathologies. Dizziness is associated with general intoxication of the body and impaired absorption of nutrients. Symptoms: digestive problems, abdominal pain. The treatment tactics are determined by the doctor after a comprehensive diagnosis.

In addition, a feeling of weightlessness can occur due to the use of certain medications, after severe infectious diseases and as a result of strong positive or negative emotions (psychogenic dizziness).

Diagnostics

The “gold standard” for diagnosing atherosclerotic lesions is ultrasound examination of the vessels of the neck and brain. Ultrasound examination allows us to evaluate the elasticity of the vessel wall, the thickness of the intima-media complex and the presence/absence of atherosclerotic plaque. Also, to determine the presence of cerebral atherosclerosis, MSCT and MRI studies can be performed, but they will focus more on indirect signs of atherosclerosis, which are most clearly identified in the presence of already calcified plaques.

Also, all patients with suspected cerebral atherosclerosis are recommended to undergo a biochemical blood test for cholesterol and its fractions (lipidogram), as well as blood clotting indicators (coagulogram).

Help during an attack of dizziness

What to do when a loved one experiences sudden dizziness? If the attack is mild, short-lived and not accompanied by other symptoms, then it is enough to lay the patient on his back on high pillows, unbutton tight clothes, open a window for air access, and give him a sweet drink.

If, along with dizziness, there is nausea, vomiting, or a strong increase (slowdown) in heart rate, then you need to call an ambulance. With high or low blood pressure, a person urgently needs to be given funds to normalize it.

Dizziness that occurs for no apparent reason can be a symptom of a variety of diseases. If attacks of loss of balance make themselves felt frequently and are accompanied by weakness, nausea, and heart rhythm disturbances, you must consult a doctor and undergo an examination, after which adequate treatment will be prescribed.

Helpful information

Severe dizziness is not a separate disease; it is often an acute symptom indicating problems in the brain or for a number of serious reasons. At this moment, a person loses the ability to control his state in relation to space. It creates the deceptive impression that it itself or the objects around it are rotating. The condition is often accompanied by weakness, darkening of the eyes, and loss of balance.

Why are attacks disturbing, what are the dangers of their periodic occurrence, what to do at this moment?

Treatment of dizziness

The listed measures will help relieve a sudden attack, but it is necessary to find out and treat the cause of dizziness. For this purpose, a comprehensive and thorough examination is usually carried out, based on the results of which appropriate therapy is prescribed.

In accordance with the identified disease, medications of different groups, surgical operations, and vestibular gymnastics can be used. It is also necessary to adjust the patient’s lifestyle by adjusting diet, rest and work. It is acceptable to additionally use folk remedies for dizziness if they are safe and approved by your doctor.

Medicines

Drug treatment of the underlying disease is prescribed by a specialist based on the results of the examination, so it is unacceptable to independently use any medications for a long course.

Among the symptomatic drugs that help cope with vertigo, get rid of nausea and coordination disorders, the most effective are the cholinomimetic drugs betahistine. Betaserc, Tagista and other tablets for dizziness are indicated for various vestibular disorders, have a pronounced therapeutic effect and are relatively safe.

Drugs that improve cerebral circulation (Cinnarizine) and antihypertensive drugs for high blood pressure are also widely used. In case of intense attacks of nausea, turning into vomiting, the use of Metoclopramide, dimenhydrinate drugs, trifluoperazine is indicated. They regulate the effects of neurotransmitters on the vomiting centers of the brain. These medications can also be taken prophylactically before air or sea travel, or long trips by car.

Traditional methods

How can you stop dizziness and prevent recurrent attacks using not only traditional methods of drug therapy? Folk medicine has accumulated many recipes for treating vestibular disorders using herbs, food and beekeeping.

For reference. The doctor decides which ones are permissible to use in each specific case, based on the diagnosis, individual characteristics, and contraindications.

However, there are several remedies that are considered the most effective and harmless.

