Dizziness

Dizziness- feeling of sickness of the person's rotation or surrounding objects, or feeling of falling, falling, unstable sex, leaving from under the feet. Such systemic dizziness is characteristic for the lesion of the vestibular receptors, the vestibular nerve or its nuclei in the brain stem. As a rule, systemic dizziness is accompanied by nausea, vomiting, increased sweating, changes in heart rate, fluctuations in blood pressure. Systemic dizziness attacks last from a few minutes to many hours. In addition to subjective disorders and vegetative disorders, nystagmus is often found. With irrigation of the vestibular structures, the nystagmus is directed toward the lesion focus, and in destructive processes - in the opposite direction. Ringing in the ear or hearing loss indicates the dependence of dizziness on damage to the peripheral elements of the vestibular system. Rotational dizziness is especially pronounced with direct damage to the labyrinth-inflammation, trauma, ischemia, edema. Dizziness caused by organic brain damage is often combined with diplopia, paresis of oculomotor muscles, bulbar marks. Nystagmus in this case is constant and can be horizontal, vertical, rotatory or diagonal.

Especially sharp dizziness is expressed with Meniere's disease. Vestibular neuronitis is characterized by dizziness, vomiting and disturbance of balance for several days without hearing disorders; The process with this disease is localized in the peripheral parts of the vestibular analyzer (inflammation of the vestibular ganglion); There are epidemic outbreaks of vestibular neuronitis with high fever, abdominal pain, sometimes with pleocytosis in the cerebrospinal fluid. Dizziness and vomiting are characteristic of tumors of the posterior cranial fossa; A combination of them with the paroxysm of severe headache after the turn of the head is called the syndrome of Bruns. The most common cause of maloformal attacks in elderly patients is circulatory insufficiency in the vertebrobasilar system, usually with the combination of atherosclerotic stenosis and cervical osteochondrosis. Occasionally, dizziness may be the equivalent of an epileptic attack.

Vertigo is also characteristic of neurotic states. Such psychogenic dizziness is described by patients very vaguely: the feeling of staggering when standing and walking, a feeling of intoxication, heaviness in the head. As a rule, this is accompanied by other neurotic symptoms, and an objective examination does not reveal organic changes.

Treatment. Antihistamines [cinnarizine, diprazine (p-polflen)], torekan, meterazine, phenobarbital, belloid, diazepines, vasodilators (thionicol, nicotinic acid), diuretics. When vomiting, often accompanied by dizziness, prescribe injections of seduxen or chlordiazepoxide (elenium). In severe prolonged dizziness, neuroleptics (haloperidol) are shown. A number of neuroleptics also have a pronounced antiemetic effect, they can be administered parenterally