Dizziness - Causes, Symptoms and Treatment .MF .
sense of balance - the old man in the acquisition process of its evolution.Man in his daily life even osnovnyzadumyvaetsya as he walks, runs, jumps, twirls his head from side to side and not fall.balance of violations leads to panic.Illusory movement of the surrounding environment or the patient, the rotational sense of coups in the head, instability, unsteadiness, throws to the side until the fall - this is called vertigo .
Vertigo patients describe different ways - swing, swimming head, rotating inside the head, unsteadiness, incoordination, weakness in the legs, unsteadiness when walking, sensation of falling or rotation in the head ...
Illusory movement items.
Maintaining equilibrium depends on the visual, vestibular, proprioceptive, and surface - sensory information and provides a unique and highly complex mechanism - vestibullyarnym apparatus.All sensor information is processed in the central nervous system, modulate the activity of the reticular formation of the extrap
vestibular system is located in a rocky part (pyramid) of the temporal bone.According to its structure resembles something unreal fantastic - bony labyrinth consists of three cavities: the front of the cochlea bone;central (vestibular) with an elliptical and a spherical sac;back (vestibular chamber), in which the upper and posterolateral direction are gaps in the semicircular canals;three bony semicircular canals.The spherical and elliptical bags located on a small spot (less than 1 mm 2) formed statolitovoy membrane mucopolysaccharide gel with the inclusion of tiny crystals of calcium carbonate - statolith.The position of the membrane depends on the size and strength of the linear acceleration.Kolboobraznye cylindrical cells and sensory epithelium of the semicircular canal system cells have appendages (hair) - a thick long and up to 50 - 110 fine.When a set of linear acceleration moves with the fluid and has an effect on the subject to the sensory epithelium with hairs.Here and there is translation of mechanical forces (acceleration) in the electrical activity (nerve impulse).This is a very complex mechanism depends on the focus of endolymph current orientation of the hairs.
bony labyrinth filled with perilymph, which by means of connective tissue strands held Interconnected System membranous sacs and membranous labyrinth.The membranous labyrinth is filled with endolymph.Liquids differ in their composition and have never contacted.Three semicircular canals (the ring-shaped formation) lie in three mutually perpendicular planes, representing the three-dimensional space.
supplies the vestibular apparatus of the internal auditory artery branch anteroinferior cerebral and basilar arteries.
vestibular nuclei located in the brain stem of the lateral zone and supplying the penetrating branches of the vertebral and basilar arteries.This area is most susceptible to ischemic damage.The outflow of blood is in the upper bone sinus and sigmoid sinus.
innervated vestibular system vestibular nerve.
vestibular nucleus - a group of cells located in the bottom of the fourth ventricle - the rhomboid fossa.Four cores integrate information from other labyrinths and somatosensory systems.Kernels associated with oculomotor nuclei of the motor part of the spinal cord with the cerebellum, with the autonomic nervous system, the temporal lobes of the cortex of the cerebral hemispheres.It is a "response" motor neurons that innervate the eye muscles (provided the stabilization of the eye position during movement of the head), the authorities involved in the regulation of posture.
Under normal conditions, vestibular activity remains at a subconscious level, there is a momentary "recognition" of changes of sensory influences patterns.The man does not think about the situation when the eye movements of the head and the slopes, diving, walking and running on the balance Hold ... All this makes it instantly vestibular apparatus.
Any dysfunction generation, integration, modulation in this amazing complex mechanism will cause dizziness, imbalance, and possibly nausea, vomiting.
Dizziness may be a slight, transient, and can be progressive and permanent symptom of a serious disease.Causes of vertigo - a pathology of the vestibular portion of the inner ear, damage to ties with the vestibular nuclei in the trunk, with the cerebellum, medial longitudinal fasciculus, the nuclei of the ocular muscles, the muscles of the neck and body, the cerebral cortex.
Diseases accompanied by dizziness
There are systemic and non-systemic dizziness.System dizziness occurs when disease of the vestibular apparatus, there is a movement of his own body and objects.It may be accompanied by autonomic disorders, panic attacks, nystagmus, hearing loss.Observed in Meniere's syndrome, bacterial and viral labyrinthitis, vestibular neurons, and post-traumatic positional vertigo.
non-system dizziness - feeling of "loss of consciousness" predobmoroka, darkening of vision, fear, weakness, discomfort - arterial hypo- and hypertension, autonomic disorders, diseases of the cardiovascular and respiratory systems.