Ginger

The root of this plant is the undisputed leader in the treatment and quick relief of dizziness symptoms. The therapeutic effect is based on the property of ginger to stimulate cerebral circulation.

It can be used in different ways:

• Chew a thin slice during an attack. This helps relieve nausea, helps stop dizziness and restores coordination.
• Add regularly to various dishes. This method ensures a constant supply of useful substances to the body and prevents relapses.
• Make ginger tea instead of regular tea by brewing several small pieces of rhizome with boiling water.

It should be taken into account that there are also contraindications to the use of ginger. For example, cholelithiasis, some gastrointestinal diseases, the second half of pregnancy and others.

Causes

In the human body, a whole system is responsible for maintaining balance, which includes:

Vestibular apparatus. The organ is located in the human brain and has sensory receptors. Eyes. Provide a visual picture of the individual's position in space relative to other objects. Proprioceptors. The peripheral elements of the organs responsible for sensory perception are located in muscle tissue, joints, ligaments and skin.

Working synchronously, all systems send information to the brain, where it is processed and gives a person the real position of his location in the environment.

When information is distorted, caused by irritation of the receptors of the vestibular apparatus or an inflammatory process, a false idea is formed in the brain, and a person suddenly begins to feel a feeling of rotation and spinning.

The causes of severe dizziness are very diverse; more than 80 disorders in the human body can cause them.

Dizziness, the medical term is vertigo, is differentiated:

on the peripheral, associated with pathologies of the vestibular apparatus; central, refers to brain disorders and is associated with systemic changes and diseases.

There is also a group of functional factors that provoke the development of symptoms, but they are not considered a serious pathology, are benign manifestations and disappear in a short period.

Each person, due to his own characteristics or ailments, experiences the condition in his own way. Therefore, it is difficult for specialists to navigate and find the cause of dizziness that occurs suddenly.

Functional reasons

Benign or false dizziness occurs in people of different age categories, regardless of gender. Usually they don’t last long, they don’t bring too much unpleasant sensations, sometimes it becomes dark in the eyes, and noise appears in the ears. They appear in the following cases:

Your head may feel dizzy when you make sudden movements or get out of bed quickly. For a moment, a person feels a darkening in his eyes, and experiences a feeling of falling into emptiness. The symptoms are caused by a sharp outflow of blood from the brain when the vessels do not have time to “rebuild” when changing body position. To avoid this, you should not make sudden movements or jump out of bed too quickly. In women, hormonal instability before menstruation or during menopause often causes a feeling of dizziness and instability. Dizziness is initiated by diets and poor nutrition, bleeding during menstruation, reducing the flow of oxygen into the blood or glucose. Psychogenic dizziness, caused by a sharp release of adrenaline into the blood, also occurs. By this condition, a person often means weakness in the legs, clouding of consciousness, confusion of thoughts. Almost all people experience a similar condition when riding a carousel; another question is how quickly it will occur. It all depends on the functioning of the vestibular apparatus; for some, just the sight of a rotating wheel makes their head spin. This phenomenon is normal and goes away after some time.

In all these cases, no special treatment is required, the main thing is to balance the diet, take a complex of vitamins, and adjust your sleep and rest patterns. Sometimes therapeutic measures are used to eliminate the cause of the problem, for example, hormonal drugs are used for women during menopause and during heavy menstruation. Peripheral dizziness

This type of severe dizziness develops due to disturbances in the vestibular apparatus, and also, since the center is part of the inner ear, also due to an inflammatory process in the ENT organs:

Vestibular neuritis. With inflammation of the vestibulocochlear nerve, which is responsible for the conduction of impulses from the ear to the brain. Dizziness is very severe, accompanied by vomiting, unsteady gait, and loss of balance. It is believed that the virus is a provocateur of the disease, so sometimes the temperature rises, there is a runny nose and cough. Meniere's disease. It occurs in the inner ear and is characterized by the accumulation of endolymph in its cavity. In parallel with inflammation, ringing in the ears, discomfort and hearing loss accompany. Otitis. A dangerous disease of the inner ear, manifests itself not only with dizziness, but with severe pain, purulent processes, swelling, and hearing loss.

