Dizziness - types, symptoms, causes and treatment

Dizziness causes a loss of balance; it seems as if the ground is “moving away” from under your feet. As a rule, even a completely healthy person sometimes faces such problems. For example, when turning the head, standing up suddenly or changing body position, after a head injury, drinking alcohol. Frequent dizziness can be the cause of more than eighty pathologies that provoke this unpleasant sensation, so treatment methods for the disease depend on determining what exactly causes such a symptom.

Serious health problems are not always easy to identify. Frequent problems with loss of balance can be caused by several diseases at the same time. There are also simple reasons that are quite easy to eliminate.

Characteristics of manifestations of dizziness and nausea

Phrases: “I feel dizzy”, “I feel sick”, “I feel weak and unwell” are heard quite often. The causes of such symptoms in women can be not only the joyful events of pregnancy, but also an imbalance in the body.

Dizziness is an uncomfortable condition caused by a false sensation of movement and rotation of objects around the body. It seems to the woman that the objects around her are rotating dynamically. The effect of ground vibration is also possible. Moreover, vision and sensation are preserved regardless of the focus of the gaze, and sometimes even with closed eyes. For each woman, the feeling of dizziness manifests itself purely individually, from lightheadedness and nausea to the effect of intoxication.

This symptomatology is mentioned by almost every patient. As medical experts have established, it can be a manifestation of more than 100 diseases, and can also be a consequence, addition of many pathological processes, or the result of excessive stress, poor nutrition and lack of rest.

Symptoms may be caused by:

local reasons. For example, poisoning, infections, intoxication process;
cerebral reasons. Due to the development of a lack of oxygen and necessary substances in the brain.

False dizziness

The symptom of dizziness in a woman can often be perceived incorrectly, since the view of this sensation is purely subjective.

The following symptoms are considered to be a feeling of dizziness:

temporary loss of balance;
loss of stability when walking;
feeling of falling through while moving;
nausea;
fainting or pre-fainting;
eclipse or darkening of the eyes.

These symptoms are not characteristic of dizziness, although they can lead to its manifestation. As medical research statistics show, 70% of women mistake the sensations of jolts, dips, ringing and emptiness in the head, instability when moving for dizziness. The effect of rotation of the body, environment, elements and objects is very rare.

Subsequent diagnostics reveal that such disorders in patients are caused by the following disorders and pathological processes:

thyroid disorder, diabetes;
dysfunction of the visual system;
disease of the cardiovascular system;
neurological pathology.

Accordingly, only 30% of patients have signs of vestibular disturbance in the form of dizziness combined with nausea, fever or cold sweat, vomiting and an actuating sensation of rotation.

Timely diagnostic methods and technology make it possible to identify the true causes of various symptoms and carry out the correct treatment.

Causes of weakness, nausea and dizziness in women

Severe dizziness and headaches among the fair sex are quite common symptoms. This problem significantly affects functioning, ability to work and personal life. There can be many reasons for dizziness in women. One of the reasons may be excessive sensitivity or emotionality.

Representatives of the fair sex of different age categories with a thin physique, as well as fans of dietary nutrition, are prone to dizziness and the development of weakness. Lack of proper and balanced nutrition leads to a lack of glucose in the blood. This process ensures a slim body shape, but depletes the body, including brain cells.

Dizziness can lead to malaise, weakness, nausea, vomiting, causing headaches. The causes of dizziness in women can be caused by the following factors and reasons:

the period of pregnancy, which from the very beginning leads to profound changes in the body, its restructuring and, accordingly, the frequent appearance of dizziness. It is normal to experience dizziness and nausea in the first trimester, when a sharp hormonal surge occurs. Dizziness is considered normal throughout pregnancy in women suffering from low blood pressure. Constant dizziness can regularly provoke toxicosis - a process that is subject to regular monitoring;
a reduced level of hemoglobin and iron in the blood also causes an unpleasant condition when dizziness, weakness and nausea occur. During pregnancy and the manifestation of corresponding symptoms, mandatory medical supervision is necessary;
weak vestibular apparatus. This physiological feature of a woman’s body leads to the fact that she gets motion sickness when traveling in a car, plane, train, watercraft, and is unable to ride on swings and carousels;
excessive emotions and stress. Women are prone to excessive emotions and stress in the process of making decisions and analyzing information. And also when participating in certain events, speaking in public and other individual events.

Important! Excitement and emotional arousal lead to poor circulation and improper supply of oxygen to the blood, which leads to oxygen starvation

Fatigue, unstable sleep, lack of rest, “chronic fatigue” syndrome, and the dynamic rhythm of life lead to exhaustion of the body. The result is a reboot of the neuropsychological system, as well as oxygen deficiency of cells, leading to dizziness.

Hypertension or hypotension, natural changes in atmospheric pressure lead to disturbances in brain function and dizziness. Women prone to hypersensitivity and dependence on natural changes (climatic, magnetic storms) may also experience symptoms of weakness, nausea, headache and dizziness.

Chronic diseases and symptoms of the acute phase of various diseases. Dysfunctions and pathologies of blood vessels, the spine, brain diseases, diabetes mellitus, and cancer lead to similar symptoms.

Menstruation and menopause are the cause of hormonal changes in the body. During menstruation, the amount of hormones in the blood increases, which leads to dizziness. A similar process occurs during menopause. Menstruation is accompanied by blood loss, hemoglobin levels are lost, which leads to oxygen starvation of the brain. Menopause is characterized by hormonal changes, so both processes can lead to malaise, nausea, weakness, headaches, dizziness, and emotional instability.

Regular dizziness in women is a very unpleasant and dangerous symptom. Delaying contact with a doctor or self-diagnosis with subsequent treatment leads to a worsening of the condition and neglect of the disease.

Weakness, characteristics and manifestation

Weakness is one of the most common symptoms, affecting both children and the elderly. The factors leading to this phenomenon can be very different, both physiological and psychological. However, manifestations and sensations are purely subjective and individual. It can manifest itself in a woman’s increased fatigue, dizziness, absent-mindedness, weakening of memory and attention, and lack of energy.

Causes of weakness in women include:

overstrain – physical, emotional, psychological. Occurs as a result of lack of proper rest or emotional and psychological stress. Lack of proper rest and sleep, poor nutrition;
chronic or acute diseases;
infectious diseases - influenza, sore throat, ARVI.

Weakness leads to physical illness, disability, poor functioning and discomfort.

Process diagnostics

In order to diagnose the causes of dizziness, nausea and weakness, a woman should go to the hospital to see a therapist, who, based on the symptoms, will determine the circle of specialized specialists who should examine the patient:

ophthalmologist, neurologist, oncologist;
gynecologist, otolaryngologist, cardiologist, etc.

The examination is carried out using various laboratory and instrumental research methods:

MRI, CT;
X-ray, blood and urine tests;
Audiography, Dopplerography, etc.

Important! A timely visit to a medical facility will allow a thorough diagnosis of the patient’s condition. The cause of the malaise will be determined, in the form of manifestations of dizziness, nausea and weakness, and a course of treatment measures adequate to the condition will be prescribed.

Women experience dizziness, nausea, vomiting, weakness and lethargy much more often than men. There are several reasons for this. Do you always need to see a doctor about this? If such symptoms are repeated frequently, this cannot be ignored and attributed to overwork and lack of sleep.

Central vertigo

Brain dysfunction is the main cause of severe dizziness. What causes this unstable condition?

Tumor. Benign or malignant, in any case will entail a number of characteristic symptoms. If the patient feels dizzy, this is the most harmless sign of this illness. Due to the growth of the tumor and its development, the brain tissue is compressed, and headache, nausea, and vomiting are added to the symptom.

Migraine. The disease is characterized by excruciating headaches, partial loss of hearing, vision and smell, and sometimes the person begins to become delirious. And dizziness is a harbinger of an attack.

Sclerosis. Damage to the nerves of the brain. Possible double vision, unsteady gait, numbness of the limbs.

Osteochondrosis. Overgrowth of cervical joints with osteocytes. When moving, especially sharply, the nerves in the vertebrae are compressed, and dizziness occurs.

Traumatic brain injuries. Consequences of bruises. If the blow was not strong, then the corresponding symptoms soon disappear. If a person often feels dizzy for a long time, then he should immediately consult a doctor.

