DEFINITION

It is a sensation of absence of stability or of not knowing what is our situation in the space, rotary, that usually goes accompanied by morning sickness, vomiting, and lacking in stability to walk. It is as if the things of the environment, the soil and everything placed around it was turning or they were not calm.

CAUSES

They are diverse being able to be for affectation of the labyrinth (that is an organ of the balance that is in the internal ear) and in this case it is a peripheral dizziness, or of the cranial nerve (that is the one that takes the information from the ear to the brain) or nuclei of the brain (where the above mentioned information is processed), which constitutes a central dizziness.

Image of the Normal Internal Ear   Image of the Internal Ear with Dizziness for Laberintitis or for Dizziness of Meniere

Between the causes we can stand out: Infections of average and internal ear The traumatism in the head Some viruses Medicines Lacking in blood irrigation Tumors of the acoustic nerve Strangers

Image of the Normal Ear

PERIPHERAL DIZZINESS

The vestibular neuronitis is a sharp and intense picture accompanied by the whole answer of dizziness with morning sickness, vomiting in instability that deteriorates with the movements of head or changes of position and that improves on having fixed the look in a place.
There can be nistagmo and acúfenos (to hear whistles inside the head, without they being in the reality) it usually lasts a few days and yields spontaneously. It is normal that it appears again in sprouts and it leaves residual instability alterations in the march.

The laberintitis takes place after the labyrinth catches fire for infectious causes (virus or bacteria) the dizziness takes place, this one collaborates to headache, fever or other signs of infection. It is necessary to treat the infectious cause so that it transfers the dizziness.

The fistulas perilinfáticas usually stem from traumatic injuries (cough or sneezes) or hiperbáricas (diving).Se it presents like a position dizziness and lacking in audition that is a hard variable a few days and yields only.

The benign positional dizziness is the most frequent of the dizziness, there are sharp pictures of of seconds of duration as regards changes posturales. It appears in certain movement or position for some weeks to yield. It usually repeats the process for years.

Dizziness pictures are the Syndrome of Meniere of minutes or hours of duration that there associate to acúfenos (sounds of the silence), sensation of oppression in the ear and lacking in audition.
Between the attacks an instability usually persists to the gait, and as the pictures are appellants is usually incapacitante both for the absence of audition and for the increase of this instability that they become permanent.

CENTRAL DIZZINESS

The secondary dizziness to cerebral vascular affectations, since in these cases the injuries are cerebral, collaborates to alterations in the speech, injuries of facial movements, alterations of the vision and palsy of extremities.

There is dizziness in the context of a migraine, these are easy to diagnose for being the pulsatile migraine of hours of duration and with familiar precedents a common characteristic.

The secondary dizziness to cerebral tumors gives progressive dizziness with focal nervous symptoms, ataxia, migraine, hipoacusia (decrease of the audition), injuries of facial movements, alterations of the vision, etc...
There is secondary dizziness to the capture of certain medicines (anti-convulsivantes, AAS, diazepinas, alcohol, etc...) A picture of epilepsy of temporary lobe can produce also dizziness.

DIAGNOSIS

A few vestibular tests and an audiometría is realized. Also there is realized a study of the movements of the eye, by means of the direct physical exploration or with aparataje (called electronistagmografía uses a skill). In this test the movements of the eyes are gathered by means of a few electrodes, before different stimuli, and they remain registered in a graph for his analysis.
To differentiate both general types of dizziness we must concentrate on the nistagmo (involuntary movement of the eye), the intensity of the dizziness and the desencadenante.

The balance measures itself in a platform that registers the movements posturales after there puts itself of feet her enzyme (posturografía of mobile platform)

TREATMENT

In most cases antihistamine medicines are used, anticolinérgicos, and antiemetic. The most frequent are the Betahistina (Fidium ®), the Tietilperazina (Torecan ®) and the Sulpiride (Dogmatil ®).
When the picture is very intense surgical treatments are realized, with drainage of the lymph by means of incisions in the labyrinth, the laberintectomía and other times the section of auditory and vestibular nerve.

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