Diziness and vertigo

Dizziness and vertigo are quite complex manifestations of a variety of possible conditions. I will try and explain in this blog the essential guide to what helps us maintain our balance:

Essentially, there are three sources of sensory information that feed our brains.

  • Eyes showing where we are in space.
  • Vestibular system which is divided into a static and kinetic systems. The static system is reliant on the position of the head.

The kinetic system relies on the head position during movement and does this with what are called the semicircular canals of which there are three and positioned at 90 degrees to each other, acting very much like a gyroscope.

  • Proprioceptors, which are biological sensors which are found around joints and muscles.

The neck is the most important, but they are also found in the spine, limbs and extremities. The proprioceptive inputs from the neck (cervical spine) and ascend in the vestibulospinal tract.

Role of cervical spine in maintenance of balance

In this case head movements lead to movement of the proprioceptors which via neural pathways to the brainstem inform it as to the position of your neck and head. In neck trauma, osteoarthritis, neck tension there are mixed signals going up to the brain from both the cervical spine the vestibular and Ocular pathways which then can lead to feeling of dizziness.

Vertigo vs diziness

Vertigo is a symptom with a feeling of rotation that you or the world are spinning and is usually indicative of an inner ear problem. When you move your head in one direction this leads to a feeling of spinning.

Dizziness or lightheadedness is a nonspecific feeling of wooziness, unsteadiness and suggests a non-vestibular pathology.

Causes of vertigo

Vestibular causes

  • Viral labyrinthitis, Meniere’s disease, ear infection, drug induced this is when vertigo lasts more than 24 hours).
  • Benign paroxysmal positional vertigo, psychological, and neck  (vertigo lasting seconds).

Central causes

Migraine, MS, tumors e.g. acoustic neuroma or stroke.

Causes of dizziness

  • Cardiovascular e.g. heart disease, arrythmias.
  • Proprioception: e.g. arthritis in the neck
  • Metabolic:  hypothyroidism, anemia, alcohol, peripheral neuropathy.

What can be done to ease vertigo or dizziness?

When drugs don’t work, it is worth getting your neck assessed as this certainly may be the cause of some of your dizziness and could be involved with your vertigo.

If you suffer from BPPV (benign paroxysmal positional vertigo), this can be caused by calcium crystals being deposited in one of your semicircular canal. Some exercises can be shown whereby these crystals are shifted to bring relief to this type of vertigo.

Both acupuncture and neck treatment may well be useful in at least mitigating these symptoms, as these can relieve neurological inputs to the brain and thereby reduce symptoms.

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