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Causes for feeling light headed

Lightheaded? Top 5 reasons you might feel woozy

Causes of lightheadedness may be dehydration, medication side effects, sudden blood pressure drops, low blood sugar, and heart disease or stroke.

Feeling woozy, lightheaded, or a little faint is a common complaint among older adults. Although it's not usually caused by anything life-threatening, it could be, so you need to be careful.

"Don't ignore it. Even if the lightheadedness does not have a serious cause, it could lead to serious injuries from a fall. And at the worst, the cause may itself be life-threatening," says Dr. Shamai Grossman, an associate professor of emergency medicine at Harvard Medical School.

If you feel lightheaded and/or woozy, Dr. Grossman recommends having a drink of water or orange juice and lying down. If symptoms last more than 15 minutes, he says it's time to seek medical help in an urgent or emergency care setting. Even if symptoms are brief, and even if you think you know the cause, report the lightheadedness to your doctor.

What causes lightheadedness?

Following are the top causes of lightheadedness and common fixes.


You may become dehydrated if you're overheated, if you aren't eating or drinking enough, or if you're sick. Without enough fluids, the volume of your blood goes down, lowering your blood pressure and keeping your brain from getting enough blood, causing lightheadedness. "A glass of water may be enough to make you feel better, but if you haven't been eating or drinking much for days, it will take more than that to rehydrate your body," says Dr. Grossman. You may need an intravenous infusion of fluid. A doctor can check to see if you need electrolytes like potassium or salt.

Drug side effects

Sometimes medications make you feel lightheaded, especially those that lower your blood pressure or make you urinate more. "If they work too well, they'll lower your blood pressure too much and make you lightheaded. Diuretics are notorious for this," says Dr. Grossman. The fix may be as simple as adjusting the dose or trying a different drug.

Sudden drop in blood pressure

The autonomic nervous system helps the body regulate the shift in blood pressure when we stand up. As we get older, this system may deteriorate, causing a temporary drop in blood pressure when we stand—known as orthostatic hypotension—resulting in lightheadedness. This may be a long-term problem, but there are medications to treat it, such as midodrine (ProAmatine) and fludrocortisone (Florinef), so this too warrants a trip to your doctor.

Low blood sugar

"When you don't have enough blood sugar, every system in your body goes on reserve to use as little energy as possible, including your brain, making you feel lightheaded or confused," says Dr. Grossman. It may only take a drink of juice to relieve your symptoms, but it's best to get your blood sugar levels checked, especially if you need more glucose (sugar) in intravenous or pill form.

Heart attack and stroke

At its most serious, lightheadedness may be a sign of a heart attack or stroke. Other symptoms of a heart attack often accompanying lightheadedness are chest pain, shortness of breath, nausea, arm pain, back pain, or jaw pain. Symptoms suggesting a stroke are the sudden onset of headache, numbness, weakness, visual changes, trouble walking, or slurred speech. "But in older adults, lightheadedness may be the only symptom of a heart attack or a stroke, especially if it doesn't go away," says Dr. Grossman. In that case, every second counts, so get to an emergency room for treatment.

Dizziness: How it's different from lightheadedness

"Are you feeling lightheaded or dizzy?" your doctor may ask. Although it is often hard to tell the difference, your answer may have a big impact on how the doctor moves forward with diagnosis. Lightheadedness is not the same as dizziness, also known as vertigo, which refers to feeling like your surroundings are spinning.

Common causes of dizziness include medication side effects; infections or other disorders of the inner ear; tumors; a stroke that occurs in the back of the brain; Ménière's disease, which attacks a nerve important in balance and hearing; benign paroxysmal positional vertigo, when tiny crystals in the inner ear become dislodged and move around inside the ear canals; and Parkinson's disease.

Treating the underlying condition can relieve dizziness. But don't ignore bouts of dizziness, warns Dr. Grossman. "Vertigo can lead to falls and injury. It's a real problem, particularly in the elderly, and in many cases, it can be prevented," he says.