Epilepsy. Seizure attacks begin with sudden dizziness. Then the person becomes lost in space and falls into convulsions.

With cardiovascular diseases, dizziness occurs, which can signal the following:

Atherosclerosis. Due to the congestion of blood vessels with bad cholesterol, the brain does not receive enough blood and oxygen, resulting in dizziness.
Change in pressure. Both low and high blood pressure can cause severe dizziness.
Arrhythmia. Due to the uneven beating of the heart, the functioning of its parts is disrupted. As a result of undistributed hemoglobin throughout the body, an unpleasant symptom occurs.
Stroke. Brain hemorrhage. The warning sign is dizziness.

The above are just some of the reasons why you may feel dizzy when it happens suddenly. No matter how strong or weak the symptoms manifest themselves, this is a good reason to consult a doctor.

Causes of dizziness, nausea, vomiting and weakness in women

Hormonal disbalance.
Oxygen starvation of brain tissue.
Orthostatic collapse.
Hypoglycemia and anemia.
Poisoning.
Spinal damage.
Stroke.

Such diseases are characterized by the sudden onset of all symptoms, dizziness, nausea, vomiting and weakness. At such moments, a woman experiences great anxiety, which can worsen her condition. Therefore, if dizziness and weakness occur, the first thing you need to do is pull yourself together.

Hormonal disbalance

There is a certain balance of hormones in the body. Its violation leads to serious consequences. If the required amount of these substances is not restored, significant disruptions in the functioning of all organs and systems may occur.

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It is impossible to establish the balance of hormones on your own ; it is necessary to undergo tests that will show the woman’s hormonal levels, and only after that the doctor will prescribe treatment. The course of taking medications can be very long, up to several years, and sometimes it only takes 2-3 weeks .

Causes:

Diseases of a gynecological nature.
Colds and viruses.
Constant strong physical activity.
Poor nutrition.
Excess weight.
Smoking , alcoholism.
Postpartum hormonal imbalance and pregnancy.
Taking hormonal drugs.
Climax.
Puberty period
Psychological reasons.

In addition to dizziness, nausea and vomiting, a woman may experience other symptoms that indicate hormonal imbalance . It is quite easy to suspect that you have a hormone imbalance, because such signs cannot be ignored.

Signs of hormonal imbalance:

Sudden change of mood.
Increasing body weight.
Constant feeling of fatigue and insomnia.
Dizziness , nausea and vomiting.
Headache .
Lack of sexual desire.
The appearance of acne on the body and face.

Oxygen starvation of brain tissue

Oxygen starvation of the brain can occur for several reasons. The signs of this condition and their severity make it possible to understand how serious and severe the disease process is.

Causes:

Poor blood circulation in the meninges.
Shock states.
Malfunctions of the cardiovascular system.
Chemical poisoning
Lack of oxygen in the air.

To make a final diagnosis, the doctor needs to know all the signs of the disease, and in addition, a number of diagnostic procedures. This condition is very dangerous for a woman and requires immediate medical attention.

Signs:

Dizziness , nausea and vomiting.
Increased heart rate and breathing.
Pale skin.
Cold sweat on the face, arms and legs.

minor appear , but the more severe the disease develops, the more organs are affected, and vital processes are disrupted.

In the acute stage, the disease cannot be ignored. The woman is hospitalized and given the necessary treatment, and in addition to the general signs of the disease, very severe symptoms are added.

Orthostatic collapse

This disease is a jump in blood pressure, downward. This happens due to a sudden change in the woman’s position, when she quickly gets out of bed or, conversely, if the woman quickly lies down. Staying in one position for a long time can also cause an increase in symptoms of the disease.

Causes:

Dehydration of the body.
Side effects of some heart medications.
Infectious intoxication
consumption .
Diabetes .
Neurological diseases.
A constant state of stress.
Refusal to eat or not eating enough.
Elderly age.

The disease is classified according to the duration of symptoms and is divided into several stages, mild, moderate and severe. Depending on the stage of the disease, the doctor prescribes treatment.

Most often, this disease affects young women trying to quickly lose weight. To quickly achieve the effect of losing weight, girls take diuretics and laxatives, which is fraught with pronounced signs of this disease.

Signs:

Dizziness, nausea, vomiting.
Fainting.
Noise in ears.
Hearing impairment.
Darkening in the eyes.
Thirst.
Weakness in the limbs.

Hypoglycemia and anemia

A decrease in blood sugar is called hypoglycemia. A decrease in hemoglobin levels is called anemia. These two diseases can manifest themselves in the same way. Both conditions are quite dangerous for a woman. A large number of representatives of the fairer sex suffer from anemia.

This is associated with monthly menstruation, especially if it is heavy. The symptoms of both diseases are similar: dizziness, nausea and vomiting.

Causes of glycemia:

Diabetes.
Dehydration.
Wrong diet.
Alcoholism.
Constant overwork.
Hormonal disbalance.
Failure of the heart, liver and kidneys.

Causes of anemia:

Prolonged menstruation and some gynecological diseases.
Bleeding of any nature.
Increased need for hemoglobin.
Poor absorption of iron by the body.

To clarify an accurate diagnosis, a number of laboratory blood tests are required. Women, turning to a specialist, must describe their condition in detail. Treatment of these ailments can take several months , and in especially severe cases up to several years .

Poisoning

The signs of poisoning are familiar to everyone: dizziness, nausea and vomiting. The causes of this condition can be various foods or chemicals. It is quite possible to cure the disease yourself if it manifests itself in a mild form. Sometimes a woman needs hospitalization.

Spinal injuries

Every woman, when dizziness, nausea and vomiting occurs, will first of all think about the cause of this condition. If there have been recent injuries or damage to the spine, it becomes clear what influenced the presence of such unpleasant symptoms.

Spinal injuries can be very dangerous; if dizziness, nausea and vomiting occur, you should immediately contact a medical facility.

Stroke

This disease is deadly. In the early stages, doctors can help a sick person recover as much as possible, so at the first signs of illness, it is better to immediately call an ambulance.

Causes:

The occurrence of blood clots in small vessels.
Rupture of the vessel wall and hemorrhage in the brain.

Women are susceptible to this disease at a later age than men, but these days, even young people are becoming victims of stroke. In order to protect yourself from such a terrible disease, you need to undergo medical examinations regularly and be less nervous.

Signs:

Dizziness, nausea and vomiting.
Depression and loss of consciousness.
Headache.
Increased breathing.

In addition to the main diseases, the symptoms of which may be dizziness, nausea and vomiting, there are more rare and deadly ailments. Only doctors are able to identify the true cause of such conditions, so medical examinations should not be neglected.

Causes

Mild dizziness in itself is a symptom and not a separate disease . Therefore, it is necessary to understand what diseases can cause it.

Presence of nausea

The most common causes of this combination of symptoms, if we exclude pregnancy, toxic infections and various poisonings, are:

vegetative-vascular dystonia;
osteochondrosis;
vertigo syndrome;
anemia;
hypotension;
hypoglycemia in diabetes mellitus;
metabolic disorders in hypothyroidism and hyperthyroidism;
coronary heart disease with heart rhythm disturbances;
traumatic brain injuries;
taking medications with similar side effects.

Feeling unwell during the day

The most common causes of dizziness are:

Motion sickness in transport, regardless of its type.
Attacks of dizziness in pregnant women due to decreased glucose levels or hypotension.
Treatment with antibiotics occurs after drug withdrawal or dose reduction.
Strong emotions, increased fatigue, stressful conditions.
Turn your head. It occurs in older people and does not pose a threat to life and health.
Dilatation of cerebral vessels. Occurs when a person suddenly stands up or bends down. Caused by a disruption of the blood supply to the central nervous system.

Every day

They usually arise for a number of fairly serious reasons. Most often this is:

Benign paroxysmal positional vertigo (BPPV). With this disease, the slightest movement of the head can cause dizziness.
Meniere's disease. Often the attacks are severe and are accompanied by tinnitus, nausea, and vomiting.
Oncological diseases. As the disease progresses, attacks become more frequent and intensified.
Diseases of the cerebral vessels (ischemia, atherosclerosis, narrowing of the arteries). Dizziness occurs due to insufficient blood circulation.
Heart rhythm disturbances such as tachycardia and bradycardia.

