Dizziness is not a disease but a symptom that can occur for different reasons and can be expressed by patients in different ways such as imbalance, dizziness, blackout, mild or severe dizziness. Depending on many different factors, complaints of varying severity may occur, from mild imbalance to a very severe feeling of spinning. Dizziness can be the only complaint or it can be accompanied by hearing loss and or tinnitus.
The ear has three parts: outer, middle and inner ear. The outer and middle ear structures collect sound waves, increase their power and transfer them to the inner ear fluid. Hearing and balance centers in the inner ear are located in the ear bone and are filled with inner ear fluids (endolymph and perilymph). Sensitive sensory nerve endings and nerve cells of the hearing and balance nerves are in constant contact with these fluids. Sound waves reaching the inner ear are transmitted through the inner ear fluids, stimulating the nerve endings and creating an electrical stimulus. Hearing occurs when this stimulus is transmitted to the brain via the auditory nerve.
ENSURING BALANCE
The balance system consists of a center and three different sensor systems. The brain acts as a center that collects and processes information about body position, which is constantly transmitted from the eyes, balance centers in the inner ear, and muscles, joints and tendons, and is responsible for maintaining balance. These three systems work independently of each other and together they function to maintain body balance. While the eyes provide information about the position of the body relative to the environment by transmitting images from the environment to the brain, signals from muscles, tendons and joints convey information to the brain about the position of the head relative to the body.
The inner ear balance system consists of semicircular canals and linear canals that detect rotational movements. It consists of two different parts called vestibule, which detect movements. These two parts, filled with liquid, are together called "labyrinth". When the head moves, the fluid in the inner ear also moves, and different nerve endings stimulated according to the shape and direction of this movement send signals to the brain informing the movement of the head.
The balance organs located in the labyrinths on both sides constantly send fully symmetrical signals to each other. They produce energy. Signals generated by head rotation create a stimulus in the semicircular canals, while linear movements back and forth or up and down create a stimulus in the vestibule. The position of the calcium carbonate crystals attached to the cells in the balance centers in the vestibule due to gravity changes, allowing the direction and intensity of head movement to be perceived. When the balance center in the inner ear malfunctions, the symmetry in the signals going to the brain is disrupted and this creates the feeling that the balance is disrupted, while the signals from the brain to the eye muscles cause involuntary movements of the eyes (nystagmus). These movements of the eyes create the perception of movement in the patient as if his or her surroundings or himself or herself are rotating.
With the combination of information coming from all centers that perceive movements, corrective reflexes occurring in the cerebellum and voluntary responses occurring in the brain, signals are sent to the body muscles to make movements aimed at maintaining balance. The balance centers in the brain, cerebellum and brainstem have the feature of adapting over time to the asymmetric signals coming from the inner ear and not being affected by them. Due to this feature, it is possible to eliminate or prevent imbalance with appropriate exercises in some diseases that cause dizziness or in some sports activities that may cause imbalance under normal conditions.
TYPES OF DITIZY
Playing a role in maintaining balance. Problems in any of the centers may cause symptoms such as dizziness, imbalance, and dizziness.
Inner ear diseases:
Inner ear-related balance disorders can be caused by changes in the pressure of the inner ear fluid or directly by It occurs due to the effects of the balance centers and/or balance nerves.
The sensitive endings of the hearing and balance nerves end in different parts of the hearing and balance centers in the inner ear, which contain the same fluid (endolymph). Changes in the circulation, pressure or content of this fluid create stimulation at the nerve endings, causing acute, chronic or recurrent dizziness, with or without accompanying hearing complaints.
Impairment in the blood circulation of the inner ear or Similar complaints occur in other problems affecting the balance nerve.
Be Yin-related diseases:
It occurs as a result of the impairment of the brain's ability to interpret the signals reaching it from the balance organs and to create appropriate responses. Hearing loss and or tinnitus may also be observed. These problems may occur due to advanced age, vascular occlusions or spasms, allergic or metabolic diseases, benign and malignant tumors.
Similar complaints may also occur in cases such as extreme stress, panic attacks, depression and tension. In such problems, imbalance may be accompanied by a feeling of fullness and pressure in the head and ears.
Neck diseases:
Disruption of position information signals sent from the muscles in the neck to the balance centers in the brainstem, which play an important role in maintaining balance. As a result, imbalance may occur. Spasms that occur in the neck muscles as a result of trauma, joint diseases in the cervical vertebrae, or pressure on the nerves in the neck can cause abnormalities in the position signals sent from the neck to the brain and ultimately balance disorders.