Image: 9nong/Getty IMages

The facts about Parkinson’s Disease

Parkinson's disease is a progressive neurogenerative disease that causes nerve cells (or neurons) in the area of the brain that controls movement to weaken and/or die. While healthy neurons produce a chemical called dopamine, which the brain needs a certain amount of in order to regulate movement, weakened neurons produce lower levels of dopamine. What causes these neurons to weaken is currently unknown. 

Some patients with Parkinson's disease also suffer from a decline in norepinephrine, a chemical that transmits signals across nerve endings and controls various functions, such as blood pressure and heart rate.

More than 10 million people worldwide are currently living with Parkinson's disease and nearly one million will be living with the disease in the United States this year, according to the Parkinson's Foundation.

Risk factors

One's risk of developing PD can depend on the following factors:

  • Gender. Men are 1.5 times more likely to have PD than women.
  • Age. The risk of PD increases with age, although some people are diagnosed with early-onset PD before the age of 50.
  • Genetics. Most cases occur in patients with no familial link to PD, but some have an inheritance pattern involving certain altered genes that could increase the risk of developing PD.
  • Environmental causes. Studies have shown a link between exposure to chemicals used in pesticides and herbicides—as well as metals and organic pollutants—and Parkinson's disease.
  • Head injury. Repeated blows to the head can increase one's risk of developing PD, however, it doesn't guarantee a diagnosis.

Symptoms of Parkinson's disease

These common symptoms of Parkinson's disease often begin gradually and progress over time:

  • Shaking or tremor
  • Rigid muscles
  • Difficulty walking
  • Unsteady balance
  • Poor posture
  • Slowing of body movements (bradykinesia)

As the disease continues to progress, additional symptoms can occur such as slurred or soft speech, trouble chewing and/or swallowing, memory loss, constipation, trouble sleeping, loss of bladder control, anxiety, depression, inability to regulate body temperature, sexual dysfunction, decreased ability to smell, restless legs and muscle cramps.


There are currently no blood or lab tests that can be used to diagnose Parkinson's disease. Neurologists make a diagnosis based on their patient's medical history and an examination.

According to the Parkinson's Foundation, at least two of the four following symptoms must be present over a period of time for a neurologist to consider Parkinson's disease as a diagnosis:

  • Shaking or tremor
  • Bradykinesia
  • Stiffness in arms, legs and/or trunk
  • Balance issues

There are a number of conditions that closely mimic Parkinson's disease, such as:

  • Essential tremor. Essential tremor is an action tremor, meaning that the involuntary shaking increases when you move and try to use your hands. In Parkinson's disease, tremors occur mainly at rest, and activity reduces the symptoms.
  • Normal pressure hydrocephalus. This condition, seen primarily in older people, happens when there is an excess of the fluid surrounding the brain and spinal cord. The classic symptoms are an unsteady gait, problems with memory and thinking, and urinary incontinence.
  • Dementia with Lewy bodies. Symptoms seen early on in PD can also develop during the late stages of dementia with Lewy bodies, a disease that causes problems with mood, thinking and movement and is characterized by abnormal protein deposits called Lewy bodies in the brain.
  • Multiple system atrophy. A progressive neurogenerative disorder, multiple system atrophy involves the death of different types of nerve cells in the brain and spinal cord. Symptoms include slowness of movement, tremor, stiffness, and impaired speech.
  • Corticobasal syndrome. CBS is a condition that affects movement, language or both. The cause is currently unknown, but some people with CBS have a build-up of tau in their brains similar to that of Alzheimer's disease patients.
  • Progressive Supranuclear Palsy. This rare condition, which damages nerve cells in the brain, can cause loss of balance, eye problems, unexplained falls, and stiffness. 

Parkinson's disease treatment

Although there is no cure for Parkinson's disease, neurologists can recommend various medications, surgeries and/or therapies to relieve symptoms.