In children

First of all, you need to understand that the child has this symptom. Young children cannot always explain this feeling. And even babies who can’t speak yet get dizzy

It is worth paying attention to changes in behavior. The child lies face down and remains motionless

Tries to fix its position to stop the rotation. At the same time, his eyes are closed. If dizziness occurs during the game, you may notice confusion and lack of understanding of what is happening.

Causes of mild dizziness in children may include::

various diseases of the inner and middle ear;
vegetative-vascular dystonia;
pathologies of cerebral vessels;
intoxication due to infectious diseases;
concussions;
various poisonings;
meningitis, encephalitis and other inflammatory diseases of the brain;
decreased hemoglobin level;
food allergies;
weak vestibular apparatus and kinetosis.

Drowsiness and lethargy in women

The state of lethargy and drowsiness appears for a number of reasons. Basically, a woman with such symptoms is simply overtired and did not get enough sleep, but if this condition lasts a long time and practically does not go away, it is necessary to consult a doctor.

Causes:

Constant excessive physical activity.
Insufficient night sleep.
Binge eating.
Pregnancy.
Stress.

If a woman is not bothered by anything other than drowsiness and lethargy, there is no reason for alarm. You just need to relax and get some sleep . If, however, more severe conditions are added to these symptoms, you cannot do without a medical examination.

People tend to overeat. Women love to eat tasty things, to which their body reacts with drowsiness and lethargy.

Pregnancy

Feelings of dizziness, nausea, vomiting, drowsiness and lethargy are common to almost all pregnant women. This condition is caused by hormonal . In the first months of pregnancy, these unpleasant symptoms are especially acute, when the body is just beginning to rebuild.

Dizziness and tinnitus

Dizziness may accompany tinnitus and hearing loss in the following conditions.

Episodic dizziness, which begins severely, lasts several hours, and has symptom-free intervals between episodes, is caused by labyrinthine disorders. Provoked by changes in head position.
The presence of hearing symptoms indicates problems with the inner or middle ear. The ear with impaired hearing is usually on the side of the affected organ.
With acoustic neuroma, there is usually a progressive unilateral hearing loss that lasts for several months, forcing the patient to see a doctor.
Hearing loss, dizziness, and ringing in the ears form the characteristic triad of Meniere's disease.
Vestibular neuritis and labyrinthitis cause continuous dizziness, which can be aggravated by movement and last for several months.
Fluid accumulation in the middle ear as a result of inflammation can cause mild dizziness.

What to do if you feel dizzy

An attack of dizziness can cause panic in a woman:

If you experience severe dizziness, you first need to calm down, because this condition is not fatal.
alleviate this feeling a little by leaning your head against a hard surface, or better yet, by lying down.
When experiencing dizziness , it is better not to close your eyes, as this may worsen the symptom.
The gaze must be focused on one object or place, this makes it easier to endure this ailment.
The air in the room where the person suffering from dizziness is located must be fresh, so it is necessary to open the windows. In addition, a sedative, preferably of plant origin, can relieve this condition.
If dizziness does not go away, despite all efforts, but only gets worse, you need to call an ambulance.

Pressure disorders

High blood pressure (arterial hypertension) is a condition in which the blood pressure at rest is higher than 140/90 mmHg. Art. Moreover, these indicators are sufficiently constant and high that heart problems subsequently begin. Accompanied by symptoms such as:

Dizziness. The most common sign of high blood pressure. Sometimes it is so strong that you have to close your eyes.
Nausea, vomiting.
Bad dream.
Numbness in fingertips.
Visual impairment - “floaters” appear before the eyes.

The disease often occurs among women over 40 years of age. In addition, increased blood pressure can be caused by other factors:

Frequent consumption of foods with saturated fatty acids (butter, sour cream, sausages, cheese, cakes, snacks, cookies, etc.)
High salt content in products. Makes blood vessels fragile, inelastic, changes their structure.
Large doses of alcohol. Provokes a strong heartbeat.
Stress, emotional overstrain.

If you do not take any action at the initial stage of arterial hypertension, then serious disturbances in the body’s vital functions occur - heart and kidney failure, problems with cerebral circulation. as a result, there is a risk of heart attack, stroke, and cerebral ischemia.

Diagnostics

Today there are many methods for diagnosing dizziness. To find out the exact cause of dizziness, a comprehensive examination is needed. Videonystagmography , videooculography and devices that examine the vestibular apparatus can most accurately determine why dizziness constantly haunts a woman.

MRI and CT will reveal this perfectly . Some laboratory tests will show the cause of dizziness, if its root cause is viruses and infections.

What causes dizziness when standing up?

The cause of dizziness during sudden movements and standing up is due to the fact that the brain does not have enough O2. If a person continues to move rhythmically, he may lose consciousness.

Experts call this condition vertigo. It occurs due to various reasons, including disorders of the vestibular apparatus, neuritis, inflammatory processes in the ears, neuronitis, stroke and trauma. Also, people who have heart and vascular diseases often suffer from dizziness when standing up.

In adolescence, a similar phenomenon occurs due to puberty.

It should also be said that such a condition as vertigo is typical for sedentary people who lead a sedentary lifestyle. That is why patients with a similar symptom are advised to move more, as well as perform special exercises, which have a positive effect on the vestibular system.

Treatment of dizziness

cannot be treated as a separate disease . If this symptom is very painful, you can temporarily alleviate the patient’s condition. First, you should find out the reason why the dizziness occurred, and only then begin treatment.

There are special medications that help relieve this unpleasant symptom, but they can only be taken as prescribed by a doctor. Traditional methods can also reduce dizziness, although their effectiveness is quite low.

Dizziness, weakness and nausea - these three symptoms can either indicate the presence of pathological processes in the body or occur for minor reasons.

In many diseases, discomfort of this kind is diluted by other symptoms characteristic of each individual ailment. For example, if the culprit of dizziness and weakness is the flu, then chills and increased body temperature are simultaneously observed. Treatment of these conditions is impossible without diagnostic measures.

In case of a sudden attack, first non-drug aid can be provided.

Types and types of dizziness

True dizziness is a state when a person feels the movement of objects that surround him, or a false sense of rotation of his body.

Most often, true dizziness indicates signs of a disease associated with the control of the spatial location of the body, especially if it is accompanied by vomiting or nausea. The spatial arrangement system of the body also includes the eyes, the vestibular apparatus of the inner ear, and sensory receptors of muscles, bones and joints.

True dizziness can be central or peripheral. If the cause is a brain pathology, this is central vertigo. When true vertigo occurs due to damage to the structures of the vestibular apparatus of the inner ear or the vestibular nerve, the condition is considered peripheral.

It should be noted that dizziness does not always indicate illness. Here are a number of circumstances when this condition is possible:

side effect of medications - the use of certain types of drugs can cause dizziness. Most often, the manufacturer lists this as a possible side effect that this medicine may cause;
rotation around the axis of the body or riding on a merry-go-round - dizziness is considered a completely normal reaction to this impact. After completion of the stimulating effect, this state passes quite quickly;
stress leads to psychogenic dizziness; this condition is provoked by disturbances in the functioning of the nervous autonomic system. Most often in these situations, a person experiences confusion of thoughts, fog, headache, and in some cases, fainting;
a sharp decrease in the amount of glucose in the blood - with poor nutrition, the level of glucose in the blood decreases, this leads to dizziness and weakness.

Physiological reasons

Sometimes you feel dizzy and nauseous as a result of some physiological processes that have been disrupted due to the increased release of adrenaline in a stressful situation. At the same time, the patient experiences vascular spasm, and disturbances occur in the brain due to lack of oxygen. Also, unpleasant symptoms arise as a result of false perception, when the brain perceives what is happening around in a completely different way, not as it really is.

Physiological causes of vertigo and nausea include the following factors:

Problems focusing your eyes.
Poor nutrition. It leads to insufficient supply of sugar into the blood, and in parallel other symptoms are also noted: weakness, weakening of the immune system.
A sharp turn of the head, which causes disruption of blood flow to the brain and problems with coordination. When performing exercises with turns, you should be careful.

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The listed conditions are not considered dangerous and are not capable of causing the development of any serious diseases. Dizziness and nausea disappear gradually, immediately after the patient stops doing exercises or moving and is at rest.

