Dizziness and vestibular disorders are related. The human vestibular apparatus is located in the inner part of the hearing organ. The human vestibular apparatus has receptors that are very sensitive and immediately detect any changes in body position. Vestibular vertigo creates a sensation of imaginary rotation of objects around the patient. Most often it is caused by certain damage to the vestibular apparatus; dizziness occurs as a result of damage to the central or peripheral parts of the vestibular analyzer. Other types of dizziness are associated with various diseases and are not related to damage to the vestibular system.
At the Yusupov Hospital they diagnose diseases that cause vestibular vertigo. In the hospital you can undergo examination, treatment and recovery in a rehabilitation clinic. The clinic carries out rehabilitation measures, uses therapeutic exercises, and various types of physiotherapeutic procedures. Instructors select exercises on simulators for patients suffering from dizziness. The vestibular apparatus, which is treated using various methods, is restored in 50-80% of patients after treatment and rehabilitation.
How to treat vestibular vertigo
Dizziness is a common complaint among patients about feeling unwell. Women and the elderly most often suffer from dizziness. Depending on the cause of dizziness, the doctor prescribes treatment. Treating dizziness is a difficult task for a doctor. He refers the patient for examination to determine whether dizziness is caused by diseases. The patient is prescribed symptomatic treatment, which helps to remove symptoms - nausea, vomiting, and stop attacks of dizziness. Vestibular suppressors are used to stop attacks. To prevent attacks from developing, your doctor may prescribe anticholinergic drugs. Such drugs are prescribed with caution to elderly people due to side effects - hallucinations, amnesia, they can cause urinary retention and psychosis in an elderly patient. Some types of antihistamines and benzodiazepines are also prescribed to enhance the inhibitory response of GABA to the patient’s vestibular system.
Therapeutic measures
They should be divided into two broad categories: therapeutic and surgical. For the use of each category there are corresponding indications and contraindications, so the choice of a specific technique must be made by a doctor.
Therapeutic methods
To eliminate the signs of acute basilar ischemia, you need to quickly follow a series of steps. An approximate algorithm includes:
- Stabilization and reduction of blood pressure.
- Elimination of systemic dizziness. A Schanz collar may be required to stabilize the cervical spine.
- Intensive therapy with neuroprotectors. These drugs increase the resistance of brain cells to hypoxia. The choice of names is up to the doctor.
- Relief of associated phenomena - dizziness, nausea, vomiting.
Acute events cannot be treated independently, as acute ischemic stroke due to VBI may be missed. An emergency vehicle must be called.
In the case of a chronic course, which is much more common, the approaches are different. Treatment of VBI against the background of cervical osteochondrosis requires regular monitoring of the dynamics of the cervical spine.
To normalize the functioning of the central nervous system, the following are used:
- Drugs for the treatment of dizziness (betagistine).
- Improving microcirculation: pentoxifylline, vinpocetine, cinnarizine, vazobral.
- Antioxidants: cytoflavin, thioctic acid, etc.
- Nootropics: piracetam, gamma-aminobutyric acid, phenibut, gingko biloba.
However, we must remember that in order to obtain a lasting effect, it is necessary to treat osteochondrosis. Often, by reducing the activity of this disease, it is already possible to obtain an effect on the central nervous system. Simply by restoring adequate blood supply.
Surgical methods
If the conservative approach (pills and injections) is ineffective, surgeons come to the rescue. The tactics of intervention depend on the cause that causes VBI.
In case of vascular anomalies - stenosis or narrowing of the lumen of the VA, bypass surgery can be performed: the formation of a parallel blood flow that goes around the bottleneck.
If the source of problems is vertebral structures, interventions are performed vertebral, on the vertebrae:
- Microdiscectomies followed by spinal stabilization.
- Using a laser to restore the intervertebral disc.
- Removal of osteophytes and growths that narrow the lumen of the VA.
- Resection of fibers of the sympathetic nerve plexus of the vertebral artery.
