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What is vertigo?Vertigo is a fictional sense, generally Rotary type, displacement of the body or objects to your around.
It must be distinguished from seasickness, which consists of a feeling of insecurity and instability, something like the drunk, while vertigo causes an impression of movement or rotation, which can be fleeting, lasting hours or even days in the patient.
In many cases, vertigo is accompanied by nystagmus, which consists of a spasmodic involuntary movement of the eyes, which can be horizontal, vertical or rotary, and can affect one eye or both.
Vertigo is associated with an alteration, either permanently or temporarily, of the balance. It can occur at any age, although it is between 40 and 60 and is more common in women.
The balancing mechanismThe balance system is a complicated reflex. The information is transmitted from the visual system and vestibular (that is housed in the inner ear). Through this gateway information amounts to the brain, where it is processed. Vertigo is caused by erroneous message receipt or the misreading of signals at the level of the brain.
In many cases the vestibulo-ocular reflex is also damaged. This reflex is responsible for stabilizing the image on the retina to turning your head, to maintain a clear image. To better understand this: when you turn your head to the right, our eyes automatically move to the left to keep the same image that we had before the giro. Deficiency or alteration of this reflex, the patient makes rapid eye movements called sacadas, if these sacadas occur when you rotate your head to the right, will be the right lobby which is affected.
Causes of vertigoThere are many reasons which produces the vertigo; currently have been described up to 305 causes, among which are:
- A head injury.
- Abnormalities, and ear infections.
- Heart disease.
- Abnormal blood pressure.
- Brain tumors.
- Multiple sclerosis.
- Clinical manifestation of cerebral ischemia.
- As a result of previous treatments with salicylates, aminoglycosides and anticonvulsants.
Symptoms of vertigoVertigo may be peripheral or central.
- Peripheral: in this case is that damaged vestibular system. Vertigo is very intense and often pursue episodic way, i.e., that there are moments in which the patient is well and others which do not. It is accompanied by hearing loss. Nystagmus has a horizontal direction and is increased by removing the fixation of the gaze.
- Central: is associated injuries in different brain levels. In this case, the vertigo is much less intense, although continuous. It is not accompanied by hearing loss. In this type of vertigo, nystagmus can have any direction.
Most important forms
- Meniere's disease: It affects the vestibular system. It is of unknown origin. It starts between 40 and 50 years and affects both men and women. It is mainly characterized by episodes of vertigo, hearing loss and sound hallucinations (known as tinnitus). Vertigo usually lasts minutes or a few hours and is accompanied by vomiting. Hearing loss worsens progressively. At the beginning, the disease manifests itself in a single hearing, although after a few years will affect both.
- (VPPB) benign paroxysmal positional vertigo: It is one of the main causes of dizziness in patients attending consultation, and predominates in adult women. It is characterized by the presence of brief episodes of vertigo accompanied by nystagmus. Occurs when the person changes position, therefore usually occurs at night (to turn the head on the pillow) causing them to wake up the patient. In almost half of cases, forwards spontaneously about three months after its inception; only a small group of people suffer from it permanently.
Diagnosis of vertigoFirstly, it is necessary to make a good clinical history, in which the form of beginning of the picture, the existence of associated symptoms (nausea, vomiting, hypotension), factors that improve or worsen the dizziness as well as a family history of the patient should be included.
It is important to check the ocular motility, because when it is abnormal may indicate that there is a dysfunction of the inner ear or the nerve connections between this and the brain.
The examination of the ear with Otoscope can to reveal the presence of any exudate or otological discharge or pain, which indicates that it is more likely that this is an infection of any other anatomical problem.
In addition, it is necessary to assess the vestibulo-ocular reflex; Normally this is done by rotating the patient's head while this fixed gaze at a point (such as the nose of the doctor).
Evaluation of the hearing aims to help differentiate a peripheral vertigo of one central.
Perform Imaging tests such as x-rays, resonance and TAC serves to rule out some bigger problems as a tumor of the vestibular nerve, or trauma or major fracture.
If vertigo is accompanied by other symptoms such as headaches, lack of coordination in the movements, double vision, weakness in the limbs and unintelligible language, may be indicative of the existence of a neurological brain disorder.
Treatment of vertigoTo relieve the vertiginous symptoms are recommended, always under advice and control of the doctor, one of this series of drugs. That Yes, keep in mind that these drugs must be in low doses at the beginning of the treatment of vertigo to, subsequently, be gradually increasing the dose:
- Promethazine and meclicina.
- Diazepam and Clonazepam.
- Tietilperacina and metoclopramide.
When medical treatment for vertigo has failed it will resort to surgery.
The benign paroxysmal positional Vertigo (BPPV) you can send by itself alone, but its treatment is important to prevent physical and emotional inability that produces. Should be autoaplicados exercises, which consist of repeated provocation of the clinical manifestations through repeated changes of position; in this way is just getting remission of vertigo. But these exercises are not always well tolerated by the patient.
In cases that do not respond to treatment as usual, when symptoms are severe and the patient's daily life is limited, are used to surgical treatment.