The head also begins to feel dizzy in complex forms of sinusitis and sinusitis.

The choice of tablets, depending on the cause of the phenomenon

Tablets for dizziness in arterial hypertension

Substances that help reduce total cholesterol and eliminate excess calcium are usually prescribed. Such drugs traditionally block the release of adrenaline. If you have hypertension, you should consult a doctor who will tell you exactly what to take in your case.

Tablets for dizziness in vascular atherosclerosis, obesity

In this case, many pills are powerless, you just need to follow proper nutrition, and after a few days the symptom of dizziness will no longer bother you. It is worth excluding fried, spicy and smoked foods from your diet. For obesity, specialists usually prescribe Analgin or Betaserc. Along with the tablets, you must drink plenty of water orally.

Medicines for rheological processes in the blood

To neutralize these phenomena, it is necessary to take any product with the main active ingredient - acetylsalicylic acid. The doctor determines how to treat the disease. Usually, drugs such as Betaserc, Tiklid and analogues are effective for dizziness and symptoms of nausea.

Remedies for disorders of the vestibular apparatus

If you don’t know what to drink if you have true dizziness, you should pay attention to the list of drugs that neutralize symptoms and signs. In addition, almost all products stimulate brain function and can be used without a prescription.

• Cavinton;
• Betaserc;
• Relanium;
• Seduxen (analogue of the previous drug);
• Cinnarizine;
• Dramamine.

If you follow the dosage and doctor's instructions, each of the remedies helps get rid of unwanted headaches. Most of the drugs presented have a wider spectrum of action and help in the fight against concomitant diseases of the inner ear and poor circulation.

Means for neutralizing pressure surges

When considering effective medications for dizziness, it is worth paying due attention to medications that prevent blood pressure problems. Doctors usually recommend taking Cavinton, Ginkofar, Ginko-Biloba, Vinpocetine. They combine well with other medications, so they can easily be combined with drugs designed to eliminate spasms that inhibit calcium metabolism.

Medicines for dizziness in cervical osteochondrosis

Osteochondrosis is caused by the accumulation of a large amount of salts in the area of ​​the vertebrae and between them, which blocks blood access to the brain. Dizziness occurs, which usually occurs when the head is raised or actively moves it to the left and right. To stabilize the general state of health, it is recommended to give preference to drugs to improve blood supply to the brain, and here is a list of them.

If the medicine is prescribed by a doctor, and the patient, in turn, follows the dosage, it will certainly help in the fight against the disease. Treatment with each drug requires a serious approach.

Vegetative-vascular dystonia: drugs for dizziness

This pathology can lead to a certain number of symptoms, including dizziness. Treatment is carried out through the use of traditional drugs - ginkofara, betaserc, vinpocetine. These remedies are universal and can be used without a prescription, but to avoid complications, it is recommended to consult a specialist.

Anti-dizziness tablets for older people

In the elderly and elderly, the condition of feeling dizzy is quite reasonable. This is due to the processes occurring in the body. Let's consider what medications need to be taken for dizziness after 50 years, and what experts advise. Treatment is carried out depending on the type of pathological process. There are three main types:

1. The true process of the disease is accompanied by nausea and vomiting. During the onset of an attack, a person faces difficulties in maintaining balance and coordinating movements. You need to take pills to improve the condition.
2. Non-systemic dizziness resembles the condition that occurs before fainting. A person's skin begins to turn pale, cold sweat appears, and darkening may occur in the eyes.
3. Dizziness of psychogenic origin. Here a state of faintness and intoxication usually occurs. The patient experiences a feeling of heaviness and difficulty in coordinating movements.

The attending physician, before determining which drugs are effective for vertigo in a particular case, must listen to all complaints about symptoms. For acute symptoms, ambulance teams use the following drugs.

It is prohibited to take medications on your own, as strict dosages must be observed. If long-term treatment is necessary, other types of drugs are prescribed.

