Dizziness (Vertigo)

Dizziness (Vertigo)

Central vertigo:

It occurs as a result of disorders arising from the brain. Central vertigos can be caused by tumors in the brain, bleeding, aneurysms in the vessels or different disorders of the brain vessels. The patient's detailed history and physical examination result can determine which type of vertigo is. In central vertigo, patients are referred to the Neurology Department.

Peripheral vertigo:

Peripheral vertigo is the deterioration of balance due to the effect of the balance center in the inner ear or middle ear. Peripheral vertigo can be caused by any problem in the musculoskeletal system such as neck pain or metabolic diseases such as hypothyroidism, hyperthyroidism or hypoglycemia. When the patient comes with the complaint of vertigo, it is first checked whether he has a problem with the ear. General metabolic tests are requested from the patients. Sugar, cholesterol, thyroid, liver and kidney function tests, as well as all tests of the person, including blood pressure, are checked. Because all of these can trigger vertigo attacks. Any imbalance in the body can manifest itself with vertigo attacks.

“Bening Paroxysmal Positional Vertigo” (BPPV), colloquially known as crystal play, is the most common type of vertigo. It occurs as a result of the crystals in the balance center of the inner ear falling into the posterior semicircular canals. In the dislocation of inner ear crystals, the person feels dizzy when in bed, turning from right to left, or lying on their back. Apart from this, nerve inflammations called neuritis that occur after upper respiratory tract infection in the inner ear and Meniere's disease are among the types of peripheral vertigo, that is, dizziness originating from the ear.

When the person comes with a complaint of dizziness, some tests are performed in order to understand why the dizziness is caused. Peripheral vertigo can cause dizziness when any of the 3 balance channels in the inner ear are affected and stimulate the sensory cells. These channels can be affected in different ways. In some patients, a single channel may be affected, while in some patients 2 or 3 channels may be affected. Their distinction can be made with a special finding.

What are the symptoms of vertigo?

The first symptom of peripheral vertigo is dizziness. Patients describe this dizziness as a spinning that wakes them up even at night. Patients state that the dizziness subsides when the head is fixed, but the dizziness recurs when the head moves. Very light head movements; Actions such as looking up and down, bending over, turning to the right or left in bed cause short-term dizziness. This situation continues throughout the day. Tinnitus and nausea may accompany vertigo. If speech difficulties, headaches and loss of consciousness are seen with vertigo, a doctor should be consulted without delay.

In the vertigo type called Menier's disease, the dizziness does not last for a short time. Meniere's disease; It occurs with an increase in pressure due to an increase in the fluid called endolymph in the balance channels of the ear. A very severe vertigo is seen in Menier's disease. Vertigo occurs in attacks. In addition to dizziness, nausea and vomiting complaints are also very common in patients. Fullness, humming and ringing in the ear are especially seen. Especially typical findings of Menier's disease are ringing and fullness in the ear, humming and hearing loss. In peripheral vertigo types, the diagnosis can be determined according to these symptoms.

What are the causes of vertigo?

Peripheral vertigo is a symptom of diseases and conditions that affect the inner ear. Upper respiratory tract infections, inner ear infections, neck pain, metabolic diseases and allergies are among the causes of vertigo. Stress, insomnia, too much smoking and alcohol use can cause vertigo. In addition, excessive salt, caffeine containing cola, chocolate and coffee are also among the causes of peripheral vertigo.

How is vertigo diagnosed?

Peripheral vertigo is diagnosed as a result of the patient's detailed history and physical examination. The gait of the patient who comes with the complaint of dizziness is checked. There are certain types of gait to be considered. If the patients' dizziness is accompanied by neurological findings such as numbness and tingling in the hands and arms, they should be referred to the Neurology Department.

Dix Hallpike test:

It is positioned by observing the involuntary eye movement that occurs when the patient's head is turned 45 degrees to the side, then tilted back and the head is hung down approximately 30 degrees. In the eye, the movement called spontaneous throwing, spontaneous throwing is followed. If this is observed in the patient, it can be determined that this is an ear-related vertigo. In addition, the Roll (spin rolling) test also helps in diagnosis.

How does vertigo pass, what are the treatment methods?

In benign positional vertigo, vertigo type with crystal play can be treated with correction maneuvers. There are maneuvers applied in benign positional vertigo. It can be diagnosed with the Dix-Halpike test and corrected with the Epley maneuver. Patients should not be given drugs before maneuvers. Correction maneuvers are in the form of sessions. In the first sessions, maneuvers are performed until the dizziness subsides. Afterwards, the sessions can be repeated every 4-5 days. The recurrence time varies according to the patient. If the dizziness is very severe and there has been crystal play in several canals in the ear, drug treatment is also applied at the same time.

What should those with vertigo pay attention to?

Sleep pattern should be at the top of the factors that those with vertigo should pay attention to. Irregular and insufficient sleep invites people to rest and many diseases, including vertigo. Everyone should pay attention to regular and adequate sleep.

Stress should be avoided, that is, the factors that cause stress should be removed from the person's life. It is important to stay away from stress, as excessive stress also negatively affects the immune system.

It is possible to be protected from many diseases related to vertigo with a strong immune system. For this reason, healthy and fresh foods should be consumed, excessive salty, oily and processed foods should be avoided. The normal levels of vitamin and mineral values, especially vitamin D, also ensure strong immunity.

After vertigo treatment, active sports and sudden movements should be avoided. Drink plenty of fluids, avoid caffeine-containing foods and drinks such as coffee, cola and chocolate, and stop smoking.

Vertigo is often described as dizziness that occurs without movement. It is also known as crystal play in the colloquial language. It is among the diseases that make the daily life of the person difficult and reduce the quality of life. Vertigo can be a symptom of other diseases or can be seen alone. It is divided into two as central and peripheral vertigo. Central vertigo belongs to the Department of Neurology, and peripheral vertigo belongs to the Department of Ear, Nose and Throat Diseases.