Dizziness and imbalance are the most common and frightening complaints of patients. Vertigo literally means dizziness, it is not the name of a disease. Vertigo/dizziness and imbalance can have many different causes. The brain, cerebellum, brainstem and its connections, the balance system in the middle ear, visual systems, spinal cord, peripheral nerve network that carries information from muscles to the spinal cord, balance spindles in the joints and the orthopedic system are all anatomical structures responsible for balance. Problems in any of these structures can manifest as loss of balance and feelings of dizziness. In addition, even if all these structures are anatomically normal, stress, infections, vitamin deficiencies, anemia, tumors, multiple sclerosis, lung and heart diseases, migraine, spring season, etc. Many neurological and non-neurological conditions, such as, can also cause a feeling of imbalance and dizziness.
It is a difficult problem to diagnose because there are so many different conditions that can cause the same complaint. Diagnosis can be reached by taking a good history of the disease, a complete neurological examination and, when necessary, blood tests, imaging methods (tomography, MRI), posturography, ear balance tests, EEG or EMG.
Treatment is mostly directed to the cause, if any. When an underlying cause cannot be found, symptomatic (complaint-relieving) treatments are applied. The most important point to know about these treatments is that they should not be used for long periods of time. Because these drugs put pressure on the balance system and prevent dizziness. The balance system, which has been under pressure for a long time, slows down and begins to deteriorate over time, causing the patient to have a constant feeling of imbalance, worsening the situation even further. The biggest mistake to make is to increase the dose of drugs even more.
In fact, the balance system is a system that can heal itself when left to its natural course, but due to incorrect practices, patients get worse day by day and even the normal oscillations caused by gravity. They start to feel it. Thus, the patient, who does not have many problems while lying down, almost begins to not want to stand up and walks with the constant fear of falling or with assistance. . In such cases, by making necessary drug adjustments and balance rehabilitation, the balance perception threshold is increased again and the patients recover significantly.
The hearing system is another system that is different from the balance system but stands side by side. They are rarely affected together. If hearing and balance are impaired together, Meniere's disease or a mass lesion that puts pressure on the middle ear-brainstem-cerebellum area should be considered first.
In addition, migraine disease can cause dizziness with or without headache, and this condition is caused by vestibular dysfunction. It is called migraine or vertiginous migraine. The main treatment is for migraine, of course vertigo medications are also used in attacks for symptomatic improvement.
Read: 0
