Among the symptoms of diseases, dizziness is a frequent manifestation of many diseases. Dizziness – it is a symptom that accompanies more than 80 diseases, and in half of the cases the exact cause of dizziness is difficult to establish. Dizziness is present with neurological, cardiac – vascular diseases, pathologies of the eyes, ears and other somatic pathologies.
Dizziness is a subjective sensation that accompanies approximately 12% of cases of neurological disease.
Violations of the vestibular apparatus. Types of vestibular vertigo
To find out the cause of dizziness and the pathological condition, the first thing to do is to clarify the nature of the dizziness, that is, vestibular or non-vestibular.
Vestibular vertigo is also called systemic or true and implies the illusion of movements of the patient himself or objects surrounding him. Vestibular dizziness indicates a pathology of the vestibular analyzer.
Types of dizziness in violation of the vestibular apparatus:
- Visual – the illusion of movements of objects that are actually motionless.
- Tactile or tactile – the illusion of uneven support under the feet or hands, the illusion of movement, swinging on the waves, falling through space.
- Proprioceptive – the illusion of the movement of one's own body in space.
Non-vestibular vertigo includes frontal and cerebellar ataxias, feelings of lightheadedness and intoxication, discomfort, emptiness and lightness in the head, pre-syncope, veil before the eyes, syncope. These sensations are not associated with the pathology of the vestibular apparatus.
Types of symptoms of vestibular disorders
Next, determine the level of damage to the vestibular apparatus in the presence of dizziness of the vestibular nature. There are central and peripheral vestibular syndromes.
Peripheral vestibular symptoms
Dizziness against the background of the pathology of the peripheral part of the vestibular apparatus appears abruptly and suddenly, often accompanied by nausea and vomiting. Such bouts of vertigo usually last up to 24 hours and are accompanied by auditory disturbances. After an acute attack, vestibular dysfunction persists. In the period between attacks, no disorders are noted.
Central vestibular symptoms
If the central part of the vestibular apparatus is affected, the symptom of dizziness is not so pronounced and pronounced, but it persists for a long time – up to several weeks. With a pathological process in the central nervous system, an acute effect on the vestibular analyzer is possible, in such cases, dizziness can feel similar to dizziness with damage to the peripheral section. Spontaneous nystagmus is present.
Approach to the treatment of vertigo. Rehabilitation manipulations
Rehabilitation vestibular maneuvers are used to treat benign paroxysmal positional vertigo (BPPV). These include rotations of the trunk and head in a certain sequence, which lead to the return of the otoliths from the canal to the sac. At the same time, a complete cure after a single such manipulations is observed in 83% of patients.
Treatment of vertigo in vestibular disorders is aimed at treating the cause. That is, specific treatment is required for diseases of the central and peripheral nervous system, as well as diseases of the inner and middle ear.
The main drugs in the symptomatic treatment of dizziness
In addition to the specific treatment of pathologies and manipulations , symptomatic treatment of dizziness is used, which alleviates the condition of patients and has a sedative effect on vestibular activity. These medications to treat vertigo include:
- Histamine analogues (betagestin). Preparations of this series are considered vestibulolytic agents that can affect the pathogenesis of vestibular disorders of vascular etiology. Histamine preparations are effective in the treatment of central and peripheral vestibular disorders. There is an improvement in the blood supply to the brain tissue of the vertebrobasilar and carotid systems.
- Antihistamines (meclozine, promethazine, dimenhydrinate, diphenhydramine). Dizziness is affected by H1 – blockers that have central anticholinergic activity. Have a side effect – sedative and hypnotic. In most cases of vertigo, these effects are highly desirable.
- Anticholinergics (atropine, scopolamine). Inhibit the activity of the central vestibular structures. Used to relieve acute attacks or to prevent painful movements.
- Phenothiazine derivatives (promethazine, thiethylperazine). They have antipsychotic and vestibulolytic activity, and also have a pronounced antiemetic effect.
- Tranquilizers (diazepam, hydroxyzine). They are used to reduce anxiety in chronic disorders of the vestibular analyzer.
- Phenibut – derivatives of GABA and phenylethylamine. They have a nootropic, vestibulolytic and tranquilizing effect.
- Barbiturates – effective in the treatment of migraine dizziness.
- Vasoactive drugs.
All of the above vestibulolytic drugs are limited in use by the presence of side effects, which allows them to be used only for the relief of an attack of dizziness or for prophylactic purposes in case of motion sickness.
For the treatment of vertigo in chronic conditions, therapy is aimed at eliminating the cause of the disease and involves individual treatment of vertigo in patients.
Share:
Add a comment