It's like the ground is slipping out from under your feet. Head spin
Hello! I am 37 years old. I don't know what's happening to me and I don't know what other doctor to turn to. There are a lot of symptoms, the main ones are frequent short-term dizziness, heaviness in the head, as if everything is in a fog (similar to a fainting state) - I also call it “like a dust bag hit on the head” :-))) I just can’t even explain this condition, but it probably looks like if you put on a tight fur hat with earflaps and walk in it for several days - all the sounds are strange, muffled, like from a basement, and this is annoying ... At the same time, there is a constant feeling of unreality of what is happening, there is no clarity in the perception of life and ongoing events, that I am like a puppet, sometimes on the contrary, as if everything around is like in a theater. Irritability and nervousness. Sometimes just panic, nothing unreasonable. Fear of something. Sometimes it’s even scary to turn my head, it seems that as soon as I do it, I’ll just fall. At these moments, even just to get up from a chair or walk, you have to make an incredible effort of will, keep yourself in suspense. Recently, two more symptoms have appeared - legs give way and the feeling that the earth is "leaving from under my feet", as if I am losing consciousness. All this lasts from several hours to several days. At the same time, blood pressure is usually normal, 120-80. True, sometimes it rises to 140, but in such cases I am happy, because 1 tablet of Andipal makes me feel better. And when the blood pressure is normal, then I don’t know which pill to take or what to do! Anything can provoke these symptoms - a sharp sound, a sharp movement, lighting, even just any picture or frame from a TV show. I noticed that often this state can begin in a store where a lot of goods are placed on the shelves. For example, this recently happened in a large shoe store - I didn’t have time to go into it and start looking at the goods, as my head was spinning, my legs gave way and it started running ... I also noted for myself that before the weather changes, especially before the temperature drops (for 1 or 2 days) the symptoms worsen every 100 times, it becomes so bad that it is simply beyond words - as if you are dying. True, I noted for myself that sometimes it helps me just to go out of the room to the street, and it seems to become easier. But when the seizures start at home, and not in the store, at work or in another public place, my "going outside" does not help me. It all started about 6 years ago, after a sharp weight loss (about 15 kg in 3 months, then only dizziness appeared, but other symptoms gradually joined. A bunch of examinations, including an MRI of the brain. Everything is normal there, except for " in the subcortical regions white matter in the parietal region on the right and in the region of the basal ganglia on the left, rounded areas of moderately increased intensity of the MR signal in the T2-VI mode are detected, which are not detected in the FLAIR mode up to 2 mm in size, probably of vascular origin. Duplex of vessels of the base of the brain - Asymmetry of blood flow through the vertebral arteries. Paravertebral venous plexuses are dilated with an increase in venous blood flow up to 35 cm.sec. Duplex of vessels of the neck - the diameter of the vertebral arteries: on the right 3.5 mm, on the left 1.9 mm. The diameter of the vertebral veins is dilated.m, 1.4 cm on the left. Conclusions: the path of both vertebral arteries is not straight. Hypoplasia of the left vertebral artery. Severe asymmetry of blood flow in the vertebral arteries. A bunch of doctors different treatment, which either does not give a result at all, or gives short-term relief (cerebralysin, actovegin, piracetam, cavinton, etc.) In July-August, she took afobazole and betaserk. While taking it, it was easier, but after 2-3 weeks everything became even worse. All neurologists unequivocally rule out VVD, and speak of cerebrovascular accident. I read a lot about this, incl. and the fact that cerebrovascular accident may be accompanied by panic attacks but the treatment does not positive results! I often get nervous, there are stressful situations. I think maybe I’m not treating the right ones and with the wrong doctors? Maybe I have a neurosis? Or all together (both neurosis and cerebral circulation plus meteorological dependence) give such a vile condition that worsens the quality of life ??? After all, I want to live a normal, full life, to perceive all events realistically and clearly. I will be very grateful to you for advice, for the help!!!
Natalia:
Hello. I am 40 years old, my name is Natalia. In 2003, I suffered severe stress and since then I have had health problems: high blood pressure, heart palpitations, fear, anxiety. In 2005 received sunstroke, and then it also fell at home during repairs, and from that time there was such a feeling that when I stand or walk, it’s as if the earth is floating away under my feet. I drank Betaserk, Vestibo, Betagis, Vertigoheel drops, Cavinton, Nicerium, injections of Mexidol, Picamilon (it made my head brighten), and the rest was useless. The doctor prescribed paroxetine - it helped, I drank for three months, then stopped. It seems that she felt fine, but now the ground under her feet is floating away again. What can you advise me? I'm very tired of this state, it just starts to pump - immediately fear. There is no way to go to the doctor yet. Before stress, there were only problems with the stomach - I have chronic gastritis, and everything else then came, along with stress. Thyroid is fine, heart too. Thank you. Sincerely, Natalia.
