Dizziness: diagnosis, medications and natural remedies

Treatment of dizziness depends on the diagnosis. Therefore, it is important to understand the origin of this symptom in order to choose the most appropriate treatment.

Diagnosis of dizziness or lightheadedness

The doctor in charge is the ear specialist or neurologist who can make the diagnosis based on:

• Medical history
• Physical examination,
• balance and hearing tests,
• magnetic resonance imaging of the encephalon (brain),
• Ultrasound examination of the carotids (carotid arteries).

It is important to exclude cardiovascular disease (which is common among diabetic patients).

Physical examination for functional analysis of the vestibular organ

Romberg experiment

Stand upright with feet together, both arms sideways, eyes closed.

The positive Romberg test can mean:

1. Vestibular damage: with a slight delay, the patient tilts and falls to the side of the diseased vestibular organ
2. Sensitive ataxia: when the patient sways in all directions with his eyes closed and then falls forward, backward or to the side
3. The patient is not able to stand on a limited footprint. It is said that the subject is unable to hold the Romberg position: cause is a cerebellar problem

If the patient is stable, the Unterberger pedal test must be performed.

Index finger test

The patient is in a sitting position, eyes closed, arms stretched forward and index fingers pointed at those of the doctor. If there is a disturbance in the area of the labyrinth, the index fingers deviate in a horizontal or vertical direction.

Unterberger pedal test

Feet together, arms stretched forward, eyes closed. The test consists of pedaling on the spot, with the knees pulled up at a time.

Healthy people maintain the same position, while those who suffer from a disorder move forward over 1 meter or turn at least 30° to the diseased side.

The Dix-Hallpike maneuver

In this examination, a person is moved from the sitting position to the supine position, the head is turned 45° to the healthy side (for example, to the left) and tilted 20° backwards. In this position, the patient’s eyes are observed. The test is positive if the patient has nystagmus (uncontrolled eye movements) and feels dizziness. Otherwise, the test is repeated on the other side.

Useful is the study of nystagmus, which can be observed:

• With the naked eye,
• By means of Frenzel glasses, this is a mask with eyeglasses, which causes myopia of +20 diopters. As a result, the patient can not fix objects. Without this tool, peripheral nystagmus may not be observed. The patient sees only blurred outlines.

A more modern method of examining nystagmus is a mask with two infrared cameras that reproduce the magnified image of the eyes on a video.

To make the differential diagnosis between central and peripheral nystagmus, it is necessary to know the direction.

If the patient sits or stands and looks straight ahead, it is necessary to see a neurologist if the nystagmus fails:

• Upstairs
• Down.

Usually, depending on the canal affected, the nystagmus that originates from the labyrinth strikes from the opposite side to the affected ear when the disease affects the semicircular canal:

• Posterior or lateral area, the nystagmus is horizontal or horizontal and rotatory,
• Anterior area, the nystagmus is vertical (occurs very rarely).

Only in Menier’s disease does nystagmus deflect towards the diseased side, but this is an exception. In an upright position, the positional nystagmus is not visible, you have to trigger special movements to identify it. Through certain movements, the otoliths on the hair cells migrate into the semicircular ducts and cause nystagmus. Rarely does dizziness show up as a sole symptom. In order to make the diagnosis, one must therefore also evaluate other health disorders.

The following are to be evaluated:

• function of cranial nerves,
• Possible movement disorders,
• adiadochokinesis,
• Other neurological symptoms.

Depending on the type of disorder, recovery times vary greatly. A peripheral labyrinth disorder improves at different times, but often the body can compensate for malfunctions of the balance system. Thus, an improvement occurs quite quickly (except in Meniere’s syndrome).

There are nerve endings that:

• Replace the labyrinth,
• Allow the body to maintain balance.

In nerve damage with reduced stimulus transmission to the vestibular risk of the brain, the cerebellum can inhibit the signals coming from this nucleus to maintain the balance system. In the absence of signals from the labyrinth, the cervico-ocular reflex can replace the function of the injured labyrinth. However, in some cases, for example skeletal muscle problems in the neck area, this may not work correctly.

Another system that can affect the cervico-ocular reflex is the stomatognathic system:

• temporo-mandibular joint,
• dental arch,
• dental alveoli,
• Gums.

There are many nerve receptors that transmit a lot of proprioceptive information (body position in space) to the brain. Many people with labyrinth disorders cannot restore balance due to a disturbed stomatognathic system, as in the case of teeth grinding. There is a significant correlation, because the signal originating from the stomatognathic system passes through the ascending root of the trigeminal nerve and to the Deiters nucleus (this is where the vestibulo-spinal bundle begins).

There may be interferences between the vestibular system and consciousness.

Many scientific studies hypothesize that a damaged labyrinth cannot be replaced or reflected by other nervous endings because the nervous system is in an over-excited state. The cause is the indirect connection between the amygdala (an area of the brain that regulates emotions) and the vestibular ones:

• Middle
• Lateral.