The latter method, unlike the previous ones, does not require significant interventions. Without these nerves, the artery only loses the ability to spasm, and excess pain impulses cease to flow to the brain. Thus, the blood flow of the central nervous system can be improved and the patient’s well-being can be improved.
Help with VBI can be provided
It is important to seek qualified professional help in time
Vestibular vertigo: symptoms and treatment in older people
Dizziness (vertigo) is manifested by the illusion of rapid rotation of objects around the patient. It may be accompanied by vomiting, nystagmus, nausea, and ringing in the ears. When vestibular vertigo develops in older people, the causes can be varied: lack of blood supply to the brain (cerebral ischemia), multiple sclerosis, head injuries, some types of brain tumors, tumors of the auditory nerve, hormonal imbalance, atherosclerosis, and other disorders. Treatment of vestibular vertigo (vertigo) in older people begins with finding the cause of the dizziness and treating the underlying disease. Vestibular gymnastics for dizziness in older people improves well-being, has a beneficial effect on the heart, musculoskeletal system, and nervous system. Treatment of vestibular vertigo is carried out with the help of drug therapy, physiotherapy, physical therapy, and reflexology.
Clinical picture
The basis of VBI is very characteristic complaints of the patient in combination with objective symptoms indicating damage to the brain structures to which the vertebrobasilar system supplies blood. The peculiarity is that neurological symptoms appear only in acute cerebral ischemia, which in turn puts the doctor in a difficult situation. It is precisely because the doctor cannot always examine the patient that he has to rely on the patient’s words, as well as on anamnestic information.
Vestibulopathy is more related to “material” disorders associated with the skeleton. These are various changes in the cervical spine, tumors or injuries, and in rare cases, infectious infections.
What both syndromes have in common with osteochondrosis is that it is not only the root cause of the manifestation of each of them, but also the coincidence of symptoms during diagnosis, which makes it extremely difficult to isolate them from each other.
Diseases of the vestibular system and dizziness
There are a number of diseases that lead to disorders of the vestibular apparatus:
- Vertebrobasilar syndrome.
- Meniere's syndrome.
- Vestibular neuronitis.
- Thrombosis of the auditory artery.
- Chronic bilateral vestibulopathy.
Vestibular vertigo can be caused by damage to the vestibular nucleus of the brain stem, the vestibular centers of the brain and vestibular connections may be affected. If the vestibular analyzer is affected, the patient will experience certain symptoms:
- Noise in ears.
- Hearing loss.
- Constant dizziness.
When the central parts of the vestibular apparatus (cerebellum, brain stem) are affected, benign paroxysmal positional vertigo, vestibular neuronitis or Meniere's disease are most often diagnosed.
Lifestyle change
The exact conditions that the patient must adhere to when treating vertebrobasilar insufficiency are indicated by the attending physician. However, for a speedy recovery, as well as improvement in overall well-being, the patient must additionally adhere to the rules of a healthy lifestyle. To do this you need:
- control your body weight and bring it back to normal if you are overweight;
- stop smoking and drinking alcohol;
- use chairs and armchairs with headrests;
- spend more time outdoors, actively moving;
- reduce physical activity;
- refuse fried, smoked, large amounts of salt and other spices;
- sleep on your side or back;
- watch your posture.
Both during the treatment of VBI and the prevention of pathology, it is very important to avoid prolonged periods of the body in a sitting position. And if there is an urgent need for long journeys or flights, use special devices to unload the neck
But one of the main factors contributing to a quick recovery is timely seeking medical help. Only a doctor, based on the diagnostic results, will draw up an effective and safe treatment plan.
Vertebrobasilar insufficiency or, popularly called, dizziness syndrome is not a rare occurrence in the presence of cervical osteochondrosis. Its main cause is considered to be impaired arterial circulation in the affected part of the spine.
There are other reasons for the appearance of this pathological condition. They and the treatment of VBI against the background of cervical osteochondrosis will be discussed below.
