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Symptoms of disease - violation of the vestibular

One of the most frequent symptoms in neurology after headache is the dizziness.

Pathogenetic mechanisms and causes of dizziness in various neurological diseases remain the subject of scientific discussions, despite the introduction of new diagnostic methods of examination of cerebral blood flow and neuro imaging structures of the inner ear and brain. Traditional treatment schemes, including sedatives, are often not efficient enough and with long-term use may adversely affect the processes of the vestibular compensation and rehabilitation of the patients. Vestibular disorders caused by vascular diseases of the brain, the frequency occupy the first place among the vestibular symptoms.

Which diseases there is violation of the vestibular

The most common causes of vestibular violations:

1. Benign positional vertigo occurs at any age, but usually after the age of 60. This is one of the most frequent causes of vestibular vertigo in clinical practice. Sometimes it is preceded by the CCT, otitis media, ischemia in vertebrobasilar the pool, but in half of the cases the reason of finding out is not possible.

The symptoms are very common - short-term bouts of dizziness, repeated every time, when a patient changes the position of the body (gets up from the bed and lie in it, to turn from side to side, tips or throws back her head). Approximately half of patients with periods of exacerbation with frequent attacks alternate with spontaneous remissions, continuing from several weeks to several years.

The diagnosis is confirmed with the help of special positional samples - nystagmus, dizziness appear within a few seconds after the change of the position of the head.

The disease is associated with the formation in the semicircular channel otoliths. Moving under the action of gravity, otoliths irritate the vestibular receptors of the dome of semicircular canal and cause a paroxysm of dizziness. In spite of the fact that the symptoms may persist for decades, no other disorders does not appear. If you have additional neurological symptoms it is necessary to exclude other causes of positional vertigo, including tumors of the posterior cranial fossa, stem stroke. The patient should explain the nature of the disease, to break the fear of the availability of stroke or tumor. We have developed a special technique, which allows the manipulation head delete otolith from the semicircular canal, relegating it is immune zone (the eve of the inner ear). The head slowly turn on 180 degrees out of position, calling the attack, in a healthy way.

Drug therapy is usually ineffective. In resistant cases, it is possible surgical treatment. The cause of severe paroxysms of positional vertigo, sometimes accompanied by a transient decrease in hearing, hyperacusis or noise in the ear, can also be a compression of the vestibular nerve loops front bottom cerebellar artery. In this case, sometimes it helps to carbamazepine (Finlepsin), under its ineffectiveness of recourse to microvascular - decompression of the nerve. Cause positional vertigo can be and alcohol, changing the density of endolymph.

2. Vestibular neuritis (vestibular neuronitis, acute peripheral vestibulopathy) - one of the most frequent causes of dizziness associated with lesions of the peripheral vestibular apparatus or vestibular nerve. The disease is possible in any age. Regular players of virtual casinos can count on: extra funds on account, no deposit free spins , bonus codes, prizes without deposit and many other casino promotions. In the further part of the article we will check what conditions a casino customer has to meet in order to get the mentioned benefits. In some cases, a few weeks before the onset of the disease is marked infection of the upper respiratory tract, which points to a possible viral nature of the disease. Urgently develop a strong rotational dizziness, nausea, repeated vomiting, horizontally-rotatory nystagmus with a rapid phase, pointing in the direction of a healthy ear. Nystagmus is directed in one direction only (the bilateral nystagmus excludes the diagnosis). When the visual fixation nystagmus disappears, so it can not be seen by a cursory examination. Hearing loss and other neurological symptoms are not available (in cases, when a similar vestibular syndrome is combined with a hearing loss is diagnosed labyrinthitis). The slightest movement of the head increases dizziness, therefore, patients sometimes specifically support the head. Loss of function of the lateral semicircular canal on the side of destruction can be detected with a simple test: the patient is asked to fix the eyes on a remote point and quickly turned his head to each of the parties approximately 15 degrees. When turning in a healthy way gaze remains fixed, while turning his head in the direction of the affected maze eyes, moving together with the head, deviated from the point of fixation, but come back to it with the help of the fast saccadic movement. If during this test revealed no pathology, diagnosis vestibular neuritis should be put in question. Severe dizziness with repeated vomiting usually lasts no more than 3-4 days, but complete recovery occurs within a few weeks, although the elderly may last for several months. Sometimes after a few months or years of relapses occur. If the condition does not improve within 1 month, it is necessary to send the patient to the CT scan or MRI to rule out the Central defeat, and to audiometriu to exclude the disease Meniere. In mild cases may outpatient treatment Positive effect sometimes has a short course of corticosteroids. In the first days of using drugs that reduce spark the vestibular symptoms, but as soon as the condition improves, they must be cancelled, and the basis of the treatment becomes vestibular exercises. The coordinated movement of the eyeballs, the head, the trunk, which the patient first performs lying, then sitting, standing, and, finally, when walking, contribute to the migration of the vestibular system and accelerate recovery. A similar syndrome may occur when neurosyphilis and aciclovir.