Medication. The most common medications used to treat Parkinson's disease are formulated to help maintain, replenish or mimic dopamine and other chemicals in the brain:

  • Levodopa replenishes the brain's decreasing supply of dopamine,
  • Carbidopa is used in combination with levodopa (e.g. Sinemet) to help reduce the side effects associated with levodopa, such as nausea, low blood pressure, and restlessness.
  • Dopamine Agonists mimic the effects of dopamine. They can be used to delay starting levodopa or can be used in addition to it.
  • Amantadine can boost levels of dopamine that are already present in the brain.
  • Anticholinergic medications are prescribed to help reduce tremor.
  • Catechol-O-methyltransferase (COMT) inhibitors block enzymes that break down dopamine and thereby prolong dopamine's action in the brain.
  • Monoamine Oxidase (MAO) B Inhibitors also blocks an enzyme that breaks down dopamine and allows it to function for a longer period.
  • Adenosine Receptor Antagonist may keep muscles working more normally in what are known as "off" periods when patients are taking levodopa/carbidopa.  

Finding the right combination of PD medications can take time in order to find what works best with the least amount of side effects, which can include nausea, low blood pressure, dizziness, constipation, insomnia, hallucinations, and dyskinesia (uncontrolled body movements). Your doctor may prescribe additional medications to relieve some of these side effects or to relieve the non-motor symptoms commonly associated with Parkinson's disease.

Deep Brain Stimulation. Typically reserved for those who don't respond well enough to medication, deep brain stimulation is a surgical procedure where thin metal wires are placed in the brain and programmed to send electrical pulses that aid in controlling motor symptoms. In general, it is considered for patients who have had PD for four years or more and it is not recommended for patients with dementia.  

Focused Ultrasound. A non-invasive option that is FDA-approved to treat tremor-predominant Parkinson's disease as well as essential tremor. Focused ultrasound for tremor destroys brain cells that cause motor problems. Unlike deep brain stimulation, focused ultrasound therapy is permanent and irreversible. It is also being tested for other PD symptoms. 

Other Therapies. Sports and exercise regimens, such as walking, non-contact boxing, biking, yoga and tai chi, have been shown to improve balance, motor control, and strength in PD patients. Physical and occupational therapy can also aid in improving gait, flexibility, speech and the ability to perform everyday activities, such as eating and dressing.

Image: MarianVejcik/Getty Images

causes, symptoms and diagnosis, indications for visiting a doctor

There is nothing pleasant about feeling dizzy - we feel anxiety, we can get injured. What is dizziness and how can it be caused? Should I ignore it, as is often the case with dizziness in men, drink self-chosen pills, as women often do with dizziness, or immediately go to the doctor? How to help yourself during an attack? Let's consider these and other questions in more detail.

Symptoms of dizziness

Vertigo (medical term "vertigo") is disorientation in space. It seems to a person that he is rotating, moving, although in fact he is motionless. It happens the other way around - there is a feeling that everything around is spinning and moving - objects, trees, the ground under your feet.

Sensations can be different - from rotational movements, to the impression of instability, when everything around (or yourself) trembles, staggers, moves. The body or parts of it may appear to be moving. Describing their condition, many say that they feel like with a strong sea roll, riding on a swing.

Additional symptoms when dizzy:

  • Feeling dizzy.
  • An illusion of mobility of your body or surrounding objects is created.
  • There is nausea, weakness, up to fainting.
  • Cold sweat breaks out.
  • Increased heart rate.
  • Fear, panic appears.
  • Numb legs or arms.
  • Impaired hearing or disturbed by ringing in the ears.

Dizziness can be sharp for several seconds or longer - up to half an hour, an hour and a constant feeling. The frequency of seizures is also different - someone encounters them regularly under certain conditions, while someone has experienced only a couple of times in their lives. Some patients notice frequent patterns when dizziness occurs. It can be trips in transport, experiences.