Functional reasons

Benign or false dizziness occurs in people of different age categories, regardless of gender. Usually they don’t last long, they don’t bring too much unpleasant sensations, sometimes it becomes dark in the eyes, and noise appears in the ears. They appear in the following cases:

Your head may feel dizzy when you make sudden movements or get out of bed quickly. For a moment, a person feels a darkening in his eyes, and experiences a feeling of falling into emptiness. The symptoms are caused by a sharp outflow of blood from the brain when the vessels do not have time to “rebuild” when changing body position. To avoid this, you should not make sudden movements or jump out of bed too quickly.
In women, hormonal instability before menstruation or during menopause often causes a feeling of dizziness and instability.
Dizziness is initiated by diets and poor nutrition, bleeding during menstruation, reducing the supply of oxygen or glucose to the blood.
Psychogenic dizziness, caused by a sharp release of adrenaline into the blood, also occurs. By this condition, a person often means weakness in the legs, clouding of consciousness, confusion of thoughts.
Almost all people experience a similar state when riding a carousel; another question is how quickly it will occur. It all depends on the functioning of the vestibular apparatus; for some, just the sight of a rotating wheel makes their head spin. This phenomenon is normal and goes away after some time.

Pathological causes

Serious pathologies, the symptoms of which are frequent dizziness with nausea, include:

VSD is a neurological disorder characterized by sudden changes in blood pressure.
Osteochondrosis of the cervical spine. Provokes disruption of blood supply. In this condition, the hands go numb, the neck moves stiffly, and the head hurts.
Hypoglycemia – a decrease in blood glucose levels leads to insufficient nutrition of brain structures.
Anemia (anemia) - a reduced level of red cells in the blood leads to a lack of oxygen in the brain structures and the occurrence of symptoms such as dizziness, weakness, lack of appetite, nausea, pale skin.
Meniere's disease is a pathology affecting the vestibular apparatus. The first sign of a dysfunction of the vestibular system is systemic dizziness, which in advanced cases can be accompanied by nausea and vomiting.
ENT diseases – otitis media in chronic or acute form, labyrinthitis.
Arterial hypertension - the described symptoms occur at the time of crisis, complemented by ringing in the ears, rapid heartbeat, and bursting pain in the head.
Hypotension - abnormally low blood pressure is characterized by attacks of nausea, dizziness, sweating and weakness.
Migraine – dizziness with attacks of nausea are common symptoms of an aura that occurs before a migraine attack.
Intracranial hypertension - the accumulation of fluid in the brain tissue and its pressure on certain nerve endings can cause attacks of nausea and dizziness.
Vertebral artery syndrome, which occurs as a result of the development of cervical osteochondrosis, leads to brain hypoxia and the appearance of unpleasant symptoms.
Infectious damage to the brain and its membranes caused by meningitis, encephalitis (including tick-borne). The condition is aggravated by fever, severe vomiting, impaired consciousness, and unbearable attacks of headaches.
Intracranial tumors - nausea and dizziness can be caused both by the pressure of the formation on certain centers, and by the toxic effect of cancer cells on all vital systems.
Stroke is a serious condition in which there is a real threat to life or loss of vital functions with a low probability of their full recovery. In addition to severe dizziness and a feeling of nausea, a person at the time of an attack experiences vomiting, impaired speech and balance, and paralysis of the limbs.

Among the described causes of nausea with dizziness, it is important to identify the true one in order to take measures to eliminate it.

The mechanism of development of dizziness

A person’s orientation in space depends on the interaction of three body systems:

visual (eyes);
proprioceptive (muscles, joints);
vestibular (ear labyrinth).

Visual impulses passing through the higher brain centers provide information about the position of the body in space. Impulses from proprioceptors of joints and muscles support information about changes in the position of the limbs relative to the body. Impulses from the neck indicate the position of the head relative to the rest of the body. Impulses from the ear labyrinth determine the position of the body in space. When the interaction of these systems is disrupted, dizziness develops.

Additional reasons for women and men

Unfortunately, women often face similar discomfort. The causes of weakness, dizziness, and nausea may be:

excessive emotionality;
excessive sensitivity;
strict diet;
poor sleep;
condition during pregnancy;
weak vestibular apparatus;
low iron levels.

Women prone to increased sensitivity to changes in atmospheric pressure experience headaches, nausea, dizziness, and weakness. Symptoms may occur during menopause, which is characterized by hormonal changes and emotional instability. This type of disorder occurs in girls during menstruation. In this condition, the content of hormones in the blood increases, hemoglobin levels are lost, and therefore weakness is felt.

Common causes of dizziness, weakness and nausea in men, doctors include:

cervical osteochondrosis;
intoxication with alcohol-containing drinks;
inflammation of the inner ear;
decreased blood pressure;
neoplasms in the brain;
mental disorders;
migraine.

The prevalence of this condition in men is about 20%, but the exact figure could not be determined. The reason lies in the fact that men rarely go to the doctor. Evidence of illness, and not a symptom of fatigue from work, is dizziness, accompanied by weakness and nausea. Discomfort often occurs after the age of 40. If these symptoms appear in young people, this indicates cardiovascular pathology.

Symptoms of dizziness

Each attack in which you feel dizzy is accompanied by individual symptoms, depending on the factor that influenced the dizziness.

In the vast majority of cases, the following symptoms are observed in the presence of dizziness:

Increased body temperature;
Deafness, a feeling of weakness and dizziness may indicate the development of malignant tumor formations in the brain ;
Strong feeling of tinnitus, possible temporary deafness;
Weakness, fatigue;
There is an increased secretion of sweat;
A feeling of general heaviness in the head and occipital area;
Rotation of surrounding objects and one’s own body in space, impaired coordination of movements and temporary loss in space;
Limited movement of the neck, or pain when moving it. This symptom often begins to appear with osteochondrosis of the cervical spine;
Feeling of rapid heartbeat;
Constant nausea and vomiting;
Depression and constant mood changes are observed during menstruation, menopause, and pregnancy in the first trimester;
Sudden changes in blood pressure;
Nausea and loss of coordination are caused by possible pregnancy;
Unsteady walking, or unsteadiness when walking.

All of the above signs can appear either once or be present for several days. In the second situation, prolonged manifestation of symptoms requires the person to go to the hospital.

If the following pathological signs are detected, you must immediately go to the hospital for a full examination:

Constant dizziness (if not eliminated within one hour) ;
Severe dizziness, accompanied by weakness in the arms and legs . In some cases, a person is unable to move or hold objects in his hands;
Loss of consciousness , especially if a person receives a traumatic brain injury;
Increase in body temperature to forty degrees;
State of coma, or crisis , which can progress with hypertension or diabetes mellitus;
Frequent urge to vomit (more than five times a day).

If one of the above symptoms is detected, you must immediately go to the hospital to find out why they appeared and apply urgent and effective treatment.

Symptoms of dizziness

Signs of vertigo are divided into four clinical groups:

Vestibular vertigo. An adult has the impression of falling from a height of height. The surrounding objects float in the eyes. In addition to the rocking of everything around, symptoms appear: increased sweating, nausea with vomiting, hearing impairment, slight visual vibration.
Pre-fainting state. A sudden drop in blood pressure and heart disease cause loss of consciousness and a feeling of cloudiness. Poor health is accompanied by pale skin, nausea, darkness in the eyes, sweating, and rapid pulse.
Psychogenic vertigo. Worldview characteristic of severe mental disorder, depression. The condition is accompanied by nausea and heaviness in the head. A person walks with a clouded consciousness, the surrounding space looks like a viscous substance. Dizziness causes fear of falling.
Lack of balance. Vertigo without nausea is associated with unsteadiness when walking. The patient has difficulty standing in one position, swaying a little. Orientation is lost in the dark, and at night a person bumps into surrounding objects.

How to recognize dizziness?

Dizziness is an imprecise symptom. Patients often use this term to describe movement problems, weakness, mild headaches, unsteadiness and depression.

Historically, dizziness has been classified into four categories:

vertigo (illusion of movement);
fainting conditions (feeling of increased weakness);
lack of coordination (loss of balance when walking);
nonspecific dizziness.

Vertigo is an illusion of movement, classically described as objects spinning around the patient. Additionally there are:

objective vertigo - a feeling that the outside world revolves around the patient;
subjective vertigo is a feeling that the person himself is spinning, although he is motionless.

