“Dizziness comes in different forms” ... Brief spinning spells: BPPV; room-spinning vertigo: vestibular neuritis [Health Talk]

[Financial News] Brief dizziness when getting up after lying down and dizziness that starts suddenly and lasts for days have different causes. Brief spinning is typical of BPPV, while a spinning sensation is typical of vestibular neuritis.
Dizziness is a common symptom, but it has many possible causes. Its manifestations vary, from feeling that the surroundings or oneself are spinning to feeling unsteady or having difficulty maintaining balance. People often first think of anemia, but problems with the balance organs in the inner ear, migraines, brain disorders, changes in blood pressure and medication can also be causes.
Anemia can, of course, cause dizziness. When there is too little hemoglobin in the blood to supply the body with enough oxygen, dizziness may occur along with fatigue, palpitations and shortness of breath. But if severe spinning dizziness comes on suddenly, problems with the vestibular system and nervous system, which are responsible for the sense of balance, should be considered first.

Professor Lee Seon-uk of the Department of Neurology at Korea University Anam Hospital explained, “When severe dizziness comes on suddenly, it is easy to assume it is due to anemia or fatigue, but it may be caused by a problem in the nervous system responsible for balance, such as vestibular neuritis.” He added, “If the dizziness lasts a long time or is severe enough to make daily activities difficult, its exact cause should be determined.”

BPPV occurs when otoliths, tiny calcium crystals in the ear, become dislodged from the inner ear’s utricle. It is characterized by repeated, brief but intense dizziness in certain positions, such as when getting up after lying down or turning the head.
Vestibular neuritis is different. The vestibular nerve carries balance information received by the ear to the brain. When it is affected, sudden, severe spinning dizziness occurs regardless of posture. Nausea or vomiting often accompanies it, and during the acute phase, walking or maintaining balance may be difficult. Symptoms can last from several hours to several days and may become severe enough to make daily activities difficult.
Diagnosis is based on clinical features, including when the dizziness began, how long it lasts and whether it changes with posture. Because the vestibular nerve is connected to the extraocular muscles, which move the eyes, the condition can be diagnosed with an eye-movement test that checks for nystagmus, or repeated involuntary eye movements. Neurological examinations and balance-function tests may also be performed, and other causes can be ruled out with magnetic resonance imaging (MRI) if needed.
Treatment begins with symptomatic care during the acute phase to reduce dizziness, nausea and vomiting. After that, vestibular rehabilitation therapy, which helps restore balance by moving the head and body, is important. Avoiding movement too much because of dizziness can actually delay recovery, so rehabilitation should begin at an appropriate time based on the patient’s condition.

However, around 10% of cases of sudden, severe dizziness may be caused by disorders of the central nervous system, including stroke, so it is important to distinguish between possible causes. Anyone whose dizziness is accompanied by weakness on one side of the body, slurred speech, double vision, or such a loss of balance that walking properly is difficult should seek medical attention promptly. Some strokes can present only with severe dizziness and difficulty walking, without obvious paralysis.
Professor Lee emphasized, “The way dizziness begins, how long it lasts and the symptoms that accompany it are important clues to the diagnosis.” He added, “If neurological symptoms such as slurred speech, weakness in the limbs or double vision occur alongside dizziness, seek medical care immediately, as it may be an emergency.”
 


[email protected] Jeong Myeong-jin, medical specialist Reporter