Vertigo and stress

In a recent survey among ENT specialists at the HNOnet NRW, they stated that on average, 50% of all complaints complained of were stress-related or related to stress in practice. This included the symptom vertigo.

There are several reasons for this. Thus, permanent overloads lead to a poorer micro-perfusion of the inner ear. The sensitive sensory cells no longer get enough oxygen and can be damaged. The metabolism also suffers from stress. Increasingly harmful substances are deposited in the cell. The function worsens and it can lead to acute damage to the organ of balance. This can be thought of as an acute hearing loss, except that in this case not the hearing but the organ of balance is affected. But even an acute attack in Meniere’s disease with vertigo, hearing problems and tinnitus can be triggered by stress.

However, permanent stress also leads to processing disorders in the brain and thus worsens the regulation of balance. You literally get out of balance. Especially in the case of previous damage to the organ of balance, this leads to a diminished ability of the brain to compensate. Dizziness increases on days of high tension and on relaxed days. In these cases, in addition to improved stress management, it is above all targeted swindling in the form of modern biofeedback processes. The balance regulation and coordination ability can thus be increased and improve subjective dizziness complaints.

Author: Dr. med. Uso Walter (Specialist for Otorhinolaryngology)


Which medication helps with vertigo?

Acute vertigo is very threatening for those affected and often goes hand in hand with anxiety, stress reactions and nausea all the way to vomiting. However, it may take some time until the causes are found and ideally eliminated. Time in which an effective treatment with specialized medication can help relieve symptoms and avoid chronicity.

The cause of vertigo can be very different, but the symptom itself always arises in the head. Effective drugs therefore have a damping effect on the brain and thus suppress vertigo. At the same time, this cushioning always causes some dizziness and can lead to different degrees of fatigue. But this in turn leads to an increased risk of falling, which you want to avoid in any case.

True tranquilizers, as they have often been in the past and of which benzodiazepines (e.g., valium) are the best known, are therefore obsolete today. Instead, in acute dizziness Dimenhydrinat, an antihistamine that works against travel sickness and is freely available in the pharmacy. However, since dimenhydrinate, as a high-dose single substance, is still relatively tired, a combination preparation of lower-dose dimenhydrinate and cinnarizine is the drug of first choice, especially for longer therapies. It suppresses the vertigo without making you tired or increasing the risk of falling. The preparation is prescription.

In Méniér’s disease, Betahistine stabilizes the inner ear and has been shown to prevent vertigo. In contrast, it is not as effective as the above-mentioned combined preparation of dimenhydrinate and cinnarizine. Betahistine must be taken regularly as a preventive drug and is subject to prescription.

Some prescription free natural remedies can reduce vertigo in individual cases. Especially in older patients who are already taking many medications, or a non-organic dizziness they are therefore a good alternative.

Author: Dr. med. Uso Walter (Specialist for Otorhinolaryngology)


Dizziness and cervical spine – is there a connection?

Many patients spontaneously claim to have had dizziness from cervical discomfort. But is there any? In any case, the experts are still not quite in agreement about this. While the ENT doctors published studies as early as the 1960s, which suggest a connection between cervical spine problems and dizziness, neurologists still find no clear indication in their investigations. A wide-ranging survey of doctors from all specialist groups, however, sees HWS-related fraud as number 4 in the top ten vertigo causes.

This different assessment is probably mainly due to a misunderstanding: The term cervical spine is used very differently by the various specialist groups. If one defines the cervical spine as only its bony parts as the neurologists and orthopedists usually do, then a direct connection with dizziness or vertigo complaints is in fact very unlikely. However, if one also includes the muscular part of the cervical spine, then dizziness can certainly be scientifically understood. Because in the neck muscles, small sensors constantly measure the tension of the muscles and report them to the equilibrium center. Permanent malpositions or tensions lead to these messages contradicting each other and in the truest sense of the word you no longer know where your head is. Cervical spine related dizziness is therefore quite possible. It is not caused by changes in the cervical spine itself, but by muscular tension.

Also, a positional vertigo (BPPV) occurs statistically more frequently in tension of the cervical spine. Here, however, the connections are still completely unclear. BPPV is caused by stray otoliths, small crystals in the inner ear, which normally measure gravity, and which, for unknown reasons, get lost in the so-called arcades, which register the spin during head movements.

Author: Dr. med. Uso Walter (Specialist for Otorhinolaryngology)


When medication causes vertigo and dizziness

Anyone who has ever drunk a glass of wine knows that dizziness can be caused not only by disease, but also by chemical substances, such as medications. But not only alcohol can cause dizziness and balance disorders. Many medications have an effect on the brain or the cardiovascular system and can trigger more or less severe dizziness and vertigo. It is worthwhile, then, to take a look at the drug list for chronic dizziness symptoms. This is particularly the case in elderly patients, who are weakened by pre-existing conditions and often take a whole list of different medications.

But what does “can cause dizziness” actually mean? If you read through the leaflet or searches on Google, you quickly get the impression that actually every drug available can cause dizziness. But it is not that bad after all: Above all, two large groups of medicines should be mentioned here: First the central acting (meaning acting on the brain) sedatives and anti-depressants and secondly many antihypertensive agents.

In the first group, it is primarily strong tranquilizers and sleep aids that affect the brain in a similar way to alcohol and disturb the balance regulation. Here is the danger of falling particularly large, so that patients with pre-existing dizziness should strictly avoid such drugs. But also antidepressants, whose use in recent years due to the increasing number of mental illness is constantly increasing, can cause diffuse dizziness.

In the antihypertensive agents especially beta-blockers and dehydrating agents (diuretics) can cause dizziness. This is caused by a reduced blood flow to the brain and usually manifests itself as feelings of insecurity, “becoming black in front of the eyes” and a slight wobble.

Much less common are dizziness complaints due to a medical damage to the organ of equilibrium in the inner ear. But here too certain antibiotics (gentamycin) or chemotherapeutic agents can damage the sensitive sensory cells and thus lead to balance disorders.

Author: Dr. med. Uso Walter (ENT Specialist)