• Anaeron tablet – reduces nerve tone;
• Cerucal relieves the symptoms of vomiting and nausea;
• Avia-sea – has a homeopathic composition, removes motion sickness;
• Dramamine is an antihistamine.

If a sick person suffers from dizziness due to circulatory problems, medications can be used to restore blood flow.

If you follow the specific instructions and recommendations of the doctor, you can achieve good results. Be healthy!

Complaints of a headache, general weakness, or abdominal discomfort will not force an adult to immediately seek help. Another thing is when an attack of dizziness occurs. In this case, consultation with a doctor is necessary to establish the correct diagnosis and prescribe appropriate therapy. The causes of dizziness are varied and may indicate pathology of the heart, blood vessels and nervous system.

Treatment of dizziness should be carried out after consulting a doctor. If the doctor sees no contraindications, then signs of dizziness can be eliminated with exercises at home.

Central vertigo

The main causes of central vertigo include changes in the brain:

Tumor. A neoplasm in the brain, even in the early stages, can manifest itself in sudden painful attacks, during which the head begins to feel dizzy, the person becomes very nauseous, even vomiting. Symptoms appear due to compression of brain tissue and irritation of neurons; they occur for no apparent reason, often in the morning. As the disease develops, signs associated with the location of the tumor appear. Migraine. Dizziness usually becomes a harbinger of a painful attack, along with other neurological manifestations of pathology, and is part of the aura, which is characterized by blurred vision, tactile and olfactory hallucinations. Multiple sclerosis. When the nerve fibers of the brain are damaged, already in the early stages of the disease it is expressed by loss of orientation, double vision, weakening of muscle activity, and numbness in the fingers. Osteochondrosis. Vertigo is a companion to degenerative changes in the cervical spine. When the head is turned, overgrown osteocytes catch nerve endings and block blood access to the brain. At the same time, the person’s eyes darken and cold sweat appears. Head injury. It occurs as a result of a bruise, and the brain also suffers. Symptoms will depend on the severity of the injury; with minor injuries, the sensations will soon go away. If disturbances in orientation remain for a long time, the pain continues, this indicates serious consequences. Epilepsy. The development of a seizure begins with sudden dizziness and loss of orientation in space. Next, the person falls, loses consciousness, and convulsions begin.

If a sudden attack of dizziness lasts more than an hour, you must call an ambulance.

Therapeutic methods

After diagnosis, the doctor prescribes pharmacotherapy aimed at eliminating the underlying disease and symptoms of vestibular vertigo. Drugs are used to reduce its severity:

• antipsychotic drugs - Promazine for severe disease;
• Betahistine hydrochloride is a vestibulolytic pharmaceutical that helps the patient regain a sense of balance;
• antihistamines - Promethazine and its analogues to reduce the severity of symptoms;
• nootropic drugs (Phenotropil, Glycine) have a positive effect on blood circulation in the brain, improving its function;
• sedatives or tranquilizers for panic attacks (Afobazol, Atarax). Relieves anxiety, reduces the manifestations of panic and fear that often accompany systemic dizziness;
• To reduce the severity of nausea, prokinetics are used (Metoclopramide, Ondansetron, etc.);
• consultations with a psychotherapist (help in the recovery period of treatment).

To improve the general condition of the patient, diet therapy, physical therapy, massage of the cervical spine or the whole body, physiotherapeutic treatment and rehabilitation in sanatorium institutions are used.

Diseases of the heart and blood vessels

Changes in the functioning of the heart rhythm and vascular system are manifested by dizziness, these include:

Atherosclerosis. The deposition of cholesterol plaques on the walls of blood vessels impairs blood circulation, which affects a person’s well-being. The brain tissue does not receive enough blood and nutrition, which is additionally accompanied by memory deterioration, decreased intellectual abilities, headaches, and increased fatigue. Change in blood pressure. An increase and decrease in pressure causes loss of orientation in space. In either case, normal blood flow is altered, causing symptoms. Arrhythmia. When the heart rhythm changes, regardless of the type and manifestations, the functioning of the ventricles and atria is disrupted, this affects hemodynamics, and this affects the state of the brain. Stroke. The development of pathology is always accompanied by sudden dizziness due to acute circulatory disorders. There is also a headache, sometimes nausea and vomiting, numbness of the limbs, difficulty speaking, loss of consciousness, and paresis.

