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  Text book of the nurse office

Learn on participating in clinical tests in this Web site of the government: Text book of the nurse office
 
CHAPTER 20   Vertigos and desmayar itself
SUBJECTS   ~  Of the Vertigos Of ~ Of the Introduction That desmaya
 

Vertigos

The vertigos are uncomfortable, worrying the sensation that can feel like rotating, unsteadiness, or I am annoying.

Whereas still she is stopped, some people feel as if the world is rotating around her, doing the sensation to him nauseated. Whereas she walks, the sensation some people its knees goes wobbly, and it feels unstable and unstable. Immediately after being unemployed for above, some people shake themselves, posteriora part of the right of the drop down in the chair feels sometimes as if its head is swimming, and. After being unemployed by awhile, some people feel light-headed. All this people can say that they feel been annoying.

Because so many diverse sensations can be described like vertigos, the doctors often try to put vertigos in categories. This people of the aid of the categories are understood when she speaks of vertigos. Four categories are used generally.

The vertigo is a sensation of the movement when there is no movement. It is often described like rotating. The vertigo is what some has people immediately after it mounts in a merry-go-round. It briefly feels as if she still is moving, later she even has both feet planted firmly in the Earth. People with vertigo can feel that she is moving or who the environs are moving whereas still it continues having. The vertigo happens generally when a person is being stopped. But position happens sometimes whereas a person is seating, lying down, or changing. People with vertigo can also have nausea, to times with vomiting, and abnormal unequal movements del eye (nistagma).

Dysequilibrium is a sense of unsteadiness or the loss of balance that implies the legs or the trunk. Dysequilibrium can happen whereas a person is being stopped or is walking.

I am annoying is a sensation that desmayar itself can happen at the next moments. I am annoying happens generally when a person rises quickly after seating or to lie down by awhile.

The mixed vertigos are a miscel√°nea category. They refer the vertigos that do not fit carefully in one of the other three categories.

The categories look like to work enough or for the vertigos that last less than a month (temporary or acute vertigos). But for the vertigos that last more than a month (persistent or chronic vertigos), the categories begin to guard meetings. For example, the vertigos can look like as I am annoying and vertigo in the same time. Or the vertigos can look like to change from a category to another one in a certain term. Older people have chronic vertigos generally, so the categories are less beneficial.

See the problems of the table that can contribute to the vertigos.

Causes

The vertigos can happen when the brain obtains incorrect information or that it is in conflict on the position of the body with respect to the environs and to the movements of the body. Several parts of the body provide this information. They include the eyes, a structure in the internal oido one (called the labyrinth to vestibular), and the nerves that take the information of great joints (in the neck, the hips, the knees, and the ankles) to the brain. The brain constantly uses the information of these pieces of body to direct to the muscle activities and the joints to maintain balance and the stability. When the body cannot maintain the balance and the stability, the vertigos happen sometimes.

To age can cause some of the implied pieces of body in balance less well to the function. But the effect is not enough to cause vertigos unless a person also has a disorder or takes a drug that adds to the effect. To have problems with several of the implied pieces of body in balance is a cause common of the vertigos in older people. For example, a person can have problems of the vision, the problems (vestibulares) of the internal oido one, and the damages or arthritis (that of the nerve can interfere with the information sent of the joints to the brain). In such cases, the brain is not able enough information to maintain the balance and the stability.

Many disorders can cause vertigos. Between older people the common causes include two disorders of the internal oido one: benign positional vertigo and disease of Meniere.

  • Benign positional vertigo: The vertigo happens when the head moves—for example, when a person lies down, rises, it upsets in bed, or it watches for above. The benign positional vertigo becomes when the particles that are distributed normally uniformly in the full channels of flowed of the oido group of internal the meetings.
  • Disease of Meniere: The vertigo is accompanied generally loss of low ear and rugiendo or sounding in the ears (humming). The disease of Meniere is caused by excess of liquid in the internal oido one.

Some disorders cause I am only annoying during or after certain activities. For example, an excessive fall in the arterial pressure after being unemployed upon quickly (hypotension orthostatic) or after eating a food (postprandial hypotension) can do that people feel light-headed after those activities. In both cases, the brain does not obtain enough blood because the arterial pressure is too low.

Some disorders tend to cause temporary vertigos. For example, a person who has an attack of the heart can feel been annoying (generally light-headed) and to suddenly continue feeling that way by some days to some weeks. Whereas the heart cures, the sensation leaves. With other disorders, how long the vertigos will last is uncertain. For example, if a person with diabetes develops dysequilibrium, they can enter a month far, or can last for a course of the life (although its severity can vary). The depression causes vertigos sometimes. People press themselves that she can lose confidence in his legal capacity reciprocally with his environs. It can then feel unstable or light-headed.

A number under the cells of red blood (anemia), a low or high level of the sugar (glucose), or a level under vitamin B12 can contribute to the vertigos. A thyroid gland underactive (hipotiroidismo) can cause vertigos.

