Dizziness (Vertigo): Causes, Symptoms, and Treatment

Whether getting up in the morning, bending over or on a long drive, dizziness (vertigo) is a complex phenomenon in various situations. Dizziness is often accompanied by headaches, nausea or ringing in the ears. The duration and the type of dizziness – rotary vertigo or vertigo – can sometimes already provide the first clues to the cause of the symptoms. Prof. Dr. Medical In the interview, Michael Strupp presents various causes of dizziness in more detail and gives tips on the proper treatment.

What is dizziness?

About ten per cent of all patients who visit their family doctor struggle with dizziness. Since dizziness occurs more frequently with increasing age, the percentage of those who often suffer from dizziness is relatively high, especially among older people. Around 30 per cent of people over 65 regularly experience dizziness.

Dizziness is an apparent movement between the environment and one’s own body. You feel that your environment or body is rotating or the ground is shaking. These movements are based on a disturbed perception of the environment, which can have a variety of causes.

 

Dizziness has numerous causes.

Dizziness is not a disease in its own right but an indication of a disturbance in the narrower or broader area of ​​the vestibular system. What triggers this disorder varies.

“There are three major groups of causes that can be hidden behind dizziness,” explains expert Prof. Dr. Dr. Michael Strupp. “The first group is disorders of the peripheral vestibular system, the second group is central vertigo, and the third group is phobic postural vertigo.”

According to Strupp, if there is a disease of the balance organ in the inner ear, the following three causes are particularly often responsible for dizziness:

• Benign positional vertigo
• Morbus Menière
• Inflammation of the balance nerve (so-called vestibular neuritis)

Benign positional vertigo

“Benign positional vertigo becomes noticeable at night or in the morning when turning in bed. Acute attacks of rotary vertigo can occur with such movements,” says Strupp. Positional vertigo is caused by tiny crystals in the ear, which stimulate the sensory cells in the inner ear with specific movements and thus trigger vertigo attacks.

“The good news for all those affected is that such positional vertigo is 100 per cent treatable,” assures the expert. “For the treatment, so-called liberation manoeuvres are carried out, which the patient can carry out independently at home after a doctor’s instruction.” The exercises move the crystals out of the semicircular canals – the patients are often symptom-free after just a few days.

 

Morbus Menière

Meniere’s disease is a disease that occurs particularly frequently in people between the ages of 40 and 60. “In those affected, the rotary vertigo occurs because too much fluid is produced in the ear. This leads to veritable vertigo attacks, which occur together with accompanying symptoms such as hearing disorders, a feeling of pressure in the ear and ringing in the ears,” explains Strupp.

Drug therapy is necessary for people who have Meniere’s disease to combat the dizziness. As a rule, betahistine is the active ingredient. “Similar to benign positional vertigo, the chances of recovery from Meniere’s disease are excellent. About 90 per cent of patients are free of attacks under treatment,” emphasizes the expert.

Inflammation of the vestibular nerve

Inflammation of the vestibular nerve is also known as vestibular neuritis. “It is characterized by an acute onset of severe rotary vertigo that lasts for days,” says Strupp. “Triggers of the inflammation are herpes viruses, which are also responsible for the unpleasant herpes blisters on the lips, among other things.”

Strupp recommends treating the inflammation of the nerve in the acute phase with the administration of cortisone. In about two-thirds of cases, the normal function of the vestibular nerve can be restored. However, it can take a few days to a few weeks for the symptoms to completely subside.