Syncopal states are often combined with weakness and impaired clarity of thinking.

Poor balance is usually described as an unsteady gait.

Nonspecific dizziness is usually associated with anxiety and panic.

For some patients, dizziness is a metaphor for an illness that can have a variety of causes, such as anemia, viral infections or depression.

Diagnostics

During the diagnostic process, doctors first find out the reasons why you feel dizzy and nauseous, and only then carry out symptomatic treatment. Based on the above, we can conclude that there are many factors that can provoke nausea and dizziness, therefore, if such symptoms are present, the patient is sent for a serious examination, which may include, depending on the situation.

The following studies are mainly prescribed:

General blood and urine analysis.
Ultrasound examination of the head and cardiovascular system. It will confirm or refute diseases of the cardiac system, their course, and pathologies.
Electroencephalography shows the presence of epilepsy and other diseases associated with brain activity.
An electrocardiogram will help determine the heart rate, all changes in the functioning of the heart muscle, and inflammation.
An X-ray of the cervical spine will determine inflammatory processes in this area, neoplasms, arthritis, deformities, sciatica and much more.
Magnetic resonance imaging of the brain will help identify heart attack and stroke, multiple sclerosis, and pituitary adenoma.
Neurological diagnostics is an opportunity to make or refute diagnoses such as: migraine, insomnia, genetic pathologies, stroke, inflammation of the nervous system, osteochondrosis, multiple sclerosis.
Pure-tone audiometry detects hearing loss or hearing problems.

Having clarified the reasons why you feel dizzy and nauseous, doctors begin to treat the underlying disease. Symptomatic therapy only complements it, and is not the main thing.

Central vertigo

The main causes of central vertigo include changes in the brain:

Tumor. A neoplasm in the brain, even in the early stages, can manifest itself in sudden painful attacks, during which the head begins to feel dizzy, the person becomes very nauseous, even vomiting. Symptoms appear due to compression of brain tissue and irritation of neurons; they occur for no apparent reason, often in the morning. As the disease develops, signs associated with the location of the tumor appear.
Migraine. Dizziness usually becomes a harbinger of a painful attack, along with other neurological manifestations of pathology, and is part of the aura, which is characterized by blurred vision, tactile and olfactory hallucinations.
Multiple sclerosis. When the nerve fibers of the brain are damaged, already in the early stages of the disease it is expressed by loss of orientation, double vision, weakening of muscle activity, and numbness in the fingers.
Osteochondrosis. Vertigo is a companion to degenerative changes in the cervical spine. When the head is turned, overgrown osteocytes trap nerve endings and block blood access to the brain. At the same time, the person’s eyes darken and cold sweat appears.
Head injury. It occurs as a result of a bruise, and the brain also suffers. Symptoms will depend on the severity of the injury; with minor injuries, the sensations will soon go away. If disturbances in orientation remain for a long time, the pain continues, this indicates serious consequences.
Epilepsy. The development of a seizure begins with sudden dizziness and loss of orientation in space. Next, the person falls, loses consciousness, and convulsions begin.

If a sudden attack of dizziness lasts more than an hour, you must call an ambulance.

What to do?

When such an unpleasant condition occurs at home, it is important to remain calm and take the necessary measures. Don't panic and take whatever comes to hand. The most important thing is to reflect on the causes of the illness and think about what kind of help you should seek in this case.

The list of actions that must be performed first in case of dizziness:

the very first thing to do is lie down, and your shoulders and head should be at the same level;
if nausea occurs, do not restrain yourself;
a cooled object should be applied to the forehead;
you can close your eyes and focus your gaze on one object;
It is advisable to create darkness in the room;
You can drink cold strong coffee.

For dizziness accompanied by nausea:

Measure blood pressure. If it deviates from the norm to a lesser or greater extent, it is first necessary to try to stabilize it using the methods that have been encountered more than once. This phenomenon is considered quite common.
Go out into the fresh air or use ammonia tincture. Often this unpleasant condition can be caused by carbon monoxide poisoning. In this situation, you will need to be in the fresh air and drink a tonic drink (tea, coffee).
Drink plenty of clean water. Perhaps the illness was caused by food poisoning. In this case, you should perform gastric lavage and refuse to eat for a while.
Call an ambulance. There are a number of reasons that cannot be dealt with on your own. These include: traumatic brain injury, drug overdose and severe poisoning.

Of course, after your health has begun to return to normal, you need to think about a further plan of action. In this case, each person decides this issue based on the general state of health and the likelihood of illness due to exposure to negative factors.

Dizziness: causes and treatment

(from the book Neurology. G.D. Weiss. Edited by M. Samuels. Translated from English - M., Praktika, 1997. -640 p.)

Dizziness is one of the most common and at the same time one of the most “disliked” complaints by doctors. The fact is that dizziness can be a symptom of a wide variety of neurological and mental diseases, diseases of the cardiovascular system, eyes and ears.

I. Definition. Since patients can call a variety of sensations “dizziness,” during the interview it is necessary first of all to clarify the nature of these sensations. They can usually be classified into one of four categories.

A. Vestibular dizziness (true dizziness, vertigo) is usually caused by damage to the peripheral or central part of the vestibular system. It manifests itself as the illusion of movement of one’s own body or surrounding objects. In this case, sensations of rotation, falling, tilting or swaying occur. Acute dizziness is often accompanied by autonomic symptoms (nausea, vomiting, increased sweating), anxiety, imbalance and nystagmus (the latter sometimes leading to blurred vision).

B. Fainting and pre-syncope. These terms refer to temporary loss of consciousness or the feeling of impending loss of consciousness. In a pre-fainting state, increased sweating, nausea, a feeling of fear and darkening of the eyes are often observed. The immediate cause of fainting is a drop in cerebral blood flow below the level necessary to supply the brain with glucose and oxygen. Fainting and presyncope usually develop against the background of arterial hypotension, heart disease or due to autonomic reactions, and the tactics for these conditions are completely different than for vestibular vertigo.

B. Impaired balance is characterized by instability, a wobbly (“drunk”) gait, but not true dizziness. The cause of this condition is damage to various parts of the nervous system that provide spatial coordination. However, patients with cerebellar, visual, extrapyramidal and proprioceptive disorders often define the feeling of unsteadiness as “dizziness.”

D. Vague sensations , often described as dizziness, occur with emotional disorders, such as hyperventilation syndrome, hypochondriacal or hysterical neurosis, depression. Patients usually complain of “brain fog,” feeling slightly intoxicated, lightheaded, or fear of falling. These sensations are quite clearly different from the sensations associated with vestibular dizziness, fainting and balance disorders. Since any dizziness, regardless of its cause, can cause anxiety, it cannot serve as evidence of the psychogenic nature of the disease.

D. Some patients with complaints of dizziness find it difficult to describe their sensations. In this case, it is advisable to conduct provocative tests.

1. The standard set of provocative tests for dizziness includes:

A. Orthostatic test. b. Forced hyperventilation for 3 minutes. V. Sharp turns while walking or spinning in a circle while standing. d. Nilen-Barany test for positional vertigo. d. Valsalva maneuver, which increases dizziness caused by craniovertebral anomalies (for example, Arnold-Chiari syndrome) or perilymphatic fistula, and also causes lightheadedness in patients with cardiovascular diseases.

2. After each test, it is necessary to ask whether the resulting dizziness resembles the sensation that worries the patient. For orthostatic hypotension, hyperventilation syndrome, positional vertigo and many vestibular disorders, test results are well reproducible, which provides important diagnostic information.

II. Clinical examination of patients with vestibular vertigo. In order to evaluate the results of research, it is necessary to have a good knowledge of the relationships of the vestibular system with the oculomotor, auditory and spinocerebellar systems. There are two main types of vestibular reflexes. Thanks to the vestibulo-ocular reflexes, gaze fixation on the objects under consideration is maintained, that is, the constancy of the image on the retina. Vestibulospinal reflexes provide the positioning of the head and torso necessary for coordinated movements and maintaining an upright posture.

A. Nystagmus in patients with dizziness is the most important sign of vestibular disorders. Knowing a few simple physiological principles can help you avoid common mistakes in interpreting nystagmus.

