Benign positional vertigo

Benign positional vertigo Benign positional vertigo is a disorder of labyrinthine function and is caused by nerve damage vestibulocohlear (cranial nerve VIII). It is also called positional vertigo of Barany's.
The frequency of the disease is about 17% of all cases of vertigo. Women are affected more often than men. This disorder is characterized by paroxysmal vertigo and nystagmus when the patient's head take certain positions.
The inner ear contains two types of receptors - auditory, vestibular, which plays an important role in maintaining balance. Vestibular portion of the inner ear vesicle consists of a circular, ellipsoidal and a three semicircular canals. Receptors semicircular canals are sensitive to angular acceleration. Vesicle receptors are sensitive to linear acceleration. Receptors consist of the gel plates with little fibers contained mucopolysaccharides and calcium carbonate crystals with a diameter of 0.5 to 30 mm. These crystals are called otoliti. After some injuries as injuries to the head, ear infections, aging, vesicles can degrade receptors and calcium carbonate crystals degrade receptors. Later otolitii can get fluid that fills the semicircular canals. In such a case, a change in head position will move otolitii, which will cause a normal HIDROMECANICA liquids in the inner ear and, therefore, will arise a feeling of rotational vertigo.
Causes
The most common cause of benign positional vertjului in people under 50 years with brain damage. Almost half of all cases of dizziness in elderly patients are caused by benign positional vertigo. Benign positional vertigo can be triggered by a migraine. Nearly 50% of all cases are idiopathic (no cause identified). Other causes that can trigger vertigo are: respiratory virozele, computer games, psychological stress.
Clinical
Symptoms are almost always triggered by a change in head position. Closure of bed or turning from side to side are movements that can trigger a bout of vertigo. Some people feel dizzy and unsure when he lifts his head to look up. Symptoms usually occur intermittently. There are mild, moderate or severe forms may cause nausea. Approximately 20% of all cases of benign positional vertigo is due to dizziness.
The differential diagnosis is made with: labyrinthitis complicating purulent meningitis, serous labyrinthitis occurs in middle ear infections, toxic labyrinthitis in alcohol poisoning, streptomycin, quinine, gentamicin. Differential diagnosis have to take into account motion sickness, injuries and internal bleeding in the ear. Usually in these cases the attacks of vertigo lasts longer.
Treatment
It can run otolitilor repositioning moves made by the Epley maneuver and maneuver Semont release. The purpose of these maneuvers is to raise otolitii one of the semicircular canals. These exercises are very effective and can be performed in a professional office in about 15 minutes. Treatment may include physical therapy exercises for the vestibular re-learning balance. They are also recommended, and Brandt-Daroff habituation exercises can be performed and at home. Canaliculara obstruction surgery may be another option.
If short-term feelings of fear during the acute crisis of vertigo can be administered anxiolytics, particularly during positional vertigo. These drugs do not affect the essential cause of the disease, but have a positive effect of short duration.
In cases of spontaneous correction is not advisable to use long-term medication. Sometimes the patient's condition improves spontaneously even without treatment. Drugs are administered in order to prevent crises.
Antiemetics (drugs that reduce the sensation of vomiting) may eliminate the symptoms of dizziness and vomiting that often accompany strong attacks of vertigo. Mild sedative may be given and the vestibular apparatus that reduce the ability to analyze signals from the inner ear pathology.
Vertigo surgical solution is the last line of treatment of vertigo, being used in a small number of cases which are resistant to conservative treatment. The surgery is usually performed if the tumor or brain injury in patients with severe brain.