10 questions about dizziness

1. What is Dizziness?

Tjasse Bruintjes: “There are three forms. With vertigo you have the feeling that the world is spinning around you or that you yourself are spinning, moving or falling. Some people then start to sweat, become pale and nauseous or have to vomit. hearing loss or experiencing ringing in the ears Another form of vertigo is a light or floating feeling in the head, or the idea that you are about to pass out Third is movement insecurity: an unsteady feeling in the legs or the feeling that you are about to fall .”

2. What are the consequences?

“Severe vertigo in particular can be very drastic. Patients who suffer from this are able to do little during an attack; they have to lie in bed until the complaints subside. If the problems persist, this has a major impact on, for example, their social life and work. People with persistent vertigo often become anxious or insecure because they are afraid of falling, or because they fear that something serious is wrong with them.”

3. Do many people suffer from it?

“Very much. An estimated one in thirty consultations with the GP is about dizziness. It is also one of the most important complaints with which patients go to a neurologist. A large part of the patients is older than 70 years. Dizziness occurs twice as much. common in women as in men. The cause is unknown.”

4. How does dizziness arise?

“There are many different causes. In about 50 percent of cases there is a problem with the inner ear. This is where the vestibular system lies. The most common disorder in inner ear problems is ‘motion-dependent vertigo’ (BPP): a form of acute vertigo that occurs with certain movements such as getting up, lying down, bending, looking up and turning over in bed The vertigo can be severe but usually disappears within a minute BPPV is caused by loosened ear debris in the inner ear: very small stones that we need to perceive certain movements.They are normally stuck in a kind of jelly, but can come loose and then disrupt the normal functioning of the vestibular system.In about 30 percent of patients, chronic hyperventilation is the explanation for the dizziness. A person then takes more breath (and thus gets more oxygen) than what the body needs, and that can be a l give a feeling in the head.”

5. What are other possible causes?

“Dizziness can also be a result of an inflammation of the inner ear (vestibularis neuritis). This gives an acute, severe vertigo that slowly decreases over a few days or weeks. Often patients have had a respiratory infection in the period before. there is Ménière’s disease, which causes sudden attacks of very severe vertigo often accompanied by nausea, vomiting, ringing in the ears, impaired hearing, pale eyesight and cold sweats. The frequency of the attacks varies from one person to another: from weekly to rarely. The seizures usually disappear over the years, but the tinnitus and hearing loss can be permanent.Migraines can cause sudden attacks of dizziness in addition to headaches, which can last from minutes to hours.Low blood pressure (orthostatic hypotension) can cause lightheadedness. in the head when standing up, because the heart cannot pump enough blood to the head fast enough. Stress, anxiety, depression and fatigue can also make you feel light-headed. Finally, as a side effect, medications can cause dizziness. For example, certain sleeping pills, diuretics, blood pressure lowers, antibiotics, antidepressants and painkillers.”

6. How is the diagnosis made?

“Dizziness cannot be ‘measured’. What the patient experiences is the most important information. If necessary, a doctor can perform additional tests, for example a balance test, a balance test, a hearing test, a blood pressure measurement or a lung function test. to find out the cause of the vertigo in 85 percent of the cases.”

7. What if no obvious cause is found?

“Unfortunately, no cause is found in one in seven patients (15 percent). With psychological help, they can learn to deal with the complaints differently and to accept them better.”

8. Is Dizziness Dangerous?

“People who are regularly dizzy often fear that they have a brain tumor, for example. Fortunately, that is almost never the case. Dizziness is extremely annoying, but almost never life-threatening. In very rare cases it can be a symptom of a serious illness, such as early multiple sclerosis, but those are exceptions. Dizziness can be dangerous for the elderly, in the sense that it increases the risk of falling.”

9. Is it treatable?

“The approach depends on the cause. BPPV can be treated well by returning the loosened ear debris to its original location. This is called the ‘reposition maneuver’. It is done by tipping the patient backwards in a certain way. The general practitioner, an ENT specialist, neurologist or specialized physiotherapist can do this. This means that 90 percent of the complaints are solved in one go. In the case of vertigo, we can combat the symptoms and nausea with medication. Unfortunately, medicines do not work with BPPV. Patients with Ménière who have frequent seizures can be treated with an antibiotic that we inject one to three times into the middle ear. With this, the attacks have disappeared in 80 percent. Physiotherapy can help with an inflamed or damaged vestibular system. Exercises stimulate the brain to compensate for the balance problems in the brain, as it were. The brain then creates balance in a new way. In BPPV, controlled induction of dizziness with exercise can speed up recovery. on www.kenniscentrumduizeheid.nl Here is an overview of all physiotherapists who specialize in vertigo.”

10. What can the patient do himself?

“The most important advice is to keep moving (with care), no matter how unnatural that feels. This stimulates the brain to cope well with the balance problems. It can also be useful to keep a complaints diary for a few weeks and to write down everything that could have to do with the dizziness. For example: when do I get dizzy? What am I doing at that moment? What do I notice about my body? How long does the dizziness last? What helps reduce the dizziness? Such a diary helps the patient better understand what could be the cause. If the dizziness lasts longer, it provides useful information for the doctor or general practitioner.”