There are two types of dizziness: vestibular (sensation of rotation, spinning, perception of movement, either self or surrounding objects) and non-vestibular (senstation of unsteadiness).
Vestibular dizziness is accompanied by symptoms like nausea, vomiting and blurred vision. Ear diseases or nervous system diseases usually cause them. A non-vestibular dizziness may be or may not be other accompanying symptoms and the causes can be very different.
Dizziness may last few hours, few days or weeks, as well disorders can be permanently even for years.
We can help differentiate the type of dizziness you have, and how to treat it.
Consultations of highly qualified and experienced neurologist and otolaryngologist are available in GK Neiroklīnika. Additional tests, like audiometry, tympanometry, video head impulse test, head and neck blood vessels b duplex sonography, if necessary.
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 a damage of the anatomical structure, which causes dizziness, its reason and method of treatment, because dizziness is one of the most heterogeneous syndroms.
The most common causes of dizziness
Peripheral vestibular syndrome causes in inner ear 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, perilymph fistula, 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 syncopes.
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