Visual Disorders:
Visual defects or The signal incompatibility that occurs when the distorted signals reaching the balance centers from the eyes due to involuntary eye movements caused by diseases in the eye muscles are not in harmony with the signals coming from other balance-sensing structures causes dizziness. Meanwhile, complaints such as sweating, nausea, and vomiting may also occur due to other inappropriate stimulations in the nervous system.
SYMPTOMS IN DIZZINESS ORIGINATING FROM THE INNER EAR
Inner ear functions and or the central nervous system of the inner ear. Diseases that affect the system's connections cause symptoms such as dizziness, hearing loss, and tinnitus. These symptoms may occur alone or together, depending on the functions affected. Dizziness may occur in the form of a very strong spinning sensation, unsteadiness, or light-headedness. Complaints can be continuous or intermittent and are often aggravated by head movements. Nausea and vomiting are also frequently observed, but loss of consciousness does not occur in dizziness originating from the inner ear. The main causes of inner ear dysfunction are infections, most commonly of viral origin, impaired blood circulation, change in pressure in the inner ear fluids, nerve inflammations, veins, medications or tumoral masses.
The most important elements in diagnosis are a detailed history and examination. Hearing and balance tests are required in most patients. In patients who cannot be diagnosed after these stages, radiological evaluations, tests for hormonal and metabolic diseases and allergies, neurological evaluation and tests may also be required.
As a result of these evaluations, it is first revealed whether there is an underlying serious or life-threatening pathology. The results of all these examinations help in choosing the appropriate medical or surgical treatment following the diagnosis.
DISEASES RELATED TO BLOOD CIRCULATION
Vasin spasm, vascular occlusion or rupture and bleeding affecting the inner ear balance organs. Circulatory disorders can cause dizziness, hearing loss and tinnitus.
Dizziness due to vascular spasm usually begins suddenly and is repetitive. Nervous fatigue, emotional stress, some medications, nicotine and caffeine can cause vascular spasm.
When vascular occlusion occurs gradually with age and arteriosclerosis, the inner ear structures can adapt to the decreasing blood circulation over time. Sometimes, a constant feeling of imbalance may occur, and sudden standing up or rapid movements may increase complaints.
In cases of sudden complete obstruction, severe dizziness is usually accompanied by nausea and vomiting. Severe complaints subside in a few days and disappear in a few weeks as the healthy ear takes over its functions.
Sudden complete occlusion-like findings are observed in vascular ruptures caused by high blood pressure or trauma.
Treatment:
In the treatment of dizziness caused by vascular diseases, vasodilator drugs are used along with drugs that relieve the feeling of dizziness in the early stages. Again, sedative medications can be used to reduce complaints by suppressing the balance centers in the early period. Substances with vasoconstrictor properties, such as nicotine and caffeine, should be avoided. Sedative drugs that suppress inner ear functions should not be used for long periods of time in order not to delay the normal ear's recovery of functions.
POSITIONAL DIZZINESS
Especially for young and old people. The most common cause of dizziness observed in middle ages is benign positional vertigo (BPPV).
BALANCE LOSS RELATED TO ADVANCED AGE
The most important factor in balance problems that occur with age is internal It is the disruption of circulation in the capillaries that feed the ear balance centers and balance nerves. This problem rarely causes severe complaints. Decreased blood circulation in the vestibule may cause positional dizziness as a result of shedding of inner ear crystals due to deterioration of cell functions in the balance organs. Balance exercises are generally beneficial in this patient group. The slowing down of vascular reflexes with age may cause loss of balance when getting up suddenly from bed, especially in patients receiving treatment for high blood pressure.
INFECTIONS
Although infections affecting the inner ear may have mild symptoms in the early stages, they affect sensitive balance areas. Symptoms such as severe dizziness and nausea and vomiting occur.
In treatment, the source of infection must be eliminated quickly. Since there are risks such as hearing loss and infection spreading into the head, surgical treatment options are also on the agenda in cases where medical treatment cannot be responded to quickly.
VESTIBULAR NEURITIS
Viral infections affect the balance nerve or balance centers in the brainstem. As a result of its effects, severe dizziness that may last for weeks may occur. In these patients, it may take months for balance tests to improve after the clinical findings disappear. This disease, which usually heals without sequelae, rarely occurs again.
Medical treatment is applied to eliminate severe complaints in the early stages of treatment, followed by supportive treatment and adaptation exercises.
METABOLIC DISEASES AND ALLERGIES
Hearing loss and tinnitus may also be observed along with dizziness in this group. The most common causes are thyroid gland diseases, sugar metabolism disorders, food and respiratory allergies.
Treatment is applied according to the causative disease.
TRAUMA
Blows to the head. It occurs as a result of the inner ear balance center or inner ear blood circulation being affected. Concomitant tinnitus and or hearing loss
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