3. Vertebral-basilar failure - a common cause of dizziness in older patients with vascular risk factors. The cause of dizziness can be ischemia of the labyrinth, the vestibular nerve and/or the trunk. Dizziness begins acutely, continues for a few minutes and is often accompanied by nausea, vomiting, poor balance. Ischemia adjacent departments of the trunk is usually cause additional symptoms: impaired vision, duplication, dysarthria, fall, weakness and numbness in the extremities. Dizzy spells are often the first symptom of vertebrobasilar insufficiency, but if these episodes are repeated for many months and even more years, and the other symptoms do not appear, then the diagnosis vertebrobasilar insufficiency should be questioned.

Cause vertebrobasilar failure can be atherosclerosis subclavian, the vertebral or basilar artery, less cardiogenic embolism, high viscosity of blood (hyperlipidemia, fibrinosis, policitemia, etc.), vasculitis. Sometimes vertebrobasilar failure provoke ortostatical gipotenzia or seizures Morgagni-Adams-Stokes equations. Contrary to popular opinion, vertebrobasilar failure rarely explain purely mechanical compression of vertebral arteries caused by cervical osteochondrosis. The diagnosis must be pay attention to the availability of related neurological symptoms, risk factors (arterial hypertension, diabetes, hyperlipidemia). At patients of young age, additional examination is necessary to exclude systemic disease or vascular anomalies. Treatment vertebrobasilar insufficiency includes the correction of risk factors, the use of antiagregantov (aspirin) and vasoactive funds. Symptomatic treatment.

4. More persistent dizziness, accompanied by a decrease in hearing, occurs when the occlusion of the internal auditory artery. Badly formed dizziness, accompanied by cerebellar Friedreich's and nystagmus, may be a manifestation of cerebellar a heart attack or a bleeding - condition, requiring urgent intervention in view of the threat of pressure in the brain stem - quick death. Сerebellar stroke at the initial stage it is difficult to distinguish from the vestibular neuritis. In favor of cerebellar stroke show: bilateral or vertical nystagmus, not suppressed during the fixation of view, the preservation of the fixation of a look at the rapid passive turning your head, inability to stand without support even with open eyes.

5. Chronic bilateral vestibulopathy are slow-growing breach of the stability and moderate (unlike unilateral lesions) dizziness. Sometimes there are also hearing loss and oscillopsia - jumping blurred image in the eyes of the movement of his head. Most cases are associated with intoxication ototoxic drugs (aminoglycosides, most often gentamicin). Vestibular disorder usually occurs no earlier than the 3rd week of treatment. In the early discontinuation of the drug vestibular function may not recover, in which case a violation of the vestibular function becomes irreversible. Less syndrome is caused by loopback diuretics, drug, solvent. A similar syndrome is possible and in some hereditary spinocerebellar ataxia. The differential diagnosis of conduct also with normotensive hydrocephalus, tumors of the posterior cranial fossa, orthostatic tremors.

