Vertigo and dizziness can be devastating, and left untreated can lead to a host of problems. Most people want to know more about the causes and treatment of vertigo and dizziness. So we’ll start with a little background information.
Your balance is a complex thing.
It is an amazing feat that we can stand upright. It all depends on the complex interaction of your body systems.
The way it works is this: to keep our balance we depend on three body systems. The inner ear system (vestibular), the sensation from your body (the proprioceptive system), and your sense of sight (visual system).
These systems send information into areas of our brains called the brain stem, the cerebellum and areas of our cerebral cortex. These areas use the information the systems bring in to produce a sense of balance.
What causes it to go wrong?
With vertigo and dizziness problems you can either have a problem with the information that is coming in, a “peripheral” problem, or a problem with the interpretation of the information that has come in by the brain, a “central” problem. Or more commonly some combination of the two.
Some examples of peripheral problems affecting the vestibular system include Meniere’s disease, benign paroxysmal positional vertigo (BPPV), perilymphatic fistulas or viral labyrithitis. These conditions all muck up the signals going into the brain, by either increasing or decreasing the signals going into the brain.
See the vestibular system works by comparing the signals from each ear. When I turn my head to the right, the signals from my right ear increase and the ones from the left ear decrease. This lets my brain know I have turned my head to the right. If I have a problem in the right ear that is increasing the signals coming from it, then my brain will think I am moving to the right when I am actually sitting still. This produces the feeling of vertigo or dizziness. When someone comes is with a peripheral problem, it is important that I identify what the cause of the imbalanced signals is, and then remove it as much as possible.
Central problems happen when the brain isn’t interpreting the incoming signals properly. This may happen when there is a peripheral problem as well and the brain can’t compensate properly for the faulty signals. Or it maybe when there is some other problem going on in the brain such as a stroke, tumour or functional problem. The important thing at this stage is to identify what the central problem is due to and correct it as fully as possible.
If you have been given medications such as stematil for your symptoms, be careful. It can actually slow down the brain’s ability to compensate. Because of prescribing laws I can’t tell you not to take medication you have been prescribed, but it has been shown that taking medication can show down the body’s ability to recover from vertigo (Herdman 2008). I would strongly recommend identifying the cause of the problem and treating it rather than relying on medication.
The treatment of vertigo and dizziness.
The exact treatment varies according to the specific problem that you have – that’s why it is so important to identify the cause or causes. For BPPV your practitioner needs to perform the Epley manoeuvre, a treatment that is usually very successful and leads to quick resolution of your symptoms. For conditions such as Meniere’s a series of specific exercises tailored to you can often help.
Central problems can be more complex, but with retraining of your brain you may be able to get relief
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