Causes of dizziness

They can be conditionally divided into physiological - normal, which do not serve as a symptom of diseases, and situations when vertigo signals some kind of illness, failure in the body.

The main causes of dizziness in a healthy person:

  • Sudden fright, when there is a sharp release of stress hormones.
  • Unusual and jerky movements, such as skydiving, rides, spinning in circles for a long time.

With dizziness, the body warns us that something is not right with it at:

  • Strong alcohol intoxication.
  • Rigid and unbalanced diets.
  • Dehydration, heat stroke.
  • Excessive exercise.
  • Decreased sugar levels.
  • Low blood pressure.
  • Taking certain medications (this side effect is indicated in the instructions).

Among the causes of dizziness in women may be pregnancy and heavy menstruation.

But not everything is so harmless with vertigo. This symptom can be in a variety of diseases. There are about eighty of them in total.

Major diseases, conditions that cause dizziness:

  • Pathologies of the ENT organs that affect the inner ear (it serves as an element of the vestibular apparatus) - otitis media, Meniere's disease and others.
  • Circulatory disorders of the brain, vascular pathologies - aneurysms, VVD, stroke.
  • Tumors of any nature in the brain, neck, cranial structures.
  • Degenerative changes in the brain - multiple sclerosis, Parkinson's disease and others.
  • Inflammatory and other diseases of the central nervous system - meningitis, encephalomyelitis and others.
  • Cardiovascular diseases - infarction, cardiac arrhythmias, arterial hypertension and hypotension.
  • Mental illness - phobias, neurotic syndrome.
  • Osteochondrosis of the cervical spine.

What to do if you feel dizzy

During an attack, it is advisable not to turn your head to the side, not to make sudden movements, for example, try to lie down immediately. You can sit down, lie down gradually, focus on deep breathing. You can wash your face, make a cold compress on your face.

If vertigo recurs, attacks become more severe, there are additional symptoms - take action and consult a doctor

It is necessary to understand the symptom of what disease is dizziness. A neurologist or a therapist will help in this, who, according to the patient's complaints, makes a presumptive diagnosis. If necessary, other specialists are involved in the diagnosis and treatment - an otolaryngologist, a cardiologist and others.

Diagnostic methods will differ for different diseases that caused vertigo. There is no single prescription for dizziness. Ear pathologies or heart disease, brain tumors or osteochondrosis - all this is treated in different ways.

To find out why dizziness bothers you, how to get rid of them and maintain health, the doctors of the Kutuzovsky medical center will help. We are waiting for you at the clinic every day by appointment.

The content of this article has been checked and confirmed for compliance with medical standards by a general practitioner Butskikh Yulia Vladimirovna.

Publication checked:

Ayvazyan Linda Volodevna

Experience: 5 years

Dermatovenereologist, mycologist, trichologist

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Causes, symptoms and treatment of vertigo

Vertigo is a misperception of one's body in space. This is a fairly common symptom of both neurological and mental, somatic diseases. An average of 15-35% of the population experiences dizziness in their lifetime. Most often these are people after 60 years - 20%, after 70 - 30% and after 80 - 50%.

Regular attacks dizziness when standing up significantly impair the quality of life and can lead to injury due to a fall. This is especially dangerous for the elderly. For people of working age, such manifestations in the body often cause a temporary loss of the opportunity to work fully.

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There are 5 main types of vertigo:

  • vestibular;
  • lipothymic;
  • postural;
  • cervicogenic;
  • psychogenic.

Vestibular vertigo develops due to damage or physiological stimulation of the peripheral vestibular apparatus and central autonomic structures. As a rule, difficulties with orientation in space arise when the head is rotated. All this passes with loss of balance, periodic falls, nausea and other unpleasant manifestations.

Lipothymic vertigo occurs in pre-syncope after excessive use of insulin or insulinoma. A characteristic symptom is "fog" in the head. A similar condition can occur after taking drugs that depress the central nervous system. For example, tranquilizers.

Postural vertigo is due to various gait disorders.