Systemic dizziness with cervical osteochondrosis

Osteochondrosis is one of the most common and widespread sources of dizziness. With this pathology, the cartilage tissue of the cervical intervertebral discs of the spinal column is damaged as a result of defects in their trophism or nutrition. As a result of metabolic disorders, degenerative processes are formed in the cartilage tissue, which leads to a decrease in its volume and destruction; as a result, the spinal column loses a significant amount of its inherent depreciation characteristics. The load on the vertebrae of the neck increases, which leads to their injuries and further destruction. Spikes or bone growths form on the vertebrae, the mobility and mobility of the vertebrae is greatly reduced, as well as their height, as a result, neurons and processes of the spinal cord are gradually involved in the process of inflammation, emerging through the lateral intervertebral arteries in the form of motor and sensory nerve fibers as part of the nerve roots . In the absence of diagnosis and treatment, osteochondrosis develops and causes significant complications in the form of damage to the nervous tissue, and then systemic dizziness becomes one of the symptoms.

What to do if you feel dizzy with osteochondrosis of the neck? First of all, you need to see a doctor and get advice. Only after the examination is it possible to judge the preparation of a treatment plan that will be effective. For cervical osteochondrosis, therapy for dizziness involves the combined use of medications and physiotherapy. The following groups of drugs are used for pharmacotherapeutic purposes:

• Anti-inflammatory non-steroidal drugs that can significantly reduce the inflammatory volume, eliminate swelling and compression of the spinal cord and nerve roots. For a more effective effect during treatment, a course of injectable types of anti-inflammatory drugs is used. The main drugs from this group include: Meloxicam, Nurofen, Ibuprofen, Diclofenac.
• Nootropics and cerebroprotectors are medications that improve blood circulation in the brain and metabolic processes in nervous tissue. These include: Vinpocetine, Cavinton, Cinnarizine, Piracetam.
• Chondroprotectors - drugs protect cartilage tissue from destruction. Such drugs improve the shock-absorbing and elastic properties of intervertebral cartilage tissue, thereby reducing compression syndrome.

It must be said that treatment must be comprehensive, only in this case there will be a positive therapeutic effect. For this, in addition to medications, physiotherapy is used: magnetic therapy and ultrasound, therapeutic electrophoresis on the neck area. Systematic therapeutic exercises are of no small importance.

Other diseases

Gastrointestinal diseases. With gastritis, various types of hepatitis, a violation of the outflow of bile, dizziness occurs due to intoxication of the body, loss of the ability to fully absorb nutrients; in case of digestive disorders, there is pain in the abdomen, nausea, vomiting, and stool disturbances. Poisoning. Sometimes severe dizziness occurs due to toxic poisoning with pesticides, alcohol or food. In this case, it is necessary to begin cleansing from toxins using gastric lavage, sorbents, intoxicants and drugs that restore water and electrolyte balance. In case of severe poisoning, qualified assistance is required.

Dizziness in children and adolescents

When examining and treating children, age indicators are also taken into account. Thus, in preschoolers and young schoolchildren, dizziness is often physiological in nature due to increased physical activity.

Therefore, when characteristic symptoms occur, anamnesis is carefully collected and differential diagnosis is carried out in order to exclude pathologies.

During puberty, the endocrine system has a decisive influence on the state of the body of representatives of both sexes. That is, the causes of dizziness in women of different ages and adolescents are approximately the same - hormonal fluctuations.

In addition, the factor of overfatigue is taken into account, since often the educational load, combined with a general increased activity, turns out to be too much for a growing body.