Doctor's answer: Good day, Natalia.
Your condition is most likely associated with a violation of the autonomic nervous system. Symptoms are provoked by stress, excessive emotional, mental stress. At the same time, against the background of seemingly complete health, various surveys heart, lungs, there are complaints like yours. Autonomic dysfunction more often occurs in people who are more sensitive, receptive to various experiences. The disease is caused by a violation of the regulation of the brain internal organs. With excessive emotional, mental overstrain, the brain fails in its vegetative activity, which is expressed in the form of such neurotic manifestations.
In the presence of dizziness, to exclude other pathology, you need to undergo a computed or magnetic resonance imaging. It is important to start treatment of vegetovascular dysfunction from the cause, that is, it is necessary to protect yourself from various experiences and create comfortable and favorable conditions around you, try to be on fresh air, sleep at least 8 hours a day, perform light gymnastics in the morning and observe proper nutrition. When symptoms worsen, you can try to do what you love, what brings you the most pleasure, while your brain will receive positive emotions and recovery will begin faster.
It is also necessary to resort to taking sedatives, antidepressants, drugs from the group of serotonin reuptake inhibitors help well in such cases, these include Paroxetine, Sertraline, Fluoxetine, Paxil, etc. The course of treatment with antidepressants in this condition can reach up to six months with a gradual transition to tranquilizers such as Grandaxin, Afabazol, Adaptol. Choline alfoscerate preparations, such as Cereton, Cerepro, will also have a positive effect; B vitamins: milgamma, neuromultivit, berocca; ginkgo biloba preparations: tanakan, bilobil, memoplant. Since you have chronic gastritis, you need to take B vitamins to reduce the effect on the gastric mucosa, cholinesterase inhibitors can be pierced in the form intramuscular injections 10 injections of one and the other drug. The course of treatment with these drugs ranges from one to three months, while the symptomatic picture is necessarily taken into account. After the course of treatment, you should take a break of 4-6 months and repeat the treatment again to prevent exacerbation. Health to you and your loved ones!
Veronica, Saint Petersburg
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Hello, please help me understand which doctor to contact. During pregnancy in the last stages, she began to notice that in the subway, when climbing the stairs, she seemed to feel a little dizzy, the doctors said that everything would pass after childbirth. After giving birth, my right shoulder began to hurt a lot and give a little to the neck, I went to the osteopath and did exercises, everything returned to normal, but I began to notice that in stores it basically starts suddenly, as if the ground was leaving from under your feet, you sit down, it gets better. Since then she lived a year after giving birth. But 7-8 months ago in the morning there were symptoms of poisoning, vomiting and everything went away from under my feet, I moved along the wall, I couldn’t do otherwise, As soon as you look somewhere in front of your eyes, everything starts to twist. A day later, everything was gone except for the condition of the head or vision, more precisely. And so it remained for 3 months, slowly decreasing. I went to many doctors, donated blood, ultrasound, x-rays, mri. An MRI of the brain and blood vessels showed nothing, ultrasound of the vessels of the neck is also fine, Everything is fine on ultrasound, but perhaps a slight vegetative-vascular dystonia, X-ray showed osteochondrosis and arthrosis of the cervical region, the blood is normal. The neurologist concluded that this osteochondrosis manifests itself in this way, the chiropractor thinks that there are problems with the vestibular apparatus, she does not see serious problems in the neck, the homeopath thinks it's caused by a virus. In general, while everything was getting better, plus trips to chiropractor possibly helped. Everything was fine for 2 months, but in January my mother had a stroke, she was very nervous and helped to lift her in the hospital, I don’t know what played the role, but this strange disease manifested itself again, but now it’s the other way around, at first a little bit, then worse. And now 2 months have passed, and she doesn’t leave, I can’t leave the house anywhere, at home it’s also very scary when my husband is at work, and I’m alone with the child, it always seems that you’re about to fall, but my head is not spinning at the same time, then there are everything in place. The doctors prescribed vertihogel (it only got worse) and betahistine (it had no effect at all) and another drug, let me remind you the name, to improve blood flow, I visit the osteopath again, so far there is no effect. It becomes especially worse when it's hot , stuffy, in the rooms, she herself begins to throw into the heat. The therapist sends to a neurologist, the neurologist does not consider anything other than osteochondrosis, prescribes betahistine again and completely denies the effects of the osteopath and the assumptions of the homeopath.