Cervicogenic dizziness is provoked by diseases of the cervical spine. Dizziness in this pathology is the result of pain and limited mobility of the neck.

Psychogenic dizziness is characteristic of people with neuroses and personality disorders. Such attacks are manifested due to feelings of anxiety, panic attacks in various situations. This type is usually described as a feeling of unsteadiness, the presence of heaviness in the head, a feeling of intoxication. Oscillatory eye movements in this case are absent, but, unlike other varieties, depression may occur afterwards. Treatment of dizziness in women and men includes psychotherapy, vestibular exercises, antidepressants.


People who experience dizziness more often describe their condition as follows:

  • sensation of body movement;
  • loss of balance and body tilt to one side;
  • feeling of tension, constriction in the head;
  • fall for no reason;
  • unsteady gait or loss of her confidence.

Symptoms may only get worse with changes in body position or head rotation. Dizziness can come on suddenly and be so severe that you have to sit up or lie down abruptly. It can last a day or even several, although it is often limited to a few minutes.

CAUSES OF Dizziness

There are many causes of dizziness, from diseases of the inner ear to taking certain medications. The most serious are determined by pathologies of blood circulation in the brain, as well as tumors or brain damage after falls or strong blows.

In many situations severe vertigo causes diseases of the inner ear, benign paroxysmal positional vertigo, Meniere's disease. Also often the basis is infectious diseases of the ear.

Less common causes are vertebrobasilar insufficiency, stroke or intracerebral hemorrhage, multiple sclerosis, vestibular migraine, acoustic neuroma, orthostatic hypotension, hypoglycemia (low blood sugar), anemia (low iron), medication.

Inner ear infections

Vestibular neuritis and labyrinthitis are disorders that result from infections. They cause inflammation of the inner ear, or the nerve that connects the inner ear to the brain. After that, the transmission of sensory information from the ear to the brain is disrupted. The result is hearing loss and balance problems.

Inner ear infections are caused by viruses or bacteria. You can find out about the presence of viruses in the body by the symptoms of an infection of the internal respiratory tract. Its manifestations are noted a few weeks before the onset of dizziness. You can get an infection at any age.

Anatomy of the ear

The inner ear consists of a system of tubes and sacs that are filled with fluid. All this is called a labyrinth, the functions of which are hearing and balance. Sound signals from the labyrinth are transmitted to the brain via the vestibulo-cochlear nerve with two branches. One transmits messages from the organ of hearing, and the other from the organs of balance.

The brain processes balance signals sent through the vestibular nerve from the right and left ear. When one party is infected, it sends false signals. This is how information is presented that does not correspond to reality, which leads to dizziness.

Vestibular neuritis (nerve inflammation) affects the balance branch. This leads to dizziness, a disturbed sense of oneself in space, a sharp movement of the eyeballs with a fast phase, but there is no transformation with hearing. It may seem to a person that objects are moving around, and when performing coordination exercises, he will usually be mistaken.

Experts also use the term "vestibular neuronitis" (damage to the sensory neurons of the vestibular ganglion). Its symptom is severe, rapidly developing, paroxysmal dizziness. It is often characterized by vomiting, imbalance. Often development symptoms of dizziness precedes SARS. Sometimes, a few weeks before the developed clinical picture, patients may notice short bouts of loss of balance.

Labyrinthitis (inflammation of the labyrinth) occurs when an infection affects both branches of the cochleo-vestibular nerve. Then the hearing changes, attacks of dizziness occur. Even with small turns of the head, the symptoms become more pronounced. Therefore, some people are forced to support their heads with their hands.

Benign paroxysmal positional vertigo (BPPV)

BPPV is one of the most common causes of vertigo which manifests itself with sudden movements and waving the head. The duration of the state is limited to a few seconds or minutes. It occurs when calcium crystals (otoliths) in the inner ear begin to move. Because of this, there is a sensation of rotation of the body.