The vertigos can also be a temporary drug indirect effect certain, including many taken for high the arterial tension. This type of vertigos often leaves after a person takes the drug for one week or two. Antihistamine and the aids of the dream, including nonprescription, can contribute to the vertigos.

Certain situations can cause temporary vertigos in healthy people. For example, giving return around or being unemployed for above can very quickly cause a brief period of the vertigos. Bifocals that uses can cause vertigos when a person goes under the stairs or watches down.

Diagnosis

Populate who must disclose the vertigos to him of the experience to their doctor. A doctor tries to identify what is causing the vertigos and if the vertigos fit in a specific category, as vertigo. In order to do therefore, the doctor requests that the person describes the vertigos. For example, the doctor asks if the vertigos are accompanied by other symptoms, such as nausea. The doctor also asks how long the vertigos have been present. If the vertigos have been present for less than a month, the doctor can ask if the person began to take some new prescription or drugs nonprescription and if the meterings of some drugs have changed recently. If the vertigos have lasted more than a month, the doctor verifies to know if there are certain disorders that can cause the vertigos.

The doctor makes a physical examinación. The hearing test to help itself to determine if an ear is working incorrectly. If an ear hears better than the other, the person can have a disorder of the internal oido one, that can contribute to the vertigos. The vision is proven, and the eyes are verified to know if there are specific problems that can limit the vision, as cataracts.

Sometimes the doctor observes the eyes for the abnormal movements that move of a pull (nistagma), which they can indicate a disorder of the internal oido one. The doctor can make a simple maneuver, call the maneuver of Hallpike. For this maneuver, the person feels in a table. The doctor puts quickly to person down with the head of the person who hangs on the edge of the table. In the same movement, the doctor gives to return to the main person the a the left right or. If the vertigos are caused by a disorder of the internal oido one, the maneuver of Hallpike can produce nistagma and vertigos quickly.

The doctor uses estetoscopio to verify the index, the rate, and the sound of the beat of the heart. The arterial pressure is moderate after the person has itself been laying down by near 5 minutes and immediately after the person she is stopped for above. One is moderate sometimes again after 3 minutes. These measures help to determine if the cause of the vertigos is hypotension orthostatic.

The doctor verifies some aspects of the function of the brain and the nerve, particularly of the senses of the position and the balance. For example, a person can still be requested to be shutdown with the been on awares, then with the closed eyes. If the person shakes itself more than awaited, the vertigos can be caused by a disorder of the internal oido one, a disorder of the brain, or a problem with the capacity of the body to send the information of the great joints to the brain.

The blood analyses can be done. Typically, the number of the cells of red blood and the levels of the sugar, vitamin B12, and hormones of thyroid is moderate.

If the evidence suggests a disorder of the heart, specially an abnormal rate of the heart, electrocardiography (ECG) can be made to register the electrical activity of the heart. The person can be requested to use a small device, with batteries of ECG (monitor of Holter) by 1 or 2 days. If the evidence suggests a disorder of the brain, tomography computed (CT) or the projection of image of magnetic resonance (MRI) can be made to obtain the images of the brain.

Treatment and prevention

The goals of the treatment are that they correct or that they control possible causes of the vertigos and that they allow people to prevent or to control vertigos so that they can make activities surely daily.

The vertigos can sometimes be cured. For example, if a drug is causing them, the drug can be stopped and be changed to the something more. If the cause is benign positional vertigo, the maneuver of Epley can provide a treatment. The maneuver of Epley is resembled the maneuver of Hallpike, that is used for the diagnosis. If I am annoying persistent it relates to the episodes of the arterial tension loss that happen when a person is stopped for above or after a person eats, to use the averages of the aid (average of the compression) can help. The drugs such as fludrocortisone and midodrine can be used.

The maneuver of Epley sees the figure: A possible treatment for the vertigo?

The people who have experienced vertigos do not have to take the drugs nonprescription that can contribute to the vertigos, such as antihistamine or aids of the dream. The antihistamine ones can make worse vertigos in older people, although the low doses of these drugs help some adults younger than they have persistent vertigo.

If the vertigos persist in spite of the treatment, the people can learn how to avoid the movements that tend to drive vertigos. The examples are watching for above, they are reaching after above, or they are bending down. A form to avoid these movements is to store to articles of the house between the waist and the level of the eye. Rising slowly after seating or to lie down by awhile can help. The squeeze of the hands and to double the feet helps sometimes, specially if the vertigos feel as I am annoying.

Perspective

For some people, the vertigos leave or diminish without the treatment. For others, the vertigos only leave or diminish after the cause is corrected. For other immovable ones, the vertigos, equal when they are treated, last per months or years. Nevertheless, most of this people it can do in front and continue daily activities, specially when the treatment controls the vertigos to a certain degree.

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