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Myths About Dizziness – The Truth Behind Two of the Most Common
Myth: I’m dizzy; I must have had a stroke
Fact: There are many causes of dizziness, and not all of them are life-threatening
Benign positional vertigo (BPV) is the most common cause of dizziness. It is caused when tiny crystals in the inner ear responsible for balance break off and float in the inner ear fluid. When the head is moved in certain positions, these floaters stimulate the balance cells, causing a brief period of dizziness.
Dizziness can have other causes as well. Labyrinthitis is inflammation of the inner ear caused by viral infection or other causes. Its symptoms include dizziness, which usually lasts for a few hours and then goes away.
Meniere’s disease is another cause of dizziness. While the causes of this condition are varied, symptoms include excess fluid in the inner ear, causing pressure. This can cause hearing loss,
Stuffy ears, and recurring dizziness that lasts for hours.
So how do you know what’s causing your dizziness? If you have BPV, you may experience room-rotating vertigo that lasts for a few seconds when you get up, down, or roll over in bed.
Labyrinthitis is characterized by severe dizziness, accompanied by nausea and vomiting that lasts for several hours. There is usually no hearing loss or other ear symptoms, and the onset may be followed by weeks of instability or temporary dizziness with turning over in bed.
Meniere’s disease is associated with recurrent episodes of vertigo, possibly nausea, and vomiting lasting 30 minutes to several hours. Meniere’s disease is often accompanied by hearing loss, ear pressure, tinnitus, or ringing in the ears.
Fortunately, all of these conditions can be successfully treated. When BPV is treated in the office, a vestibular therapist performs a maneuver called a Semont Maneuver, which moves the crystals away from the balancing cells. Ninety percent of people with vertigo are cured with this treatment, which occasionally needs to be repeated.
Labyrinthitis is treated with oral medications to relieve dizziness and fluids for any associated nausea and vomiting. In severe cases, hospitalization is required to provide the drug intravenously until symptoms subside.
Meniere’s disease can be treated with a variety of drugs and surgical procedures, all of which are designed to help reduce the frequency of vertigo attacks.Medications used to treat Meniere’s disease include diuretics, cycling medications, sedatives, and steroids
Despite these possible causes of dizziness, a stroke cannot be ruled out as it is also a cause. A stroke occurs when blood flow to the brain is interrupted and brain cells are starved of oxygen.There are several symptoms of a stroke, including
o Sudden onset of dizziness or vertigo;
o Difficulty walking or loss of coordination;
o Numbness or weakness in the face, arms, or legs;
o speech difficulties; and
o Severe headache.
If any of these symptoms develop suddenly, the person should be taken to the emergency room immediately for evaluation and treatment. Every minute that the brain is deprived of oxygen increases the likelihood of brain damage, so it is imperative that emergency room physicians evaluate a suspected stroke immediately.
Myth: My balance is bad because I’m getting older and I’m going to have to live with that
Truth: Age is Not a Factor in Maintaining Healthy Balanced Function
Your balancing mechanism is like a tripod. The three arms of the tripod are the balance tubes for the inner ear, vision, and sensation to the joints and muscles of the legs and feet. Sensory information from three sources is sent to the brain, where it is organized into meaningful information. Based on this information, your brain sends new messages – instructing your muscles to maintain balance.
Dizziness and imbalance can have many causes. Confused information, blocked information pathways, or weakness in the brain or tripod limbs can all lead to an imbalance. Other possible causes include:
o lack of circulation in the balanced areas of the brain,
o a drop in blood pressure when you change from sitting to standing (orthostatic hypotension),
o Inner ear disorders,
o bone and joint disorders,
o side effects of the medicine, and
o Drug interactions.
Also, irregular heartbeats or heart and neurological disorders may cause dizziness, lightheadedness, or imbalance.
But most balance problems are caused by dysfunction of the inner ear’s balance tube. And both tripod limbs are dysfunctional at the same time, making it more difficult to maintain balance.
To properly diagnose the cause of your dizziness, you should be evaluated by an otolaryngologist. This evaluation includes specialized tests to measure inner ear and balance function. In some cases, consultation with a neurologist or other specialist may be necessary.
You can write down some basic symptoms yourself and share them with your doctor to help with diagnosis:
o If your imbalance only occurs for a short time when you wake up or rise from a sitting position, it may be due to a temporary drop in blood pressure.
o Instability or imbalance when walking alone may be related to problems with the balance center of the brain or the balance tubes of the inner ear.
o Vision problems may also be the cause of dizziness or loss of balance.
Sometimes dizziness has multiple causes and more professional treatment may be needed. But in most cases, dizziness and imbalance can be treated by initiating vestibular rehabilitation (VR).
VR is a personalized at-home exercise and activity program designed by a therapist with professional training in balance disorders. Before starting VR, your musculoskeletal system will be assessed by testing arm and leg strength, coordination, and range of motion. The therapist will also watch your balance while walking.
With this information, your therapist can design a program to meet your specific needs. Your progress is then monitored at regular follow-up appointments.
The goal of VR is to reduce dizziness, enhance balance, and improve daily activity levels. Remember, age is not a factor in maintaining healthy, balanced function!
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