The causes of BPPV are a history of traumatic brain injury, as well as otitis media. Often, the cause of the disease cannot be identified. Then the diagnosis is confirmed by taking a Dix-Hallpike sample. To do this, the patient quickly lies down from a sitting position and slightly lowers his head, turned 45 degrees. The test is positive if, a couple of seconds later, an attack of dizziness and nystagmus occurs.

Between 20% and 28% of patients with BPPV report symptomatic relief on their own up to a month after the onset of vertigo. The disease is benign and recurs within the first 12 months in only 15% of cases.

Treatment of BPPV

Treatment includes the Epley maneuver. It allows, with the help of head manipulations, to shift the otolith (crystal) into an insensitive zone - the vestibule of the inner ear.

If the effectiveness of such treatment is low, the patient is additionally prescribed a set of exercises to perform at home. This is Brandt-Deroff gymnastics, according to the method of which you need to practice 2-3 times a day from 1 to 3 weeks. Taking medication in this case usually does not give positive dynamics.

Operations are performed when repositioning techniques fail. Surgical interventions carry the risk of complications in the form of injuries of the facial nerve and hearing loss.

Among the possible operations:

  • obstruction of the posterior semicircular canal;
  • removal of the vestibular nerve;
  • labyrinthectomy;
  • selective neurectomy.

Meniere's disease

A disease characterized by repeated attacks of rotational vertigo. They last several hours and are not without noise in the ears, their congestion or bursting, as well as hearing impairment. It occurs in about 0.2% of the population, usually in people from 40 to 60 years old. The disease is based on the expansion of the endolymphatic system in the inner ear, which leads to the degeneration of the labyrinth receptors.

The disease has the following manifestations:

  • dizziness;
  • unsteady gait;
  • hearing loss;
  • problems with perception of sounds;
  • nausea and vomiting;
  • ringing in the ears.
Treatment of Meniere's disease

An attack is treated with vestibulosuppressive agents. Prevention of the disease necessarily includes a low-salt diet, avoidance of alcohol and caffeine, the use of betahistine and diuretics.

If the chosen therapy does not lead to positive dynamics, more serious treatment is required. These can be injections of drugs directly into the ear or surgery.

Diagnosis of dizziness

Patients with dizziness undergo Halmagi tests to determine the level of the vestibulo-ocular reflex. Its violation speaks of central and peripheral lesions.

The Halmagi test does not require the use of additional equipment and lengthy preparation. The patient needs to stop looking at the bridge of the nose of a specialist who sits opposite. At the same time, the doctor holds the patient's head with both hands and turns it from side to side by 15 degrees. With a normal vestibulo-ocular reflex, the eyes remain looking at a given point. If there is a violation, then the gaze turns along with the turn of the head.

Severe dizziness with repeated bouts of vomiting lasts up to 3-4 days, after which the patient improves. Recovery can take up to several months. In older people, it is usually delayed and often incomplete. If positive dynamics is not observed within a month, then an MRI of the brain and audiometry should be performed to rule out Meniere's disease.


The alarm should be sounded if dizziness becomes regular or prolonged. Immediate help is needed if you experience severe dizziness and unsteadiness in combination with the following symptoms:

  • sudden headache;
  • pain in the retrosternal region;
  • labored breathing;
  • numbness or weakness of limbs;
  • fainting;
  • rapid or intermittent heartbeat;
  • slow or slurred speech;
  • problems with coordination;
  • ongoing vomiting;
  • convulsions;
  • sudden hearing loss;
  • numbness or asymmetry of the face.