This connection runs through the brainstem and the parabrachial nucleus. In anxious patients, compensation may therefore be impeded.

Diagnostic Schema

First, it is necessary to find out the location of the injury. Then you have to find out if there are extravestibular factors that can influence compensation. Finally, an overall assessment regarding the patient is required in cooperation with other specialists:

1. Dentist
2. Orthopedist
3. Physiatrists,
4. Psychiatrist.

Medication for dizziness

With severe dizziness, there are drugs that can quickly relieve the symptoms:

• Antihistamines, such as promethazine (Trimeton or Farganesse i.m.), even if the cause is Meniere’s syndrome.
• Alternatively, the doctor may administer 500 ml of physiological saline with the addition of levosulpiride (Levopraid).

In the post-acute period, when symptoms are less severe but not completely gone, the doctor may prescribe cholinergic drugs to support the compensatory mechanism of the balance system.

Histamine medications such as betahistine (Microser) are only indicated for Meniere’s syndrome.

Drugs with antiemetic action

The drug cyclizine for motion sickness or kinetosis has a good effect and causes less fatigue than generic antihistamines. Cinnarizine (Cinazyn) for motion sickness and balance disorders (for example, Meniere’s disease). Promethazine (Farganesse) for severe morning sickness in pregnancy. It is prescribed less often nowadays because it causes severe fatigue.

Diet and nutrition for dizziness

Dizziness can also be caused by improper diet. According to the blood group diet, dizziness can be caused by foods that are incompatible with the immune system. Depending on a person’s blood type, some foods may be tolerated, while others may cause symptoms and diseases.

However, all people can experience dizziness when consuming:

• cereal products containing gluten,
• Milk and dairy products.

Natural diets can reduce symptoms because they:

• have an anti-inflammatory effect,
• Improve the functioning of organs.

According to hygienism, the health of the body depends on diet and lifestyle. Improper nutrition leads to the accumulation of toxins in the blood, the result is the development of symptoms and diseases. Naturopathy sees the person in its entirety. Therefore, an organ disorder cannot be considered separately.

The diet recommended by hygienists is vegan, most foods should be eaten raw and one should avoid:

1. milk and dairy products,
2. Meat
3. Fish
4. Eggs
5. desserts and processed products,
6. Sweetened, carbonated or stimulant drinks.

Natural remedies for dizziness

With benign paroxysmal positional vertigo, there are several effective movements, in other cases, the following remedies can reduce symptoms.

Indian gooseberry (Ribes uva-crispa)

The Indian gooseberry is a popular Ayurvedic remedy for dizziness. This remedy is rich in vitamins A and C, which:

• strengthen the immune system,
• promote blood circulation,
• Help treat and prevent dizziness.

Preparation:

1. grind 2 gooseberry fruits (without seeds),
2. Mix with 2 teaspoons of coriander seeds and a cup of water,
3. Leave overnight,
4. The following morning, strain and drink the water,
5. Repeat daily for a few days.

Deep breathing

Deep breathing is one of the best ways to combat dizziness. According to the website top10remedies.com, it makes it possible to carry sufficient oxygen to the brain, thereby allowing:

• relax the nervous system,
• reduce dizziness.

How does deep breathing take place?

1. Sitting or lying in a comfortable position,
2. Place one hand on your stomach,
3. Press the thumb of the other hand against one nostril and close the mouth,
4. Inhale slowly through the open nostril until the lungs are filled with air.
5. Hold your breath, close both nostrils and press your lips together.
6. After 2 or 3 seconds, exhale slowly and try to exhale the air from the abdominal area as well.
7. Repeat these steps 10 times.
8. Then sit comfortably for 5 minutes and breathe normally to avoid dizziness again.

Ginkgo biloba

Ginko biloba is another effective home remedy for dizziness. It serves to improve cerebral circulation in order to stop or avoid dizziness in the head. Also, this herb helps treat the tinnitus that can occur along with dizziness.

This medicinal herb is available in the form of:

• Tablets
• liquid extract,
• dried leaves.

The standard dose is 120-150 mg of ginkgo biloba extract, three times a day for a few months.

Note: Ginkgo biloba may interact with some medications. Before taking this supplement, the doctor should be consulted.

Ginger

Ginger is a remedy that has long been shown to work against dizziness and nausea. It stimulates blood circulation in the brain and other areas of the body, thus helping to reduce the intensity of dizziness.

1. Chew a small slice of fresh ginger root or suck a ginger candy against the dizziness.
2. Drink a ginger infusion several times a day to prevent dizziness in the head.

Tips to avoid dizziness

• In case of dizziness, immediately sit down or lie down.
• In case of loss of balance and dizziness, lie down and concentrate on the surrounding immovable objects. This distracts the consciousness from dizziness.
• Perform daily gymnastic exercises to improve blood circulation throughout the body and avoid dizziness.
• Avoid getting out of bed quickly.
• Avoid caffeine, alcohol and tobacco because these substances can aggravate diseases that often lead to dizziness in the head.

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