1. Canal-ocular reflexes. Each horizontal semicircular canal is connected through the neurons of the brain stem with the oculomotor muscles in such a way that a decrease in impulses from it causes the eyes to deviate towards this canal, and an increase causes movement in the opposite direction. Normally, the impulses constantly flowing into the brain stem from the right and left semicircular canals and otolith organs are equal in intensity. A sudden imbalance of vestibular afferentation causes a slow eye deviation that is interrupted by rapid cortical activation-induced corrective eye movements in the opposite direction (nystagmus).

2. Lesions of the labyrinth usually cause a decrease in impulses from one or more semicircular canals. In this regard, with acute unilateral lesions of the labyrinth, unidirectional nystagmus occurs, the slow phase of which is directed towards the affected ear, and the fast phase - in the opposite direction. Nystagmus can be rotatory or horizontal. It intensifies when the eyes are moved towards its fast phase (that is, towards the healthy ear). With acute vestibular dysfunction, surrounding objects usually “rotate” in the direction of the fast phase of nystagmus, and the body in the direction of the slow phase. Patients sometimes better determine the direction of rotation with their eyes closed. In a standing position, patients deviate and fall predominantly towards the slow phase of nystagmus (that is, the affected ear).

3. Central nystagmus. Alternating nystagmus, which changes its direction depending on the direction of gaze, is more often observed with drug intoxication, lesions of the brain stem, or pathological processes in the posterior cranial fossa. Vertical nystagmus almost always indicates damage to the brainstem or midline cerebellar structures.

B. Cold test. Normal physiological stimuli simultaneously affect both labyrinths. The value of the cold test is that it allows you to study the function of each labyrinth separately. The study is carried out with the patient lying down; the head is raised at an angle of 30°. The external auditory canal is washed with cold water, thereby simulating unilateral vestibular hypofunction (observed, for example, with vestibular neuronitis or labyrinthitis). Cold water causes movement of the endolymph, as a result of which the impulse from the horizontal semicircular canal decreases. Normally, this leads to nausea, dizziness and horizontal nystagmus, the slow phase of which is directed in the direction being examined, and the fast phase in the opposite direction. Monitor the direction, duration and amplitude of nystagmus. A decrease in response on one side indicates damage to the labyrinth, vestibulocochlear nerve, or vestibular nuclei on that side. The study is contraindicated if the eardrum is damaged.

B. Electronystagmography. The retina is negatively charged in relation to the cornea, so when the eyes move, the electric field changes and an electric current occurs. Recording this current (and therefore eye movements) using electrodes placed around the eyes is called electronystagmography. This method allows you to quantify the direction, speed and duration of nystagmus. Electronystagmography is used in functional vestibular tests to record spontaneous, positional, cold and rotational nystagmus. Electronystagmography can be used to record nystagmus with eyes closed. This provides important additional information since nystagmus is often suppressed during gaze fixation.

D. Hearing loss and tinnitus can occur with diseases of the peripheral vestibular system (inner ear or vestibulocochlear nerve), if the hearing aid is involved in the process. When the central nervous system is damaged, hearing is rarely impaired. For vestibular vertigo, audiological testing often helps establish the diagnosis.

1. In pure-tone audiometry, the threshold for the perception of sounds of different frequencies is measured. For differential diagnosis of sensorineural and conductive hearing loss, the auditory threshold for air and bone conduction of sound is compared.

2. For a more accurate audiological assessment, speech perception and intelligibility, the phenomenon of accelerated increase in sound volume and tone decay are additionally examined.

D. Stabilography - the study of balance using a moving platform - allows you to quantify involuntary postural reflexes that prevent falls, as well as the role of information from various senses in maintaining balance.

E. Functional vestibular tests, electronystagmography and stabilography are complex and labor-intensive procedures. They cannot replace a thorough clinical examination, and for non-vestibular vertigo they are not necessary.

III. Diagnosis and treatment of diseases accompanied by vestibular vertigo. The two most common causes of vestibular vertigo are vestibular neuronitis and benign positional vertigo.

A. Vestibular neuronitis (acute peripheral vestibulopathy, vestibular neuritis).

1. General information. Vestibular neuronitis is characterized by a sudden, prolonged attack of dizziness, often accompanied by nausea, vomiting, loss of balance, and a feeling of fear. Symptoms worsen with head movements or changes in body position. Patients tolerate this condition extremely hard and often do not get out of bed. Spontaneous nystagmus is characteristic, the slow phase of which is directed towards the affected ear. On the same side, the reaction to a cold test decreases. Positional nystagmus is often noted. Sometimes there is noise and a feeling of fullness in the ear. Hearing does not decrease, and the results of audiological examination remain normal. There are no focal symptoms indicating damage to the brain stem (paresis, diplopia, dysarthria, sensory disturbances). The disease occurs in adults of any age. Acute dizziness usually resolves spontaneously within a few hours, but may recur over the next few days or weeks. Subsequently, residual vestibular dysfunction may persist, manifested by imbalance, especially pronounced when walking. In almost half of cases, attacks of dizziness recur after several months or years. The cause of vestibular neuronitis is unknown. A viral etiology has been suggested (as with Bell's palsy), but there is no evidence of this. Vestibular neuronitis is more of a syndrome than a separate nosological form. Neurological and otoneurological examinations help establish the peripheral nature of vestibular dysfunction and exclude lesions of the central nervous system, which usually have a less favorable prognosis.

2. Therapeutic measures. A few simple techniques can significantly reduce dizziness.

1) Since head movements and external stimuli increase dizziness, the patient is recommended to lie in a darkened room for 1-2 days.

2) Gaze fixation reduces nystagmus and dizziness in peripheral vestibular disorders. Often the condition improves - and even to a greater extent than when lying with eyes closed - if patients fix their gaze on some nearby object (for example, on a picture or a raised finger).

3) Since mental stress increases dizziness, it is advisable to combine gaze fixation with mental relaxation methods.

4) In case of persistent vomiting, intravenous fluid administration is indicated to prevent dehydration.

5) Measures for persistent dizziness. With vestibular neuronitis, the condition does not improve significantly in the first 1-2 days. The person feels seriously ill and is afraid of repeated attacks of dizziness. In such a situation, it is important to reassure the patient, convincing him that vestibular neuronitis and most other acute vestibular disorders are not dangerous and pass quickly. It should also be explained that within a few days the nervous system will adapt to the imbalance between both vestibular organs (even if one of them is irreversibly damaged) and the dizziness will stop.

6) Vestibular gymnastics, which stimulates central compensatory processes, begins a few days after the acute manifestations subside.

B. Benign positional vertigo

1. General information. Benign positional vertigo is probably the most common vestibular disorder. Dizziness in this case appears only when moving or changing the position of the head, especially when tilting it back and forth. This condition often occurs when the patient turns over from his back to his side and suddenly, at a certain position of the head, feels that “the room has moved.” Dizziness usually lasts a few seconds. Often patients know in what position of the head it occurs. Changes in head position can worsen vertigo in vestibular neuronitis and many other peripheral or central vestibular disorders, but in benign positional vertigo, symptoms occur only with certain movements and are absent at other times.

2. Differences from positional vertigo of central origin. Positional vertigo can also occur with many other diseases, including lesions of the brain stem (multiple sclerosis, stroke or tumor). In order to distinguish benign positional vertigo from more dangerous diseases of the central nervous system, the Nilen-Barany test is performed. The seated patient is tilted with his head at an angle of 45°, after which he is lowered onto his back. Then the test is repeated, after first turning the thrown back head first to the right, then to the left. The result is assessed by the appearance of nystagmus and dizziness. The latent period, duration, direction and exhaustibility of nystagmus are of important diagnostic importance. In benign positional vertigo, the latent period of nystagmus and dizziness is several seconds, the nystagmus is rotatory, and its fast phase is usually directed towards the affected ear. Nystagmus and dizziness are usually short-lived (less than 30 s) and decrease with repetition of the test (depletion of nystagmus). The Nilen-Barany test can confirm the diagnosis of benign positional vertigo. However, a negative result does not exclude this disease, since its symptoms are transient and are not always triggered by head movement.