  • Treatment of vestibular neuronitis When diagnosed, the patient is hospitalized, but sometimes outpatient treatment is acceptable. In either case, treatment should be aimed at reducing the degree of dizziness, stopping vomiting, and accelerating vestibular compensation. Symptomatic therapy includes the use of vestibular suppressants. When vomiting, injectable forms of drugs are used. The duration of treatment is determined by the complexity of the manifestations of dizziness. However, in most cases they are taken no longer than 3 days. An additional effect is given by a course of corticosteroids and antiviral drugs for middle ear infections. The vestibular apparatus is best stabilized through special gymnastics. At first, it can negatively affect the well-being, but after 2-3 days, therapy should stabilize the condition. You need to repeat gymnastics at least twice a day.
  • Tumors of the cerebellopontine angle (acoustic neuroma) Quite a rare cause of vertigo. It manifests itself as a slowly progressive hearing loss and tinnitus. Rotational vertigo is rare, but unsteadiness is often noted. For some time, vestibular disorders may be the only symptom of the disease. After that, hearing disorders begin to be observed. People with a similar problem should have an MRI of the brain with IV contrast. This will help check the patient for the presence of a tumor in the posterior cranial fossa. When a tumor is found, patients need to consult a neurosurgeon for referral for surgery.
  • Vertebrobasilar insufficiency and cerebrovascular diseases It is distinguished by the development of a reversible dysfunction of the brain stem, cerebellum and other structures that receive blood through the main and vertebral arteries. Ischemic attacks may occur due to violations of their patency. The reason is atherosclerotic changes, vascular hypoplasia. A little less often, inflammation, extravasal compression of the vertebral artery (with a neck injury) or dissection of the artery become a prerequisite. A key cause of loss of coordination during dizziness is a malfunction in the work of small arteries with high blood pressure, diabetes, or two diseases together. According to statistics, cerebrovascular accidents account for about 6%. The cause of dizziness at normal pressure can be a malfunction in the functioning of both the labyrinth itself due to problems with blood circulation, and a violation in the area of ​​​​various brain systems. Most patients with vertebrobasilar insufficiency are diagnosed with other neurological symptoms. Separately, dizziness with problems with blood vessels is very rare. In such situations, further diagnosis is required to remove other concomitant factors. You should not associate bouts of dizziness when changing the position of the head with compression of the vertebral arteries. Often, the rapid development of severe dizziness, along with nausea, vomiting and increased pressure, can be perceived as a signal of the development of a cerebrovascular disease. But usually it rises due to severe dizziness and stress. If a stroke is suspected, a person must be urgently hospitalized for examination and immediate treatment. The hospital performs an MRI of the brain, which in a stroke will show a focal lesion of the cerebellum or brain stem.
  • Vestibular migraine Vestibular migraine is relatively rare, although it is regarded as a common cause of recurrent non-positional vestibular vertigo. Its manifestations are dizziness of varying severity, combined with migraine and weakness. It can occur both during the migraine attacks themselves, and in the intervals between them. The duration of such attacks - from 3-5 minutes to 2-3 hours, sometimes days. They are not accompanied by noise or ringing in the ears, as well as hearing loss. Such attacks usually recur. The diagnosis of vestibular migraine is made on the basis of the typical clinical picture, as well as in the presence of migraine and after the exclusion of other possible causes of dizziness in women and men. Treatment of the disease, as with ordinary migraine, includes 3 stages: elimination of provoking factors, relief of an attack and preventive measures. Anti-migraine drugs or analgesics, as well as vestibular suppressants, are taken to eliminate vestibular migraine. Prevention is necessary for regular and severe attacks of vestibular migraine. Then specialists prescribe β-blockers and tricyclic antidepressants.
  • Treatment of multiple sclerosis The most important thing in the treatment of this diagnosis is the elimination of life-spoiling sensations and related disorders: difficulties with coordination, hearing or vision. Treatment is determined by the cause of dizziness in men and women and the mechanisms of its development. It is important to guarantee the almost complete independence of the patient in everyday life, try to avoid sources of stress and minimize the risks of falls and injuries. Relief of symptoms includes the use of vestibulolytics. The time of their intake should be short and discussed with the doctor, because the inhibition of nerve formations does not allow compensatory changes to develop. The effectiveness of treatment increases with regular gymnastics, as well as exercises to restore the stable functioning of the vestibular apparatus. Therapy is also important to improve coordination, stabilize gait, and develop skills in a person to avoid balance problems in the future. Usually, physiotherapy exercises are used for this, which not only reduces discomfort, but also gives independence when moving.

