2023-05-29 06:43:00
Impression that everything is moving around us, that we no longer have balance… Which of us has not felt these discomforts one day or another? Doctors, however, make a distinction between “true vertigo” and dizziness. “When you have a sensation of movement around you, as if you were on a merry-go-round, you are subject to ‘true vertigo'”, explains Dr Julie Chastang, general practitioner and vice-president of the College of General Medicine.
This can be accompanied by a feeling of imbalance, nausea, vomiting… On the other hand, if you do not have this rotary sensation, but only a feeling of pitching and imbalance, it is a dizzying sensation. “. Both require medical consultation, especially if they are frequent and/or intense.
A year ago, Jocelyne, 58, had violent but brief dizziness, accompanied by nausea: “It happened both when I was in bed and when I was standing. I was worried. I consulted my GP who, after examining and questioning me, sent me to an ENT doctor, who diagnosed benign paroxysmal positional vertigo (BPPV). »
As its name suggests, this ENT disorder, which is due to a dysfunction of the vestibular system located in the inner ear, is not serious. But it is uncomfortable, even anxiety-provoking. “This is the most frequent cause of ‘true vertigo’, explains Dr. Chastang. It appears when the position of the head changes. »
Short anatomical explanation: in the inner ear, the vestibule plays a central role in balance, in association with other organs such as the eyes and the feet (enameled with proprioceptive sensors). Within the vestibule are fluid-filled semicircular canals.
Their walls are lined with small crystals that sometimes break off and migrate along the inner ear canal. Result: our brain receives bad information, causing dizziness. How to diagnose this disorder? First the doctor asks you about their date of appearance, their intensity, their duration, their frequency and the elements that trigger them. In addition, certain maneuvers (including that of Dix-Hallpike, which triggers vertigo and nystagmus, which corresponds to involuntary rhythmic movements of the eyes) make it possible to confirm the diagnosis.
The main treatment? It consists of repositioning the small crystals in the semicircular canal by various maneuvers that can be performed by a physiotherapist, a doctor trained in these (general practitioner, ENT or neurologist).
Call 15
If you have feelings of dizziness and loss of balance with nausea/vomiting which does not yield. Other signs: difficulty speaking, visual disturbances, abnormal eye movements, difficulty coordinating the movements of the arms and legs when walking… These symptoms could indicate a serious neurological disorder, such as an accident vascular of the cerebellum.
Dizziness
We sometimes have our heads spinning and the impression that we can no longer stand up during an anxiety attack, hypoglycemia, anemia… and when taking certain medications.
Other causes
When the doctor has not diagnosed BPPV, he may prescribe specific examinations to determine the origin of these “true vertigos”. These examinations include an audiological assessment (carried out by an ENT specialist) and an electronystagmography (electrophysiological test evaluating the integrity of the vestibular system), as well as an MRI of the ear and the brainstem. The second most frequent cause of “true vertigo” is vestibular neuritis, which is characterized by the sudden onset of prolonged rotatory vertigo lasting several days, associated with nausea and vomiting. Scientists believe it may be linked to a viral infection, although uncertainties remain. The treatment consists of relieving the symptoms (drugs against vomiting possibly combined with corticosteroids). It also includes vestibular rehabilitation with a physiotherapist.
Some dizziness is due to Ménière’s disease. Intense, they are associated with nausea, vomiting and tinnitus. They last about twenty minutes to several hours, which is very difficult to live with. People can suffer hearing loss, which is not always reversible. This disease is linked to an imbalance of pressures in the inner ear, the causes of which are poorly understood. It would be of various origins: viral, autoimmune, even family genetic predisposition. Treatment is with medications to change the pressure in the ear (such as diuretics), salt-restricting diets, and sometimes surgery on the inner ear.
EGLANTINE GRIGIS
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