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Dizziness and Vertigo

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Dizziness or some form of imbalance and unsteadiness is particularly common in the population for which there are many possible causes not related to the balance organ of the ear including heart, thyroid and brain problems, fainting attacks, low iron or haemoglobin in the blood and many more. These causes often give a feeling of "light-headedness", "giddiness" or imbalance.

The balance of an individual is dependent on three systems, the eyes, joints and the inner ear; all of which give information to the brain. If any one of these is faulty, then dizziness may arise.

Diseases of the inner ear or labyrinth tend to cause a dizziness known as "vertigo" which is when the environment feels like it is rotating or spinning around the person and is frequently accompanied by a feeling of sickness. Most people who suffer this kind of dizziness will recover over a short time without medication. Persisting or recurring vertigo requires you to be seen by a doctor in order to find the cause and to arrange treatment.

Inner ear disease and vertigo symptoms

Several different conditions can affect the inner ear and cause vertigo. The best way to find the cause is by probing into the details of the dizzy attacks; their length of duration, their frequency etc.

Short-lived attacks (few seconds) of dizziness provoked by head movements particularly on lying or arising from bed are caused by a condition called benign paroxysmal positional vertigo or BPPV. It may be brought on by a recent or past head injury but usually no cause can be found. These usually settle down with time but the doctor can assist recovery of this condition by some simple movements of the head which "repositions" some free floating sand like particles back to their original position in the labyrinth which is where they are to have been considered to have dislodged.

Longer episodes of dizziness lasting between half an hour to twelve hours may be due to another condition called Menière's disease ( endolymphatic hydrops). Usually this accompanied by some deafness and noises and a pressure in the affected ear. The hearing recovers once the vertigo has settled, but may gradually deteriorate with time.

When the attacks of rotatory vertigo are longer, usually a few days then, there may be an inflammation of the nerve for balance or vestibular nerve (vestibular neuronitis) or even an infection of the inner ear (labyrinthitis). The patient will usually be bed bound for 2-3 days with a gradual return to normal balance in the ensuing weeks.

Investigations

Investigations that may be helpful include hearing tests, tests of balance, blood tests, an MRI scan or CT scan.

Treatment

Usually there is no specific treatment for vertigo other controlling the patients symptoms with vestibular sedatives. Some special conditions may merit specific medication or even surgery.

Rehabilitation

The brain naturally compensates after inner ear disease and some exercises have been specifically designed to speed up this process and are named Cawthorne Cooksey exercises.

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