These tests for vertigo through the inner ear are | Vertigo through the inner ear

These tests for vertigo through the inner ear are

The medical history plays the most important role in the diagnosis of vertigo through the inner ear. By interviewing the affected person, the symptoms and their cause can be narrowed down. Special tests for vertigo through the inner ear can include examinations of standing and gait (even with eyes closed).

Increased attention is paid to the extent of the dizziness and whether affected persons have a tendency to fall to a certain side. Also whether the vertigo is directional (always walking in one direction) or non-directional. In addition, the nystagmus (rapid twitching of the eyes when dizziness occurs) can be tested. This can already be triggered at rest, during certain movements or only with the help of Frenzel glasses (glasses with very high vision, which prevent the affected persons from being able to fix something in their surroundings with their eyes).

Treatment

The treatment of vertigo naturally depends on the exact causes. For example, if it is benign paroxysmal positioning vertigo, even simple positioning maneuvers can help to treat the condition. Affected persons should sit upright, turn their head to the side and then let themselves fall onto a soft surface (e.g. mattress, sofa).This sudden movement allows the free crystal in the inner ear to be moved to a fixed place so that it no longer causes any discomfort afterwards.

If the focus is on nerve irritation, an infusion of cortisone together with agents that prevent nausea and nausea can provide relief. The cortisone should help here by its decongestant effect and relieve any pressure on the nerve. Also blood-thinning or blood circulation-promoting agents are used.

Anyone who suffers permanently from recurrent dizziness should also receive physiotherapeutic treatment. In the physiotherapy sessions one can learn how to maintain everyday movement despite the dizziness. However, due to the very individual symptoms and fewer studies, there are hardly any generally binding therapy standards.

Many methods from the field of alternative medicine are also supposed to help with dizziness. For example, autohaemotherapy or oxygen enrichment. Training and the performance of exercises are indispensable, especially in cases of prolonged dizziness.

Through these measures the brain learns to live with the existing stimuli so that even if the cause cannot be eliminated, the symptom dizziness disappears. For dizziness originating in the inner ear, there are a number of exercises that can help to eliminate the cause of the dizziness. This can be done, for example, in the case of benign positioning vertigo.

If the actual cause cannot be eliminated, balance exercises can still help the brain to get used to the new situation. In this way, the stimuli that were mixed up in the case of dizziness can be put in order again. Head and eye movements: If you suffer from severe dizziness, you can start by moving your eyes to different points in space.

If this is possible without any problems, you can move the whole head and try out different angles of inclination and head positions. Standing and walking training: If it is possible, you can try to balance on one leg while standing. Standing with straight legs and closed eyes is also an exercise that is often difficult in cases of dizziness.

As an extension, you can also try to balance on special boards and thus improve the perception of space in the body. Walking on an (imaginary) line, or walking on tiptoe or on the heel also helps to improve coordination. Endurance and repetition are especially important in all exercises.

Because only gradually the brain learns to replace faulty sensory stimuli with correct ones. Positioning maneuvers: In the case of benign positional vertigo, certain positioning maneuvers help to eliminate the cause of the vertigo. The Semont maneuver involves sitting on a couch or bed.

The maneuver is performed on the right ear as follows. The head is turned 45° to the unaffected side, i.e. to the left, while sitting. Now you quickly lie down on the side of the affected side, in this case the right side.

After about 1 minute, change sides quickly and lie exactly on the other side of the body. The posture of the head is maintained the whole time. It is important to change quickly and that the rotation of the head remains constant.

It is normal for the dizziness to increase in the lateral position. Another positioning maneuver is that according to Epley, but it is rather difficult to perform without a treatment table. For more information, please refer to our topic: Exercises for positional vertigoCompared to dizziness through the inner ear, different homeopathic remedies can be used.

Depending on the underlying cause, different remedies are used: For example, nux vomica can be taken for dizziness with nausea and gagging. If the dizziness is worsened by movement, Bryonia can be used. If there is ringing in the ears in addition to dizziness, cocculus can be taken as a homeopathic remedy.

Lac defloratum can be taken for recurrent dizziness. The vestibular labyrinth belongs to the organ of equilibrium in the inner ear. It also contains a bony labyrinth as a system of cavities in which the actual sensory apparatus, the membranous labyrinth, is suspended.

The vestibular apparatus contains two macular organs (macula sacculi and macula utriculi) and three arcade organs, one anterior, one posterior and one horizontal. In a normal body posture, the horizontal arcade in the inner ear is raised by 30°. The bony arches are arranged at an angle of approximately 45° to the main axes of the head.The position of the archways is of clinical importance for the thermal function test.

As mentioned above, the horizontal arcade in the inner ear is tilted forward by 30°. This means that when the head of a lying patient is raised by 30°, the arcade is vertical. The thermal function test serves to examine the vestibular organs separately, since both organs are normally always excited.

The density properties of the endolymph are an advantage here. If an auditory canal is rinsed with warm (44°C) or cold (30°C) water, the endolymph expands in warm water and rises to the top. A vestibular nystagmus (jerky eye movements, vestibulo-ocular reflex) is observed as a reaction.

This procedure is used, for example, in cases of dizziness of unclear origin. The semicircular canals in the inner ear continue to widen to form an ampulla with sensory epithelium (cristae ampullares). It carries specialized sensory cells, the hair cells, embedded between supporting cells.

These essentially correspond to the structure of the hair cells of the cochlea. They carry the finest stereovilli and long kinocytes. The tips of the longer stereovilli are connected to the next smaller villus.

Here again, the transduction process takes place in the inner ear. In the archways, the hair cells are oriented in such a way that the cinematocytes all point in the same direction. The sensory apparatus again contains endolymph fluid, which is washed around by perilymph.

The composition is similar to that of the cochlear lymph. The endolymphatic spaces of the cochlear and vestibular labyrinth are connected via the ductus reuniens. The perilymphatic lymph is drained via the ductus perilymphaticus into the subarachnoid space.

The archways take angular or rotational accelerations. If we rotate on a carousel, the information about the direction in which we are rotated is given from here. The principle of inertia is important here.

Above the sensory epithelium of the archways there is a gelatinous mass (cupula), which has the same density as the endolymph surrounding it. However, this mass is connected at its upper end to the roof of the archway wall. If the archways are now moved by rotational acceleration, the endolymph has the tendency to stop.

So the wall moves faster than the liquid for a moment. But since the cupula is attached to the wall, it is moved against the sluggish endolymph and bent against the acceleration. As mentioned, the vestibular labyrinth still contains two macular organs.

They measure linear accelerations, for example when braking and starting the car or riding in an elevator. So all up/down, forward/backward movements that can cause dizziness are measured here. The basis for this is formed by calcite crystal deposits (otoliths, earstones), which have a higher density than the endolymph.

This heavier otolite membrane slips off via the sensory epithelium during linear acceleration and excites the hair cells. Since the macular organs are approximately perpendicular to each other, traction is always triggered in at least one sensory epithelium. As a result, although we are not necessarily consciously aware of the constant gravitational force, we can unconsciously be sure that we are standing upright in space.