Dizziness occurs when:
- diseases of the ear - acute or chronic inflammation of the middle ear (otitis media);cholesteatoma;after operations on the mastoid, on the inner ear labyrinth with damage;barotrauma;otosclerosis;toxic, infectious and traumatic labyrinthitis;acoustic neuroma;age-related degenerative processes of the vestibular labyrinth;
- cerebrovascular diseases;
- infectious diseases, syphilis of the temporal bone;
- traumatic brain injuries, trauma of the temporal bone;
- nervous system diseases - multiple sclerosis, syringomyelia, Parkinson's disease, diseases of the cerebellum ...;
- diseases of the cerebellum - the degeneration of the tumor;
- diseases of the cervical spine, Paget's disease (deforming ostoz) with a lesion of the temporal bone;
- intoxication - alcohol, industrial solvents, drugs, mercury, drugs;
- psychogenic disorders;
- somatic diseases - hypertension, atherosclerosis, rheumatoid arthritis, coronary heart disease, arrhythmias, stroke, anemia, cancer, peptic ulcer disease, metabolic disorders ...;
- mental illness.
Dizziness when spine pathology provoked by the disorder of blood circulation - vertebro-basilar insufficiency, disorders of the cervical sympathetic plexus, resulting in neck injury (thin shout), degenerative spinal processes, spondylolisthesis, congenital malformations of the spine.
thin shout mechanism of injury of the cervical spine .
Skeletal abnormalities occipital and neck area accompanied by vertigo, provoked by the turns of the head, accompanied by pain in the neck, back of the head, tinnitus, irritability.
positional vertigo - dizziness in the same position, when you turn in bed, in the position at which - the side, tilting the head.This short-term dizziness, possibly accompanied by nausea, does not occur when moving his head slowly.Observed in head injuries, vascular diseases, diseases of the cervical spine, which can lead to failure of blood circulation through the maze of vertebral artery.
Vertigo - the most common symptom in combination with pathological manifestations of vertebrobasilar insufficiency .This periodic or persistent dizziness, spontaneous or provoked by movements of the head and neck, accompanied by a fall, headache, reduced vision, double vision, numbness of the lips and tongue.Vertebrobasilar insufficiency is atherosclerosis of the carotid arteries, hypertension, vascular encephalopathy, cerebral arterial disease.Consequently, all these diseases have in their clinical dizziness.
Dizziness occurs in acute cerebral circulatory disorders - stroke (ischemic and hemorrhagic), often in the brain stem and cerebellum, subarachnoid hemorrhage and can often be a symptom of the traumas of the brain disasters.
vertigo in neurological diseases is never the only symptom and is combined with neurological symptoms - headache, noise, ringing, paresthesias and numbness of the face and limbs, nausea and vomiting, visual disturbances, paresis, paralysis, ataxia, loss of consciousness and objective neurological symptomswhich will see a neurologist.
List drugs with side effects - dizziness, inexhaustible: analgesics, antianginal drugs, antihypertensive agents, beta-blockers, diuretics, cardiac glycosides, antibiotics, nonsteroidal anti-inflammatory agents for the treatment of peptic ulcer disease, antidepressants, anticonvulsants, tranquilizers, hypnotics, antiparkinsonian agents, hormones, ... especially ototoxic aminoglycoside antibiotics - streptomycin, neomycin, kanamycin, gentamicin, tobramycin.The defeat of the inner ear aminoglycoside antibiotics is sometimes very difficult to treat.Imbalance in the application vestibulotoksichnyh drugs is usually transient and recovered after discontinuation of the drug.
Since the list of disease states with huge vertigo, the patient requires thorough examination to determine the cause of vestibular disorders.Primarily need to consult an otolaryngologist doctors and a neurologist;therapist, ophthalmologist, infectious diseases, vascular surgeon, cardiologist - on request.ENT doctor will examine directly the vestibular and hearing aids.Neurology examination except for the detection of specific neurological symptoms may require X-rays of the cervical spine, the temporal bone, the main vessels Doppler, CT and magnetic resonance imaging.Necessary laboratory diagnostics - its amount depends on the individual condition of the patient and found somatic diseases.
Dizziness due to lower intelligence, unfounded pain, hypochondria and depression indicates the presence of neurological or psychiatric causes of the disease.Vertigo - a symptom characteristic of a large number of diseases.Quite often the cause of vertigo remains unexplained even after a full clinical examination.
Treatment of vertigo
for the symptomatic treatment of vertigo use betahistine medications in a daily dosage of 48mg (betaserk, vestinorm);Cardiovascular drugs to improve blood circulation - Sermion, cavinton, memoplant;B vitamins is the main treatment for the disease, a symptom of which acted as dizziness.
For the prevention of vestibular disorders recommended healthy lifestyle, elimination of toxic substances, alcohol, nicotine, drugs, exercise, prevention of cerebrovascular diseases, timely treatment to the doctor and perform the necessary examinations and treatment recommendations.Useful massage darsonvalization neck area, reflexology, health - resort treatment, depending on the existing conditions.
By the way physicians treat when there is dizziness:
take advice doctors otolaryngologist and neurologist;therapist, ophthalmologist, infectious diseases, vascular surgeon, cardiologist - on request.
neurologist Kobzev SV