Diagnosis

In the diagnosis of swaying vertigo, a detailed anamnesis regarding triggering factors, duration, strength, etc. plays an important role. The diagnosis of phobic swindling is based on a typical medical history and the absence of physical and neurological abnormalities.

Further examinations serve to exclude other causes. These include, among others, the control of the visual and hearing organs, the orienting examination with Frenzel glasses (glasses that prevent the eyes from being “focused”) to exclude a so-called nystagmus and the rinsing of the external auditory canal by the ear, nose and throat doctor to check the function of the vestibular system. In unclear cases, imaging procedures such as ultrasound or a CT (computed tomography) and an MRT (magnetic resonance imaging) are used.

Spatial masses, for example an acoustic neuroma, can be detected in this way. There is no specific examination in the diagnosis of the so-called cervicogenic syndrome.After definite exclusion of all other diseases, the diagnosis cervical spine syndrome can be considered. In case of muscle tensions, the affected persons often stand out due to a crooked head position.

In a routine examination by an ophthalmologist, visual disorders, general diseases and diseases of the eye itself can be detected. During a complete examination, not only the eyesight, but also the eye fundus including blood vessels and the intraocular pressure are checked. Annual check-ups fulfill a preventive function in the presence of certain diseases.

Frequency distribution

Vertigo is relatively common, at 15 %, compared to all types of vertigo. Phobic vertigo is the most common type of vertigo in the population, together with vestibular neuronitis and benign paroxysmal positional vertigo.

Symptoms

A typical symptom of swaying vertigo is the panic-like fear of falling, which occurs in attacks. Affected persons usually do not fall, but complain about uncertainties when standing and walking. A dizzy feeling is often reported.

Seen from the outside, no abnormalities seem to be present. Furthermore, vegetative symptoms such as palpitations, sweating and a slight tremor (trembling) may be associated with the dizziness symptoms. Vomiting and nausea are not typical for phobic swindling.

In combination with alcohol and physical activity, the symptoms improve. Headaches are sometimes an accompanying symptom. If the cause is a cervical spine syndrome, headaches and dizziness can occur in combination.

If a severe headache occurs for the first time, a cerebral haemorrhage should be ruled out in any case. If, on the other hand, the symptoms are accompanied by pronounced dizziness, this may indicate vestibular migraine. Furthermore, headaches also occur in the context of kinetoses.

The swaying vertigo can be accompanied by visual abnormalities. Those affected perceive their surroundings as blurred, see streaks or a flickering of light. Nausea and vomiting are typical symptoms of vertigo, which occurs in the context of seasickness, travel sickness or air travel.

In patients with vertigo, dizziness while lying down is not usually observed. In this case, the benign paroxysmal positional vertigo is more likely to be present, which is often associated with these symptoms. It should be excluded as a differential diagnosis.

Patients suffering from vertigo often complain about an insecurity of gait. This results from insufficient orientation in the room. The brain receives permanent feedback from the muscles, visual stimuli and the organ of equilibrium about the position and orientation of the body.

If one of these components is missing, the other systems may still be able to compensate for this coupling. For example, it is still possible to hold oneself upright with closed eyes without feeling dizzy. However, if a disease-related process takes place, it is possible that the balance of the body’s own information systems is no longer maintained.

The brain then no longer receives sufficient or even possibly incorrect feedback about the posture of the body, which can lead to a feeling of dizziness. The therapy of this gait insecurity depends on the underlying cause. These can be versatile.

A frequent reason for gait disorders is neurological diseases. As mentioned above, however, tension in certain muscles can also cause such an imbalance. This can be counteracted with targeted relaxation exercises.

A medical examination by an ENT specialist can also provide helpful information, as there may be a disease of the organ of balance in the inner ear. If the insecurity of walking is only slightly pronounced, it can also help to consciously concentrate on fixing certain objects in the room while walking. This promotes the visual information system. If this is not possible, an ophthalmological examination should be performed. Here you can find the main article gait disorder