Diagnosis
To make a diagnosis, a detailed anamnesis is necessary, i.e. a detailed questioning of the person concerned about underlying diseases and current complaints. In the case of dizziness, the patient should be asked in particular what type of vertigo is involved (vertigo of rotation or swindle), when exactly the dizziness occurs, how long the dizziness lasts in each case and whether it is accompanied by other complaints such as headaches, ringing in the ears, hearing loss, drowsiness, anxiety and panic attacks. In addition, a physical examination should always be carried out, which should also include a roughly orienting balance test.
Here the patient is asked to perform various tasks with closed eyes, such as standing on the spot or touching his own nose with his index finger. Blood pressure and heart rate should also be determined. If, for example, there is evidence of paroxysmal positional vertigo, a positioning maneuver should be performed as part of the physical examination.
The patient should perform certain movements, which may eventually provoke the dizziness. If Menière’s disease is suspected, an additional hearing test should be performed. In order to distinguish whether the dizziness is due to a disturbance of the vestibular organ or to a pathological change in the brain, so-called vestibular tests are carried out. In some cases, additional imaging procedures, such as magnetic resonance imaging, computer tomography or ultrasound examinations of the head and, if necessary, an internal medicine and orthopedic examination of the affected person are required.
Therapy
For the treatment of dizziness, medicinal, physiotherapeutic, psychotherapeutic and rarely operative measures are considered. Which measures are taken in each individual case depends on the cause of the dizziness. Medications used to treat dizziness are called antivertiginosa.
These are also effective against nausea, which often occurs together with vertigo. They are used to treat physiological dizziness, which can occur, for example, when travelling by boat or car. They are also used in Meniere’s disease and in vestibular neuritis when there are acute symptoms of dizziness.
Physiotherapeutic procedures are very important in the treatment of dizziness. They include exercises in which the affected person is exposed to uncertainties in standing and walking and these are to be compensated for by corrective movements. Physiotherapeutic procedures are used in particular for paroxysmal positioning vertigo and Menière’s disease.
In the case of paroxysmal positional vertigo, a special positioning maneuver can also be learned. Here, an attempt is made to shift the small calcium carbonate stones, which irritate the organ of equilibrium, through certain movements and rotations of the body and the head so that no more dizziness occurs.In the case of dizziness caused by psychological stress and vertigo forms that are associated with a high level of suffering, those affected can benefit from psychotherapeutic treatment or participation in self-help groups. Operative measures, such as the removal of an organ of balance, are very rarely performed.