3. Etiology. Benign positional vertigo can occur after traumatic brain injury, a viral disease, otitis media or stapedectomy, as well as with certain intoxications (for example, alcohol and barbiturates). Idiopathic cases of the disease, apparently, in most cases are associated with cupulolithiasis, a degenerative process with the formation of otoconial deposits in the cupula of the frontal semicircular canal, resulting in a sharp increase in the sensitivity of this canal to gravitational influences when the position of the head changes.

4. The course of the disease can be very different. In many cases, symptoms resolve on their own within a few weeks and then do not return until months or years later. Sometimes a short-term attack occurs only once in a lifetime. Only rarely does positional vertigo persist for a long time.

5. Treatment. For symptomatic therapy, the above remedies are used, but they are often ineffective. With careful repetition of movements that provoke dizziness, pathological reactions are gradually “exhausted.” Some believe that vestibular exercises, which include provocative head movements, speed up recovery. Patients are advised to hold their head in a position that usually causes dizziness for 30 seconds. This simple exercise, performed 5 times every few hours, in most cases brings improvement within a few weeks. If such vestibular gymnastics is accompanied by too unpleasant sensations, then a soft corset is used that immobilizes the neck and prevents the head from tilting in an unfavorable direction. As with vestibular neuronitis, it is important to convince the patient that, despite the extremely unpleasant sensations, the disease will soon pass and is not life-threatening. It is extremely rare for severe persistent positional vertigo to transect the ampullary nerve coming from the frontal semicircular canal on the affected side.

B. Post-traumatic dizziness. Despite the fact that the labyrinth is protected by a bone sheath, its thin membranes are easily damaged by injury. Uncomplicated concussion is accompanied by dizziness in more than 20% of cases. With traumatic brain injury, transient autonomic disorders (palpitations, hot flashes, increased sweating), which are accompanied by non-vestibular dizziness, are also possible. Post-traumatic dizziness manifests itself in two main syndromes.

1. Acute post-traumatic dizziness. Vestibular dizziness, nausea and vomiting can occur immediately after injury due to the sudden shutdown of one of the labyrinths (labyrinth shock). Less commonly, dizziness is caused by transverse or longitudinal fractures of the temporal bone, which are accompanied, respectively, by hemorrhage in the middle ear or damage to the eardrum with bleeding from the external auditory canal.

Clinical picture. Dizziness is constant. Characterized by spontaneous nystagmus with a slow phase directed towards the lesion, and imbalance with a tendency to fall in the same direction. Symptoms intensify with sudden movements of the head and in a position where the damaged labyrinth is at the bottom.

2. Post-traumatic positional vertigo. Within a few days or weeks after the injury, repeated short-term attacks of vestibular dizziness and nausea may occur, which are provoked by head movement.

A. The clinical picture is the same as for benign positional vertigo.

b. Forecast. In most cases, spontaneous remission occurs within 2 months after injury, and within 2 years in almost all.

3. Perilymphatic fistula. The membranous labyrinth filled with endolymph is surrounded by the perilymphatic space. When a rupture occurs in the area of the oval or round opening, a perilymphatic fistula can form, through which changes in pressure in the middle ear cavity are directly transmitted to the inner ear. The cause of a perilymphatic fistula can be, in particular, barotrauma (from straining, sneezing, coughing, diving).

A. Clinical picture. Characterized by intermittent or positional vestibular vertigo and variable sensorineural hearing loss. Worsening often occurs with elevation (including rapid ascent in an elevator) and with physical exertion similar to the Valsalva maneuver (straining or lifting). Sometimes dizziness occurs with loud sounds (Tullio's symptom).

b. Diagnostics. A perilymphatic fistula should be suspected when vestibular or auditory disturbances appear after trauma. However, due to the variability of symptoms, it can be difficult to distinguish from other diseases (Meniere's syndrome, benign positional vertigo, craniovertebral anomalies). There are no pathognomonic signs in the study of pressor nystagmus, electronystagmography, or stabilography. Perilymphatic fistula is probably one of the common causes of vestibular vertigo of “unexplained etiology.”

V. Treatment. The perilymphatic fistula usually closes spontaneously, which is accompanied by the disappearance of symptoms. In persistent cases, if a perilymphatic fistula is suspected, surgical intervention is indicated (tympanotomy with restoration of the integrity of the oval or round foramen). After surgery, vestibular symptoms usually improve, but hearing is rarely restored.

G. Meniere's syndrome

1. General information. Meniere's syndrome usually begins between 20 and 40 years of age. It is characterized by sudden attacks of severe vestibular vertigo, lasting from a few minutes to several hours. Before an attack, and sometimes after it, there is a feeling of stuffiness and fullness, or noise in the ear, transient hearing loss. After an attack, imbalance may persist for a long time, especially noticeable when walking.

2. The course is characterized by remissions and exacerbations. At the onset of the disease, sensorineural hearing loss (mainly for low sounds) is episodic. As a result of repeated attacks, hearing progressively decreases, but periods of improvement are possible.

3. Pathogenesis. The main morphological changes in Meniere's syndrome are stretching of the walls and an increase in the volume of the endolymphatic space (endolymphatic hydrops). The cause may be impaired absorption of fluid in the endolymphatic sac or obstruction of the endolymphatic duct.

4. Treatment. During an attack, bed rest and vestibulolytic drugs are prescribed. The rational choice of drugs for the prevention of attacks and the assessment of their effectiveness are difficult due to insufficient knowledge about the pathogenesis of the disease and the unpredictability of its course (including the possibility of long-term spontaneous remissions). According to recent studies, any of the existing treatment regimens (including placebo) causes temporary improvement in approximately 70% of patients.

A low-sodium diet in combination with diuretics (thiazides or acetazolamide) has been recommended for the treatment of Meniere's syndrome; it has been suggested that this may reduce fluid accumulation in the endolymphatic space. However, the pathophysiological feasibility of this therapy has not been proven, and in recent years it has been used less frequently.

5. In a small proportion of cases, for frequent, severe, treatment-resistant attacks, surgical treatment is indicated. There is no ideal surgery for Meniere's syndrome. Shunting of the endolymphatic sac reduces dizziness in 70% of patients, but in 45%, hearing continues to decline after surgery. Destructive operations (selective transtemporal transection of the vestibular part of the vestibulocochlear nerve, labyrinthectomy or translabyrinthine vestibulectomy) are indicated for persistent severe dizziness and severe unilateral hearing loss.

6. Differential diagnosis

A. In all cases, it is necessary to exclude a tumor of the cerebellopontine angle (including schwannoma of the vestibular-cochlear nerve. Tumors of this location cause noise in the ear, hearing loss, imbalance, but only rarely - attacks of dizziness.

b. The cause of attacks of dizziness and hearing loss can also be infectious labyrinthitis, perilymphatic fistula, Cogan's syndrome, and hyperviscosity syndrome.

V. Congenital syphilis. Symptoms of labyrinthine lesions in congenital syphilis often appear only in middle age and can mimic Meniere's syndrome. Treponema pallidum persisting in the temporal bone causes chronic inflammation leading to endolymphatic hydrops and labyrinthine degeneration. The course is progressive. As a result, both ears are affected. All patients with bilateral Meniere-like symptoms should be examined for latent syphilis using treponemal reactions (primarily RIF-ABS), since non-treponemal reactions (including the reagin rapid test and the VDRL reaction) in syphilitic labyrinthitis can give negative results.

D. Labyrinthitis

1. Bacterial labyrinthitis. When there is a bacterial infection of the middle ear or mastoid process (such as chronic otitis media), bacterial toxins can cause inflammation of the structures of the inner ear (serous labyrinthitis). Symptoms may be minimal at first, but they gradually worsen without treatment. Direct infection of the labyrinth (purulent labyrinthitis) is possible with bacterial meningitis or disruption of the integrity of the membranes separating the inner ear from the middle ear. Patients experience acute vestibular dizziness, nausea, hearing loss, fever, headache and ear pain. Purulent labyrinthitis is a dangerous disease that requires early diagnosis and antibiotic therapy.

2. Viral labyrinthitis. Damage to the auditory and vestibular organs is observed with various viral infections, including influenza, herpes, rubella, mumps, viral hepatitis, measles, and infection caused by the Epstein-Barr virus. Most patients recover on their own.

E. Functional vertigo occurs as a result of a disruption in the interaction between the vestibular, visual and somatosensory systems, which normally work together to provide spatial orientation. Dizziness can also be caused by physiological stimulation of normally functioning sensory systems.