Vertebrobasilar insufficiency is characterized by dizziness, which occurs due to insufficient blood flow to certain parts of the brain. In areas of the spine affected by osteochondrosis, blockage of the arteries occurs. In which, due to circulatory disorders, the brainstem, visual cortex and cerebellum suffer. And, since the cerebellum is responsible for the correct coordination of movements, if there is insufficient blood flow into it and useful elements carried with its current, inconsistency of movements appears.
Impaired blood circulation leads to oxygen starvation of the brain. After all, along with a decrease in blood flow, the supply of oxygen also decreases. Which also leads to painful dizziness in a patient suffering from cervical osteochondrosis.
Other reasons why vertebrobasilar insufficiency develops include various types of pathologies of the vertebral arteries, namely:
- Vascular atherosclerosis;
- Arterial hypertension;
- Pathology of connective tissue, causing it to bend;
- Injuries and inflammations;
- Pathologies of vascular development;
- Various types of compression effects;
- "Stealing" syndrome;
- Thrombosis;
- Cardiogenic embolism.
According to medical data, vertebrobasilar insufficiency is diagnosed in 30% of patients with cervical osteochondrosis. Fortunately, this pathological condition, if treated, is reversible.
Benign vestibular vertigo
Benign vestibular vertigo is most often considered a pathology of the inner ear; dizziness often occurs when turning the head to the side. The disease may manifest as sudden severe dizziness, nausea and vomiting. Paroxysmal benign positional vertigo develops as a result of the deposition of calcium salts in the ampulla of the semicircular canal. Peripheral vestibular vertigo occurs when the peripheral part of the vestibular apparatus is damaged. Systemic vestibular vertigo is manifested by symptoms of swaying one's own body, rotating objects, bending or falling, accompanied by impaired hearing, balance, nausea and vomiting. Caused by damage to the central or peripheral part of the vestibular system.
Diagnostics
Diagnostic measures begin with an examination by a specialist of the appropriate profile. After a superficial examination, the doctor prescribes examinations to clarify the diagnosis and determine the severity of the disease.
- A neurological examination is based on checking the nerve trunks of the eyeball and the functional state of the muscles of the facial skull. To check the condition of the cerebellum, a finger-nose test is used to assess the degree of impaired coordination of movements.
- An MRI or examination using a magnetic resonance imaging scanner makes it possible to determine the condition of the neck muscles, bones and joints of the cervical spine.
- Checking the condition of the inner ear, ear canal and eardrum.
Based on the examination results, the doctor makes a diagnosis and prescribes treatment.
Exercises for vestibular vertigo
Dizziness often occurs when turning the head or body - this forces patients to try to avoid such movements. Gymnastics for patients with vestibular system disorders includes various types of exercises, including exercises with head and body turns. Exercises can be performed while sitting on a bed, with or without a pillow, sitting on a chair, or standing. The exercises are based on the principle of sensory mismatch between the movements of the eyes, torso and head. Special simulators that work on the principle of biofeedback will help increase the effectiveness of gymnastics. During the training period, you should avoid taking sedatives and alcohol.
Tablets for vestibular vertigo
Drugs for vestibular vertigo are Betaserc, Betagistin, Tagista, Vestibo, as well as drugs that support the endocrine system, the heart, and reduce blood pressure. Betaserc improves blood circulation in the brain and promotes the functioning of the vestibular apparatus. Betahistine is often used in complex treatment; it helps with nausea and vomiting. Tagista improves blood circulation in the brain and reduces lymph pressure in the labyrinth of the inner ear. A stable effect is achieved after a month of treatment. Vestibo improves blood circulation in the inner ear and brain; the drug is used in complex therapy.
Treatment in Moscow
The best treatment for vestibular disorders is considered to be exercises for dizziness or vestibular rehabilitation. Vestibular rehabilitation is carried out in many special centers, including the rehabilitation center of the Yusupov Hospital. Therapeutic gymnastics is carried out by an instructor, classes are developed individually for each patient. A preliminary examination by a neurologist will help determine the cause of dizziness, and the doctor will prescribe effective drug treatment. A neurologist will tell you what examination to undergo and how to cure vestibular vertigo during your consultation.
