Article in “Die Wirtschaft”

EQUIVert has been published in the new issue of the IHK magazine Die Wirtschaft! If you want to read the article, you can find it on the website of the IHK Bonn. Click here!


Vertigo diary to fill in

With our dizziness diary, you can record your vertigo symptoms systematically. This can make it easier for your doctor to make a diagnosis and assess the severity of your vertigo over time.
You can download the vertigo diary here: Vertigo diary


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)


Positional vertigo and BPPV

Two-thirds of all acute dizzy spells are caused by dysfunction of the inner-ear equilibrium organ. And here again half of those affected suffers from a positional vertigo. The positional vertigo is thus the most common cause of acute dizziness and vertigo. It manifests itself as a fierce, only a few seconds lasting vertigo that occurs in certain movements of the head, typically e.g. when turning from one side to the other in bed. Because it is a harmless and well treatable form of vertigo, he is also called “benign paroxysmal positional vertigo” or BPPV.

The positional vertigo is caused by small crystals in the inner ear, which usually sense gravity and acceleration. However, these crystals get disloged and subsequently lost in the so-called semicircular canals, which are the fluid-filled accelerometer of the inner ear. Certain head movements whirle them around just like the snow in a snow globe. This leads to an extremely violent vertigo, which quickly fades away when the crystals sink down again.

The shift of the crystals is triggered, among other things, by concussion or whiplash. However, tension of the cervical spine is a accompanying symptom, although the relationships are not yet conclusively clear.

The diagnosis of a positional vertigo can be determined by the ENT specialist by means of a positional test. He brings the patient on the couch with his head in a low position and triggers a dizzy spell by abruptly turning the head. By observing eye movements during the following dizzy spell BPPV can clearly be diagnosed.

The treatment of the benign paroxysmal positional vertigo consists in so-called positioning maneuvers by which the stray crystals are to be conveyed out of the archways. Depending on which archway is affected, different storage maneuvers come into question. The exercises can be done by the doctor alone at home and usually lead to success after a few days. Not to be confused with these exercises are a dizziness training for chronic dizziness.

The most common positioning maneuver is the Epley maneuver.

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


What to do in the case of acute vertigo?

Almost every second person suffers acute dizziness or vertigo at least once in their lives. What is the best way to behave when such an acute vertigo occurs? Doctors recommend to keep calm first. Luckily there are very few serious illnesses behind the vertigo and panic reactions are usually more dangerous than vertigo itself. If possible, you should stay in place first and then get help. This can be relatives in the case of slight dizziness, but also the nearest available doctor with a strong dizziness.

Vertigo drugs that contain the active substance dimenhydrinate improve vertigo and nausea relatively quickly and can also be given as suppositories or infusions. An immobilization, especially of the head area, is also helpful, since the vertigo is then not triggered further by a constant stimulation of the balance organs.

In any case, a detailed diagnosis should then be carried out promptly by the ENT specialist or neurologist, who can determine with various examinations, where the vertigo attack came from. Two-thirds of acute attacks of vertigo are caused by disorders of the balance organs in the inner ear, a quarter by neurological or psychological causes and the remainder by disorders of the cardiovascular system or rare diseases. Depending on the diagnosis, treatment can then consist of further medication, positioning exercises or vertigo training.

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


Dizziness, vertigo and fear – when the psyche loses its hold

The whole world turns suddenly, the ground sways and you seem to lose your footing. Dizziness and vertigo often feel very threatening to those affected and causes strong feelings of anxiety. And even if the vertigo has subsided again, this fear often remains.

Usually, fear is intended to warn of impending dangers and is triggered by the release of certain messenger substances in the brain. So anxiety is part of a general stress response of the body and is associated with a rise in blood pressure and pulse, dry mouth and with strong internal tension. However, this often causes dizziness and vertigo, as if the ground under one’s feet were pulled away and one loses his grip. There is even a separate diagnosis for this anxiety-related dizziness: phobic dizziness.

Dizziness is so scary and fear leads to dizziness. A classic vicious circle that does not always make it easy to break free. In addition to treating the cause of dizziness, the fight against anxiety also plays an important role.

Fear arises above all when one has no opportunity to influence the events and feels victim of his illness. The first step is therefore the detailed explanation: Only if one knows as much as possible about his illness, one can deal rationally with its complaints and influence it positively. The second step is the earliest possible movement: A posture to avoid the dizziness worsens it increasingly and leads to ever new fears, while active movement trains the balance systems in the body and the complaints improved sustainably. A targeted vertigo or balance training can be very helpful here.

If these simple measures are not enough, behavioral therapy may be required. In the process, one learns to recognize the subconscious attitudes and behaviors that lead to fear and dizziness, and gradually to replace them with useful ones.

Information on other types of dizziness and treatment options can be found here.

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


Seniority vertigo: counter fall risks with vertigo training

From the age of 70, seniority vertigo and with it the risk of falling increases with every other year of life. The causes for this are manifold: visual and hearing disorders, degradation processes in the brain, a weakness of the musculoskeletal system and cardiovascular diseases add up and can bring one in the truest sense of the word out of balance. Since aging processes and many cases can not be completely avoided, the provision of old age precautions plays a particularly important role.

Keep moving!

In particular, regular exercise helps to balance and improve walking safety. Extensive scientific studies have shown that exercise supports almost all physical and mental functions and can partially halt aging processes. Exercise strengthens the muscles and the cardiovascular system and promotes the interaction of the organs involved in the sense of balance. Subjective dizziness and balance disorders can be improved.

Good things improved: dizziness training with biofeedback

Even more effective is vertigo and balance training in the form of a modern biofeedback process in countering seniority vertigo. This allows targeted training of the sense of balance and coordination and minimizes the risk of falling sustainably. Through an acoustic feedback via a headphone, for example, in the case of the dreamer trainer EQUIVert, the practitioner is notified of any body fluctuation and thereby learns to stabilize himself. In a customized training program, the level of difficulty is increased step by step and it shows usually after a few practice sessions significant improvements.

Autor: Dr. med. Uso Walter (ENT specialist)