6. The disease Meniere is manifested 4 the main symptoms: episodic vertigo, noise in the ear, as a rule, low-frequency, the feeling of stuffiness and expansion in your ear, fluctuating reduced hearing. Dizziness reaches a maximum in several minutes and then regress within a few hours. After an acute episode a few days remain volatility and moderate dizziness. At the early stage of the hearing loss is reversible, but from attack to attack the ears of being lost. Noise in the ear becomes permanent, seeking to attack and during it. The frequency of attacks varied, sometimes they are separated by long remissions. In some patients there are sudden fall without disturbance of consciousness or related neurological disorders, caused by the irritation of the vestibular receptors sudden increase in pressure in the inner ear. Some patients have bouts of dizziness may some time be the only manifestation of the attack, while the other symptoms (noise in the ear, hearing loss) is missing or go to the second plan. It is important to exclude hypothyroidism, neurosyphilis, hard currency. CT and MRI are necessary only in the case when dizziness is combined with other neurological symptoms.

7. Post-traumatic vertigo develops after CCT and can be linked with a concussion of the maze, fractures of the temporal bone (in this case usually suffer not only vestibular, but also auditory part of the nerve, as well as the facial nerve), education peri-lymphatic fistula. In the latter case, dizziness, when amplified sneezing and straining.

8. Other diseases of the ear. Sometimes the cause of dizziness are sulphuric cork, otoscleros, dysfunction of the Eustachian tube, often associated with pathology of the temporo-jaw joint (in this case, the condition is sometimes easier rubber gasket between the teeth, inserted at night). Dizziness may occur acute otitis media, if that is complicated by purulent labyrinthitis. Meniere's Disease
 is also described in chronic average otitis, can in some cases cause the secondary endolymphatic dropsy.

9. The tumor cerebellopontine angle of rare cause of dizziness. Neurinoma the auditory nerve is slow progressive (but sometimes sharp) hearing impairment and noise in the ear. Rotary vertigo is rare, but there is often a feeling of instability. Duplex neurinoma the auditory nerve may occur when neurofibromatosis, therefore, you should pay attention to the multiple skin spots of natural coffee and milk colors and skin neurofibromas.

10. Baziliarnaya migraine. Paroxysms of dizziness may be the only manifestation of the migraine. Migraine dizziness nature especially common in adolescent girls. Migraine dizziness nature rarely lasts more than 1 hour. Many of these patients are marked tendency to motion sickness and a positive family history. Dizziness during the attack is reduced under the influence of the ANTIMIGRAINE drug - aspirin, ergotamine, triptanov, etc. Prevent attacks can be with the help of systematic receive beta-blockers, calcium antagonists, tricyclic antidepressants, drugs valproeva acid, methysergide.

11. Epilepsy. Short-term dizziness can be a manifestation of epileptic seizure, but in this case it is often accompanied by stereotypical sensory (visual hallucinations), the vegetative (discomfort in epigastria, nausea, salivation) or motor phenomena (chewing movements), as well as the violation of consciousness, to the effect that during the attack at least temporarily lost contact with the patients. Isolated dizziness rarely has epileptic nature.

12. When combined dizziness with cerebellar Friedreich's, speech disorders, swallowing and nystagmus down, you should think about craniovertebral anomalies. Attack of the rotary vertigo with nausea and vomiting may be the debut manifestation of multiple sclerosis (a plaque in this case can localize in the outlet from the trunk kohleo vestibular nerve).

Which doctor should I contact if there is a violation of the vestibular

  • Neurologist

Are you experiencing violation of the vestibular? You want to know more detailed information, or you need an inspection? Please sign up on reception to the doctor! Doctors will examine you, examine the external signs and help to determine the disease the symptoms, they will consult you and provide the necessary assistance. You can also call the doctor on the house.

Do you feel disrupted vestibular? You should be very careful approach to your health in general. People pay not enough attention to the symptoms of the disease and don't realize that these diseases can be critically dangerous. There are many diseases that in the beginning didn't manifest in our body, but in the end it turns out, unfortunately, it have already been treated too late. Every disease has its own specific features typical symptoms - called symptoms of the disease. Definition of symptoms is the first step in the diagnosis of diseases in general. You just need a few times a year to be screened by a doctor, not only to prevent a terrible disease, but also to maintain a healthy spirit in a body and the organism in general.

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Map of the symptoms and the types of disorders is intended solely for educational purposes. We strongly recommend do NOT self-medicate; on all matters relating to the definition of the disease and ways of its treatment, contact your doctor. Md-tips is not responsible for the consequences of use information posted on the site.