WHEN THE EARTH LEAVES UNDER THE FEET... (The doctor explains, warns, advises...)
The appearance of dizziness, accompanied by imbalance or causing only a subjective feeling of uncertainty while standing or walking, is always a cause for concern.
Sometimes a person, experiencing the approach of losing consciousness, perceives a feeling of emptiness, “lightness in the head” as dizziness. These complaints are characteristic of a pre-syncope state and are combined with vegetative disorders: pallor skin, palpitations, nausea, blurred vision, hyperhidrosis (sweating). A similar condition can be caused by cardiovascular pathology, orthostatic hypotension (decrease in pressure), anemia, high myopia.
Meniere's syndrome deserves special attention, characterized by the paroxysmal appearance of dizziness and headaches, which are accompanied by nausea, vomiting, pallor of the skin, tinnitus, nystagmus. The attack may come with a sensation of blows to the head and loss of balance.
If there is uncertainty when standing or sitting, staggering when walking, a feeling of body vibration, intoxication, etc., such dizziness is called non-systemic.
The causes of dizziness are varied. Let's consider some of them. It could be cervical osteochondrosis. Changes in the cervical spine irritate the vertebral arteries, causing their spasms. And since the vertebral arteries supply blood to the posterior arteries of the brain, the lack of blood supply to these parts of the brain is manifested by dizziness.
Dizziness very often occurs with atherosclerosis of cerebral vessels. It is usually combined with other signs of atherosclerosis: dull headache, increased fatigue, irritability, absent-mindedness, forgetfulness, memory loss, noise and ringing in the ears and head.
In patients suffering arterial hypertension, dizziness also occurs quite often.
People suffering from neuroses often complain of persistent dizziness. Dizziness is more common with anxiety disorders, depression. Patients complain of fog, heaviness in the head.
Very often, dizziness is a symptom of a disorder in the inner ear. These dizzinesses are possible with ear pathology due to damage to the vestibular apparatus, nerves and blood vessels, or the Eustachian tube. Dizziness is combined with hearing loss, pain or tinnitus. The simplest reason might be sulfur plug in the external auditory canal.
Many diseases gastrointestinal tract, For example, peptic ulcer stomach, duodenum, blood diseases, malignant neoplasms various bodies the use of certain drugs, viral diseases or a threatening stroke may also be accompanied by dizziness.
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Ekaterina Ivanova
Most people experience dizziness at least once in their lives. This unpleasant sensation can accompany various disorders of the central nervous system and in some cases becomes a real problem for the patient. However, there are effective ways to treat this condition, allowing you to quickly remove pathological symptoms and restore a normal lifestyle.
Lesions of the vestibular analyzer at the peripheral and central levels
The cause of dizziness is damage to the peripheral or central part of the vestibular analyzer, which can be caused by various reasons. A lesion at the peripheral level is usually understood as the pathology of the labyrinth of the inner ear and the peripheral neurons innervating it. One of the most common vestibular disorders is benign paroxysmal positional vertigo(BPPV), which occurs in the form of short (less than 1 minute) seizures with a certain position of the head and trunk or rapid movement (leaning forward or backward). The rest of the time there are no symptoms of dizziness. This disorder can occur after traumatic brain injury, infections and inflammatory diseases middle ear or as a result of intoxication, in particular alcohol. In many cases, symptoms resolve after a while and do not require special treatment. Meniere's disease is severe dizziness that can last several hours. As a rule, it is accompanied by nausea, nystagmus, a feeling of pressure, tinnitus and hearing loss. In the absence of adequate treatment, irreversible hearing loss, damage to the otoliths, and pathological changes in the organ of Corti may develop. The disease occurs due to endolymphatic edema of the labyrinth against the background of infection, allergic reaction or without visible reasons. Usually pathological process develops first in one ear, but over time captures the second (becomes bilateral). Neuroma of the cranial nerve of the eighth pair early stages characterized by a gradual decrease in hearing, subsequently accompanied by bouts of dizziness, sometimes quite severe. Intoxication can lead to nerve damage, incl. many medicines. In this case, it is necessary to cancel the drug. Labyrinthitis is the result of a viral or bacterial infection, acute and otitis media, or surgery.
