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Dizziness

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  • Dizziness

    Dizziness is an weakening in spatial perception and stability. The term dizziness is also referred as vertigo, presyncope , disequilibrium, or a non-specific feeling such as giddiness or foolishness Treatment :variously depends on the patient's dizziness condition . Dizziness is often a symptom of other medical conditions. Treating the illness can decrease the symptoms of dizziness. Some common treatments for conditions that cause dizziness include: Medications such as meclizine or benzodiazepines are used to control the spinning feeling associated with dizziness, when vertigo is a possible cause. Sometimes the cause of dizziness may not be immediately found. The affected individual may need the services of a specialist, or very detailed specialized testing to uncover the cause and develop a treatment plan for the person's dizziness Pathophysiology : The end organs of the vestibular system, the semicircular canals and the otolith organs, sense angular and linear motion, respectively. As a result, a patient's description of a spinning sensation is likely to indicate an abnormality of the semicircular canals or the central nervous system structures that process signals from the semicircular canals. Similarly, an illusory sensation of floating or tilting may indicate an otolith system disorder. Important to the pathogenesis of vertigo is the fact that there is a vestibular labyrinth on each side of the body. The central nervous system receives signals from both the right and left labyrinths and compares these signals with one another. When the head is still, tonic discharges in both vestibular afferents are exactly balanced. During motion, the right and left labyrinths are alternately excited and inhibited, leading to a left-right difference in eighth nerve activity, which is recognized as motion. The spurious left-right differences that result from an acute unilateral peripheral vestibular disorder are also interpreted by the central nervous system as motion or vertigo The neurochemistry of vertigo includes six primary neurotransmitters that have been identified between the three-neuron arc that drives the vestibulo-ocular reflex (VOR). Glutamate maintains the resting discharge of the central vestibular neurons, and may modulate synaptic transmission in all three neurons of the VOR arc Research: Acute vestibular syndrome (acute dizziness lasting more than 24 hours) is most frequently caused by peripheral, viral vestibular neuritis or central ischaemic stroke in the brainstem or cerebellum. Superficially, they may present themselves in very similar ways. The differential diagnosis between the two is easy: a simple bedside examination consisting of the head impulse test – searching for direction changing nystagmus and/or vertical misalignment of the eyes – reliably identifies stroke in acute vestibular syndrome.

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