1. Motion sickness is caused by unusual acceleration of the body or a discrepancy between afferentation entering the brain from the vestibular and visual systems. In a person in a closed cabin on a ship or in the back seat of a moving car, vestibular afferentation creates a sensation of acceleration, while visual afferentation indicates the relative immobility of surrounding objects. The intensity of nausea and dizziness is directly proportional to the degree of sensory mismatch. Motion sickness is reduced when there is sufficient panoramic visibility to verify the reality of the movement.

2. Visually caused dizziness occurs when observing moving objects - due to a mismatch of visual afferentation with vestibular or somatosensory (for example, when a person watches a movie with a car chase).

3. High-altitude vertigo is a common phenomenon that occurs when the distance between a person and the stationary objects he observes exceeds a certain critical value. The often observed fear of heights prevents adaptation to the physiological mismatch of vestibular and visual afferentation.

G. Transient ischemia of the brainstem

1. General information

A. Clinical picture

1) Vestibular dizziness and imbalance are the two most common symptoms of transient brainstem ischemia resulting from damage to the arteries of the vertebrobasilar region. At the same time, only in rare cases are they the only manifestations of this disease. If repeated attacks of dizziness are not accompanied by other signs of brainstem ischemia (diplopia, dysarthria, sensory disturbances of the face or limbs, ataxia, hemiparesis, Horner's syndrome or hemianopsia), then they are usually caused not by vertebrobasilar insufficiency, but by peripheral vestibulopathy.

2) Impaired balance and blurred vision occur both with vestibular neuronitis and with lesions of the trunk, and therefore do not allow us to clarify the localization of the lesion. Acute hearing loss is not typical for ischemic lesions of the brainstem; a rare exception is occlusion of the anterior inferior cerebellar artery, from which the internal auditory artery arises to the inner ear.

b. Differential diagnosis

1) Since transient brainstem ischemia requires active therapy aimed at preventing brainstem stroke, it is important to differentiate it from more benign disorders (in particular, vestibular neuronitis).

2) In the interictal period with transient ischemia of the brainstem, there are no signs of focal brain damage. However, during an attack, careful examination can reveal disorders such as Horner's syndrome, slight strabismus, internuclear ophthalmoplegia, central alternating or vertical nystagmus, etc., characteristic of damage to the trunk, but not the vestibular apparatus. With ischemia of the trunk, it is often possible to induce positional nystagmus. The Nilen-Barany test helps to distinguish central from peripheral lesions. Vestibular vertigo and imbalance may also occur with brainstem lesions of other etiologies, such as multiple sclerosis or tumors.

H. Cerebellar stroke

1. Clinical picture. Damage to the cerebellum due to ischemia or hemorrhage in the posterior inferior cerebellar artery can manifest as severe vestibular vertigo and imbalance, which can easily be mistaken for symptoms of acute vestibular neuronitis. Sometimes the lesion is limited to the cerebellar hemisphere, and in this case there are no signs of damage to the lateral medulla oblongata (dysarthria, numbness and paresis of the facial muscles, Horner's syndrome, etc.). Infarction in the superior cerebellar artery causes abasia and ataxia, which are usually not accompanied by severe dizziness.

2. Diagnostics. Impaired balance with a tendency to fall towards the lesion is observed with damage to both the vestibular system and the cerebellar hemispheres and does not help in the differential diagnosis. Central alternating nystagmus, the fast phase of which is directed towards gaze, and hemiataxia indicate damage to the cerebellar hemisphere. A CT scan can diagnose cerebellar hemorrhage, but may not detect a heart attack (especially if the test is performed immediately after the onset of symptoms). A more reliable method for diagnosing cerebellar infarction is MRI.

3. Current. Cerebellar infarctions and hemorrhages are often limited in size and the outcome is favorable. Typically, gradual recovery occurs and the residual defect is minimal. More extensive lesions, accompanied by cerebellar edema, can cause compression of the trunk and fourth ventricle. This severe complication requires surgical decompression, but it can be prevented by timely dehydration, so early diagnosis and careful monitoring in the acute phase are extremely important for cerebellar strokes.

I. Oscillopsia is the illusion of vibration of stationary objects. Oscillopsia in combination with vertical nystagmus, instability and vestibular vertigo is observed with craniovertebral anomalies (for example, Arnold-Chiari syndrome) and degenerative lesions of the cerebellum (including olivopontocerebellar atrophy and multiple sclerosis).

K. Vestibular epilepsy. Dizziness can be the leading manifestation of simple and complex partial seizures if they occur in the vestibular areas of the cortex (superior temporal gyrus and association areas of the parietal lobe). Dizziness in this case is often accompanied by noise in the ear, nystagmus, and paresthesia in the contralateral limbs. The attacks are usually short-lived and can easily be confused with other diseases that manifest as vestibular vertigo. In most cases, such seizures are combined with typical manifestations of temporal lobe epilepsy. The diagnosis is confirmed by EEG changes. Treatment: anticonvulsants or resection of the affected area of the brain.

L. Migraine

1. Clinical picture. Dizziness can be a leading symptom of basilar migraine. During an attack, visual and sensory disturbances, disturbances of consciousness, and intense headache are also noted.

2. Diagnostics. Recurrent attacks of vestibular vertigo (in the absence of other symptoms) may be a manifestation of dissociated migraine. The diagnosis of migraine in this case is possible only if all other causes are excluded; it is more likely if there are other manifestations of this disease.

M. Chronic vestibular dysfunction

1. General information. The brain is able to correct the disrupted connection between vestibular, visual and proprioceptive signals. Thanks to central adaptation processes, acute dizziness, regardless of its cause, usually resolves within a few days. However, sometimes vestibular disorders are not compensated due to damage to the brain structures responsible for the vestibulo-ocular or vestibulospinal reflexes. In other cases, adaptation does not occur due to concomitant visual or proprioceptive impairments.

2. Treatment. Constant dizziness, impaired balance and coordination of movements can cause disability for the patient. Drug therapy in such cases is usually ineffective. Patients with persistent vestibular dysfunction are shown a set of special exercises (vestibular gymnastics).

A. Exercise goals

1) Reduce dizziness. 2) Improve your balance. 3) Restore self-confidence.

b. Standard complex of vestibular gymnastics

1) Exercises to develop vestibular adaptation are based on the repetition of certain movements or postures that cause dizziness or imbalance. It is believed that this should promote adaptation of the vestibular structures of the brain and inhibition of vestibular reactions.

2) Balance exercises are designed to improve coordination and use information from multiple senses to improve balance.

Prevention

To prevent the occurrence of such unpleasant symptoms, the following preventive measures should be taken:

When the patient is predisposed to seasickness or needs to go somewhere, then before traveling you should not eat for several hours. You need to take some anti-sickness medication.
It will also be useful to find out the recommendations of a nutritionist when following a diet. In this case, the patient will not feel weak and angry, as is observed with a lack of glucose and other microelements.
To increase the hemoglobin content, improve the functioning of the immune system and saturate the body with vitamins, it is permissible to use Amosov paste (a product that consists of dried fruits processed in a meat grinder, lemon with peel and walnuts with honey in equal quantities).
In the presence of anxiety and negative emotions, special breathing exercises, certain types of meditation and various kinds of psychological techniques help.
Hangover syndrome is effectively eliminated through sweet and sour juices, fermented milk products, aspirin and various specialized medications.

Therapy for dizziness associated with nausea is prescribed by a specialist. It is permissible to use traditional medicine in combination with drug treatment.

Diagnosis, treatment

Undoubtedly, dizziness brings great discomfort to the patient. Therefore, if you observe such a symptom, you should definitely contact an experienced specialist. The latter will identify the cause of this phenomenon and prescribe appropriate treatment.

It should be especially noted that dizziness in itself is not a disease. This is just a secondary symptom of a particular disease. To identify it, the patient may be sent for an MRI, ultrasound of the brain vessels, computed tomography, etc. The patient is also sent for general and special tests.

As mentioned above, with a condition such as dizziness, the patient is often referred to a neurologist. However, the same problem can be seen by an endocrinologist or cardiologist.

Attacks of dizziness, vomiting, weakness or nausea may go away on their own. If such conditions are associated with the presence of serious diseases, then their intensity is reduced by taking certain medications.