What does the balance system consist of?
Our balance system simply consists of the balance organs (semicircular canals) in the inner ear, the balance nerve, brainstem, cerebellum and the magnificent connections of these regions with other parts of the nervous system. In this way, our balance or adaptation of our body to the position in space is ensured.
What is dizziness?
Dizziness usually results from a disruption in the balance system. Dizziness (vertigo) is not a disease. The medical term for dizziness is vertigo. It is often a symptom of various diseases. True dizziness is when a person spins around himself or the environment spins. The feeling of feeling bad, dizzy, unbalanced or nausea often expressed by patients is not medically real dizziness.
What are the causes of dizziness?
Dizziness can be caused by diseases related to the inner ear, nervous system (balance nerve, cerebellum). and brainstem) diseases, psychogenic (expression of stress and distress in the outside world) and systemic causes (such as low blood sugar, high blood sugar, vitamin B12 deficiency, low blood pressure, high blood pressure and anemia). The most common cause related to the inner ear is benign repetitive motion-related dizziness. Dizziness most often occurs due to disease of the balance organ in the inner ear (benign positional dizziness). This is followed by inflammation of the balance nerve (vestibular neuritis) and Meniere's disease. Among brain diseases, cerebrovascular diseases, inflammatory diseases in the brainstem and cerebellum, multiple sclerosis, tumors, migraine attacks and epilepsy seizures may cause dizziness.
What should be done to a patient presenting with dizziness?
Details of dizziness history, duration of dizziness, detection of accompanying symptoms, and detailed systemic and neurological examination are required. The patient's arterial blood pressure must be checked. Positional tests (Dix-Hallpike test, figure 1) and balance tests should be performed. If positional tests are not performed, the examination will be incomplete. The patient should be evaluated in terms of hearing. If an abnormality is detected in the patient's positional tests, maneuvers to treat dizziness should be performed and the patient should be taught. The patient's findings are neurological If it suggests a neurological disease, brain imaging (brain tomography and magnetic resonance, depending on the situation) should be performed. Blood tests are performed when necessary, neurological follow-up, follow-up for ear diseases and psychiatric follow-up are recommended.
When should dizziness due to cerebrovascular diseases be considered?
In dizziness due to cerebrovascular diseases, the vessels leading to the balance centers in the brain are either blocked or blocked. bleeds. In this case, in addition to sudden dizziness, other neurological findings are also added to the patient. These findings include double vision, tremors in eye movements, slurred speech, gait disturbance, imbalance, headache, paralysis, numbness on one side of the body, and loss of consciousness. Sometimes sudden dizziness may be the only symptom of a brain hemorrhage. Therefore, if sudden dizziness persists, urgent brain imaging should be performed.
When should dizziness due to brain tumors be considered?
Continuous dizziness may occur due to brain tumors, but tumors often add other neurological symptoms to dizziness. In addition to dizziness, headache, hearing loss, double vision, imbalance and paralysis can be observed in tumors of the auditory nerve in the inner ear, brainstem or cerebellum. Patients' complaints are often continuous and increase with the growth of the tumor over time. Therefore, if dizziness constantly increases and other findings are added to dizziness over time, brain imaging with medication is essential.
Does multiple sclerosis cause dizziness?
Multiple sclerosis can cause dizziness because it affects the central nervous system. In addition, rather than dizziness, it causes imbalance, slurred speech, double vision, or clumsiness in the hands. If the areas related to balance in the brainstem and cerebellum are affected, it may also cause dizziness only if the disease affects a small area. Multiple sclerosis should be kept in mind, especially in young women when dizziness and other symptoms accompany it.
Is there dizziness associated with migraine?
Motion sickness is very common among migraineurs. Dizziness is more common in patients with migraine than in those without migraine. While dizziness sometimes occurs during the aura period before the migraine headache, most of the time it ukla takes place without headache. The diagnosis of migraine-related dizziness is made by recurrent dizziness attacks on the basis of the presence of migraine. Its treatment is done as migraine treatment. The patient is asked to stay away from triggering factors for migraine and pay attention to regular sleep and meals. Prophylactic treatment such as propronalol is given to migraineurs who experience dizziness even though headaches are not frequent.
What is inflammation of the balance nerve (vestibular neuritis)?
It is a severe dizziness that lasts for hours and days, caused by inflammation of the balance nerve, often as a result of a viral infection. . In this disease, dizziness is long lasting. A special examination method (head turn test) is important in the diagnosis of this disease. Different medications, including cortisone therapy, are used in its treatment.
What is Meniere's disease?
In Meniere's disease, an increase in the fluid pressure in the organ called the snail in the inner ear is observed. For this reason, complaints such as ringing in the ears of patients and the inability to hear especially high-frequency sounds accompany dizziness. In this disease, changes in hearing tests at different times may be instructive. Drugs such as betahistidine are used in its treatment. It is a condition that should be followed by an ear, nose and throat specialist.
How is dizziness treated?
The treatment of dizziness varies depending on the cause of dizziness. Therefore, treatment directed towards the cause of dizziness is essential. In the treatment of benign recurrent positional dizziness, which develops due to inner ear crystals, which is the most common cause of dizziness, a treatment called Epley (Figure 2) or Semont maneuver (Figure 3) is applied, in which the patient's head is turned to certain positions on a stretcher. In the rarer form of benign positional dizziness, the Lempert maneuver is applied (Figure 4). After this treatment, patients are advised not to lean forward or backward too much and to lie down with the head in a high position for 24 hours. The use of a neck brace may also be recommended for patients who cannot do this effectively. The maneuvers may need to be repeated in some patients. Dizziness exercises that can be done at home (Brandt and Daroff exercises, figure 5) are very useful for patients with positional dizziness. � will happen. Drugs that suppress the cells in the balance system are also used in the treatment of dizziness. However, these drugs are mostly recommended for short-term use, except for Meniere's disease.
What should I do in case of recurrent dizziness?
In this case, if there is no other symptom accompanying the dizziness, there may be two problems: either you have Meniere's disease or you have inner ear crystals. Your vertigo is recurring. The distinction between the two conditions is made by examination and hearing tests. Preventive treatments that reduce intra-ear pressure for Meniere's disease, and for dizziness due to ear crystals, in addition to maneuvers, some balance exercises and exercises that desensitize the balance organ in the inner ear (Figure 5) are recommended. If you have any other complaints other than dizziness (such as headache, numbness, double vision, slurred speech, loss of strength, etc.), you may have a brain disease. In this case, brain imaging (MRI) is required. Treatment can be applied according to the appropriate diagnosis.
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