For our colleagues
Vestibular dizziness (vertigo or systematized dizziness) can be both peripheral and central. Typically, this condition is accompanied by vegetative symptoms like nausea, vomiting, sweating, blood pressure change, etc. Dizziness is caused by damage of the vestibular labyrinth, vestibular nerve, vestibular nucleus and ascending or descending vestibular pathways.
Non-vestibular dizziness (pseudovertigo or unsystematic dizziness) is usually described by patients as unsteadiness, sway, oscillation of objects, approaching unconsciousness and similar difficult to define feelings. Non-vestibular dizziness is caused by damage of other parts of the nervous system, or it is caused by disturbance of compensation mechanisms resulting in further adjustment disorders. Reasons may be an optical pulse disintegration (optical dizziness), sensorimotor polyneuropathy, ataxia (imbalance or instability), a global hipoperfusion (presyncopal stage), affective cognitive disorders (psychogenic dizziness), epileptic activity (cortical dizziness).
We can help differentiate the type of dizziness to investigate and treat it. Consultations of highly qualified and experienced neurologist and otolaryngologist are available for patients in our clinic. Additional tests with modern Interacoustics brand hardware, like audiometry, tympanometry and video head impulse test (vHIT Interacoustics EyeSeeCam) will be made if necessary. Head and neck vascular duplex sonography are performed with the latest generation Philips ultrasonograph.
Dizziness (vertigo and pseudovertigo) is one of the most frequent complaints, why the patient visits the family doctor. In accordance with epidemiological data, dizziness occurs in 20% to 25% of population. In particular, this symptom often occurs in people, who are elderly. However, only 15% of the patients with complaints of dizziness have been sent to specialists – a neurologist or otolaryngologist. It is very important to differentiate the type of dizziness – a vestibular (vertigo) or non-vestibular (pseudovertigo) dizziness, as well as to determine precisely the damage of the anatomical structure, which causes dizziness and its reason, because on it depends the treatment and positive outcome. It should be noted, that the dizziness is one of the heterogeneous symptoms that requires very accurate investigation.
The most common causes of dizziness
Peripheral vestibular syndrome causes in labyrinth (inner ear part) level:
Benign paroxysmal positional vertigo, Meniere’s disease, vestibular neuritis, neurolabyrinthitis (after viral infection), labyrinthitis (secondary mastodoitis or middle ear inflammation), kinetosis, dizziness after ear operations, vascular (blood supply) labyrinth disorders – an ischaemia in a. labyrinthi basin, hemorrhage, perilymph fistula (PLF), traumatic hearing dice and other traumatic injuries, developmental abnormalities and congenital disease, ototoxic/vestibulotoxic medications, tumors.
Peripheral vestibular syndrome causes in n. vestibularis level:
Infection, reaction to inflammation in adjacent tissues, tumors, cysts, nerve compression of the artery or vein. Symptoms are similar to trigeminal neuralgia, that means transient (from few seconds to few minutes) systematic attacks of dizziness.
The most common causes of central vestibular dizziness:
Acute ischemic disorders of cerebral circulation, brain-stem encephalitis, tumors in the brain- stem as well as and brain-stem injuries and their consequences, degenerative central nervous system (CNS) diseases, pathologies of craniospinal transition, such as Arnold-Chiari malformation.
The most common causes of non-vestibular dizziness:
Optical dizziness: impetuous paralysis of the eye muscle, explicit refractive changes, eye visual field defects, cataracts, macular degeneration.
Presyncopal dizziness: orthostatic (postural) hypotension and other types of hypotension, cardiogenic diseases – heart rhythm disorders, heart failure, significant aortic stenosis. Hypovolemia and changes in the chemical composition of the blood – anemia, hypoglycemia, hypocapnia, vasovagal syncope. May be caused also by medication – antihypertensive and psychotropic.
Psychogenic dizziness: hyperventilation in connection with anxiety, affective cognitive impairment.
Balance and coordination disorders: polyneuropathy, ataxia.
Cortical dizziness: temporal lobe epileptic activity in the cortex.
Treatment of vestibular dizziness
Causes of vestibular dizziness and related diseases
Dizziness treatment tactics: investigation and diagnosis