Demyelinating disorders (multiple sclerosis)

People with demyelinating lesions of the CNS, especially those with multiple sclerosis, may be diagnosed with vertigo. Diagnostic difficulties may occur when dizziness develops at the onset of the disease without other manifestations or with their moderate severity. Dizziness in this case can be of a mixed nature, and also be characterized by a persistent course. To confirm the diagnosis, the patient needs to undergo an MRI of the brain with intravenous contrast.


  • CT of the temporal bones and MRI of the brain;
  • Ultrasound of neck vessels;
  • Audiometry;
  • Neurologist appointment;
  • ENT doctor's appointment;
  • General practitioner appointment;
  • Diagnostic tests to verify BPPV and vestibular neuronitis.


  • Diagnosis and treatment of balance disorders in diseases of the nervous system. Clinical guidelines, Moscow, 2017.
  • Jahn K, Kressig RW, Bridenbaugh SA, Brandt T, Schniepp R. Dizziness and Unstable Gait in Old Age: Etiology, Diagnosis and Treatment. Dtsch Arztebl Int. 2015 Jun 5;112(23):387-93. doi: 10.3238/arztebl.2015.0387.
  • Neurology: A Practitioner's Handbook / D.R. Shtulman, O.S. Levin. - 6th ed., add. and perab. — M.: MEDpress-inform, 2008. —— 1024 p.
  • Brandt T., Dieterich M., Strupp M. Vertigo: per. from English. // M.: Practice, 2009.
  • Parfenov V.A., Zamergrad M.V., Melnikov O.A. Dizziness: Diagnosis and Treatment, Common Diagnostic Mistakes: A Study Guide. // M.: MIA, 2009.
  • V. Parfenov, N. Bestuzheva. Diagnosis and treatment of dizziness in outpatient practice // Vrach, 2012
  • Neurology. National leadership. Brief edition / ed. E. I. Guseva, A. N. Konovalova, A. B. Gekht. — M.: GEOTAR-Media, 2018 — 688 p.


Natan Rashbilovich

Neurologist, Ph. D.

Work experience: 10 years

Published: 07/29/2022

Updated: 09/16/2022

Checked: 09/16/2022

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Remote consultation of a neurologist, PhD, primary 8,000 RUB
Remote consultation of a neurologist, repeated ₽

Injection of Botulinic toxin type A, 1 bottle (without the cost of the drug) 7 800 ₽
Botulinic -toxin injection (no cost (without cost)0498 13 000 ₽

Remote consultation of a neurologist, rehabilitologist, head of the neuro-rehabilitation of the Him Shiba Medical Center (Tel-Hashomer) Delery Branus
Remote consultation of a neurologist, leading specialist in the Department of Pediatric Neurology at the Edmond and Lily Safra Children's Hospital of the Chaim Sheba Medical Center (Tel Hashomer) Michal Zadok 55 000 ₽
Remote consultation of a neurologist, professor, head of the department of children's neurology of the children's hospital Edmond and Lily Safra of the Khaim Shiba Medical Center (Tel-Hashomer) Brury Ben-Zeev 76 000 000 ₽ ₽ Remote consultation of a neurologist, Professor, Head of the Department of Movement Disorders of the Institute of Neurology at the Sourasky Medical Center (Ichilov, Tel Aviv) Tatyana Gurevich 6 7 200 ₽
SENTERS SECTIONAL CARTIONS for joint diseases (60 minutes) 7 200 ₽
SENTRAL CAMISE AT DISEASES OF THE CENTERIAL NERY STEP (60 minutes) 7,000 $ vertebral therapy for diseases of the peripheral nervous system (60 min)0498 22 100 ₽
Treatment with the drug Xeomin, 50 units.

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