Dizziness, or vertigo as it is called in medicine, and related imbalance are frequently encountered clinical conditions. Although it can be seen at any age, the frequency of these complaints increases in the elderly population. There are many different causes of dizziness. The disorder we call positional vertigo is caused by crystals pouring into the balance channels in the inner ear and is the most common cause of dizziness at all ages. Viral infections affecting the inner ear and balance organs, and vertebrobasilar insufficiency syndrome, which occurs due to low blood flow to the back part of the brain, are other common causes. Menier syndrome, which occurs with hearing loss, severe dizziness and nausea, is among the causes of migraine vertigo. It should be kept in mind that, in rare cases, brain tumors can also cause such complaints.
Imbalance is the decrease in a person's ability to stand balanced due to the effect of vertigo and other factors. Especially in the elderly, falls due to vertigo and imbalance are an important problem. In this age group, falls due to osteoporosis can cause hip and wrist fractures. Hip fractures can have extremely dangerous consequences, especially in the older age group.
Positional vertigo, also known as benign paroxysmal positional vertigo, is frequently encountered, but its treatment is the most neglected. In these patients, dizziness is affected by head movements. The patient begins to feel dizzy in situations that require neck and head movements, such as turning over in bed at night, tying one's shoes, or looking up. The most important feature is that the dizziness stops within seconds, at most a few minutes. The new head movement initiates a second dizziness attack. In these patients, inner ear crystals can be placed where they should be with a simple maneuver. However, due to lack of knowledge and experience, these patients are given long-term symptomatic medication. However, in such patients, drug treatment has no place after the first 3 days, which we call the acute period. With a special examination method, the diagnosis can be made on the examination table without the need for any device, and it is treated with a simple maneuver in the same environment. The success rate of a single maneuver is around 98-100% and it is extremely effective. After the maneuver, the patient is given a two-day program and neck exercises are performed. Their attachments are somewhat restricted. Afterwards, the patient can return to his normal life.
Dizziness and imbalance may remain after diseases such as vestibular neuritis affecting the inner ear. In these patients, medications should be discontinued as soon as possible and the patient should be included in a vestibular balance rehabilitation program. Research has shown that long-term use of medications disrupts the brain's balance adaptation system and prevents recovery. Contrary to popular belief, drugs have no therapeutic effect in this group of patients. The vestibular rehabilitation program is extremely effective in these patients and the patient's imbalance can be corrected to a large extent. These types of patients can recover with special exercise practices under the supervision of a physiotherapist and with the help of a number of special devices.
In the elderly group, blood flow to the back parts of the brain may decrease due to atherosclerosis and neck calcification. In this case, dizziness is long lasting. It may take hours or days. In such a case, vasodilator and blood thinner medications may be partially effective.
An important cause of imbalance in the elderly is excessive use of medications. Using too many medications, especially blood pressure medications, can cause imbalance and cause falls. The medications of these patients should be reduced to the minimum level possible. This group of patients may develop a fear of falling after a fall and become completely confined to their homes. These patients do not go out and stay at home due to their fear of falling, which causes inactivity, and inactivity causes muscle weakness. As a result, these patients begin to fall even at home. These patients should be encouraged for movement and should be included in a leg strengthening and balance exercise program.
It should not be forgotten that dizziness and imbalance are often treatable conditions, and these patients should not be left to their fate.
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