Why do I feel dizzy when I turn my head?

As the weather has gradually become hotter in recent days, the hot summer weather is gradually approaching, and the temperature of our living environment is also gradually increasing. Therefore, some friends who work in a high temperature environment will have some physical burden or some symptoms of physical discomfort gradually appear, so they need to understand some measures to prevent heatstroke. So let’s understand why we feel dizzy when we turn our head.

The description is vertigo. Vertigo is an illusion of movement or position that leads to a distortion of the relationship between a person and the environment reflected in the cerebral cortex, causing rotation, dizziness, and even nausea, vomiting, palpitations, sweating, tinnitus, etc. Vertigo is very common, with a prevalence rate as high as 40% in people over 40 years old, and it is the most common reason for medical treatment in people over 70 years old. About 25% of emergency patients present with vertigo as their chief complaint. Vertigo can be divided into two categories: central and peripheral, and about 60% is benign paroxysmal positional vertigo (BPPV).

The second most common causes are posterior circulation ischemia (including vertebral basilar artery insufficiency, posterior circulation infarction, etc.), Meniere's disease, vestibular neuronitis, cervical vertigo, and other inner ear vertigo. Rarely, there are tumors, multiple sclerosis, migraine attacks, epilepsy, hypoglycemia, etc. When the head position of BPPV patients changes, they will experience transient rotational dizziness and nystagmus, accompanied by a floating or flipping sensation, nausea, and vomiting. Although BPPV has been known for more than 80 years, its potential pathophysiological mechanism was only gradually clarified after the otolithiasis hypothesis was proposed in 1969 and the presence of movable granular matter (otoconia) in the endolymph of the semicircular canals was found during posterior semicircular canal surgery in some patients with vertigo.

These hypotheses and discoveries also directly promoted the establishment of a variety of manual reduction treatment methods. The disease is not well treated with drugs, and the preferred treatment method is manual reduction: by changing the patient's head position in a certain order, these movable granular substances are moved from the posterior semicircular canal to the utricle, thereby alleviating the patient's symptoms. This method is simple and can be treated at any time in the outpatient clinic or ward. It takes about 10 minutes, has a definite effect, is immediate, and has a low recurrence rate. After BPPV, the most affected semicircular canals are found, followed by the horizontal and superior semicircular canals. Mixed canals also account for a certain proportion, and mixed semicircular canals are more difficult to reposition. Reduction of ridge cap otoliths is rarely successful and is prone to recurrence.

Guidance:

Get more rest and avoid turning your head. Once symptoms appear, it is recommended that you remain still and wait for the symptoms to improve. Then continue to turn 90 degrees in the original direction to see if the above symptoms appear. Continue to turn 360 degrees and see. Does the dizziness last for a few minutes each time? Will it get better if I stay still or turn my head back?