Dizziness, nausea, and spinning head

The symptoms of many diseases cannot allow people to judge what disease they have. Sometimes people feel dizzy and nauseous, and they think it is caused by high blood pressure. They take antihypertensive drugs but it doesn't get better. When they go to the hospital for treatment, they don't know which department to go to. They have done all the possible tests but still can't find the cause of the disease. In fact, there is a disease called otolithiasis that can cause people to feel dizzy and nauseous.

1. Symptoms of otolithiasis

The scientific name of otolithiasis is benign paroxysmal positional vertigo. As the name suggests, paroxysmal attacks occur repeatedly, and positional attacks occur only when the body position changes, generally manifested by turning over, getting up, lying down, or lowering and raising the head, so most patients develop the disease when they get up in the middle of the night or in the morning.

1. Characteristics of the disease: time and space (location).

2. Characteristics of vertigo:

(1) Latent period: Symptoms appear several seconds after the head position changes;

(2) Duration: gradually increasing, gradually decreasing, short-term, reversible, fatigue;

(3) Adaptability: fatigability;

(4) Interchangeability: Available for both lying down and sitting up.

3. Characteristics of nystagmus: Same as characteristics of vertigo. Direction: rotational or horizontal, geotropic.

4. If a vertigo patient feels dizzy and dares not open his eyes, he will often experience nausea and vomiting, and in severe cases, he may also have diarrhea. This is due to the autonomic nervous system reflex.

5. Some people experience panic, chest tightness, shortness of breath, and cold sweats. This is because the patients hold their breath and gasp for air desperately. After excessive elimination of carbon dioxide, hypocapnia occurs, and symptoms such as numbness and cramps in the hands and feet occur. Sometimes the symptoms are similar to motion sickness, and may also include nausea, vomiting, palpitations, and pale complexion.

6. Typical symptoms also appear a few seconds after the body position changes, and usually last for a short time, about a few seconds to tens of seconds. Keep one posture still and the dizziness will soon disappear.

2. Treatment of otolithiasis

Although benign paroxysmal positional vertigo is a self-healing disease, its self-healing time may sometimes take months or even years, and in severe cases, patients may lose their ability to work. Therefore, once patients find that they have similar symptoms, they should receive treatment as early as possible, otherwise it will affect their normal daily life.

1. Psychotherapy

Point out that this disease is a benign process with no serious sequelae in order to reduce the patient's mental burden.

2. Body and head position

When vertigo attacks are severe, try to avoid body and head positions that may cause vertigo attacks.

3. Anti-vertigo drugs

Phenergan, barbiturates, cholinesterase inhibitors, etc. have certain effects.

4. Vestibular habituation therapy

The purpose is to increase tolerance to vertigo, which has a certain therapeutic effect.

5. Postural therapy

Instruct the patient to close his eyes and move from a sitting position to a side-lying position. When the dizziness disappears, sit up. After 30 seconds, lie on the other side again. Alternate between the two sides until the symptoms disappear. Do this every 3 hours. Usually, the symptoms will disappear after 7-10g.

6. Manual otolith repositioning

The purpose is to reposition the otoliths deposited in the posterior semicircular canal. The technique varies depending on the semicircular canal where the otolith is ectopically located.

7. Surgical treatment

If the above treatments are ineffective and affect the quality of life and work, posterior ampullary nerve transection, semicircular canal occlusion, intratympanic injection of 4% polycaine and streptomycin, etc. can be performed. Surgical treatment is suitable for unilateral lesions and patients with severe hearing loss or loss.

Drug treatment cannot prevent vertigo attacks caused by otolithiasis, but some elderly patients with cerebrovascular disease may need to be given infusion therapy at the same time. Some patients who have anxiety, depression, insomnia or autonomic dysfunction need to be given appropriate medication to prevent the recurrence of otolithiasis.