The disorders of the vestibular apparatus caused by it can last from several days to several weeks and disappear as the cause of the disease is eliminated. Vestibular neuronitis is a syndrome of still unknown etiology, accompanied by a sudden and prolonged attack of dizziness with nausea, nystagmus, and a violation of the sense of balance, which is aggravated by movement or a change in the position of the head. No hearing loss was observed. If the patient has these symptoms, a neurological examination should be performed to exclude the possibility of damage to the central nervous system. Attacks usually recur after several months or years. Post-traumatic dizziness can develop as a result of damage to the bone structure of one of the labyrinths and eardrum and associated hemorrhage and edema. A sharp movement of the head in such cases leads to a worsening of symptoms and is accompanied by pain.
Lesions of the vestibular apparatus at the central level occur as a result of a number of disorders of the central nervous system, including stem encephalitis, cysts and tumors of the cerebellum and brain stem, intracranial hypertension, ischemia and cerebral hemorrhages, etc. If these diseases are suspected, careful neurological diagnostics and highly qualified treatment are necessary.
Treatment of dizziness: modern approaches
Treatment of dizziness is usually to relieve unpleasant symptoms. If the symptomatology is based on an established pathology, special agents prescribed by a specialist are used for its treatment. In many cases, the brain adapts over time to pathological condition vestibular system and dizziness disappears. The acceleration of this process can be facilitated by the implementation of specially designed sets of exercises. In such cases, drug therapy is used at the initial stages of the development of pathology to quickly relieve symptoms and alleviate the patient's condition, while the drugs used should not disrupt the course of normal adaptive processes in the central nervous system.
One of the most effective approaches in drug therapy dizziness is an effect on the histaminergic system, the role of which in the development of these symptoms is very important. Endogenous histamine has many vital functions in the body and is found in almost all organs and tissues; to date, three types of its receptors have been discovered: H1, H2 and H3.
Intravenous administration of histamine causes a decrease blood pressure, increased permeability and expansion of capillaries. Injection of a weak histamine solution was first successfully used to treat Ménière's disease over 30 years ago. At the same time, the exact calculation of the dosage of the drug was of particular importance, because. histamine causes many side effects.
Clinical efficacy of the drug betahistine
A modern analogue of histamine, devoid of these side effects, is betahistine. This substance has a significant structural similarity to histamine, but unlike it is not metabolized in the liver and can be administered orally. Betahistine causes an increase in cerebral blood flow and improves blood supply to the inner ear, and also affects the neurons of the vestibular nuclei of the brain. In the treatment of dizziness, the therapeutic effect of this drug is complex and includes three levels of action: on the cochlear blood flow, on the central and peripheral parts of the vestibular apparatus. Being a functional analogue of histamine, betahistine binds to its H1 receptors localized in the cells of the blood vessels of the inner ear, causing a local improvement in microcirculation and reducing endolymphatic edema. At the level central department betahistine interacts with H3 receptors in the brain as a strong histamine antagonist. Thus, it regulates the release of histamine itself and some other neuromodulators from nerve cells. Due to this effect, betahistine promotes regenerative processes in the central nervous system, for example, after neurectomy, which has been shown in animal experiments. It has also been established that betahistine significantly reduces the excitability of the nerve cells of the medial vestibular nucleus, exerting an inhibitory effect on the development of unwanted action potentials in the vestibular nerve, which are involved in the formation of a feeling of dizziness. The therapeutic effect of the drug at the level peripheral department is to reduce the impulse activity of vestibular receptor neurons. It is known that changes in the activity of these cells are one of the immediate causes of the feeling of dizziness. One of the important advantages of betahistine is the absence of a pronounced sedative effect: the drug does not cause drowsiness and is well tolerated, in particular, it does not reduce a person's ability to drive a car.
During clinical trials, incl. double-blind placebo studies have shown high efficiency betahistine for the treatment of dizziness of various etiologies. The use of the drug for the treatment of Meniere's disease on early stages helps prevent the development of hearing impairment due to the protective effect on the neurons of the vestibular apparatus. Betahistine has a favorable pharmacokinetic profile and is rapidly absorbed from the intestine. Its half-life is 3-4 hours, and during the day the drug is almost completely excreted in the urine. Metabolites of the drug formed in the body do not have any activity. Betahistine rarely causes side effects and has proven to be safe.