Vertigo - How many kinds of dizziness?

• Peripheral dizziness: it suddenly occurs, it's very violent and continuous and, during the outbreak, can vary in poignancy. It feels like beeing on a spinning merry-go-round.
  • Benign paroxysmal: rotatory vertigo, lasting less than a minute, is due to the detachment of some tiny bones in the inner ear which are necessary to transmit information about the motion. The occurence is sudden, after head and neck movements, with nystagmus (involuntary eyes movements). Moreover, nausea, vomiting, tachycardia are involved too. The diagnosis is made - besides the classic description of symptoms - through maneuvers carried out by the specialist that highlights the presence of a typical nystagmus.
  • Vestibular neuritis: "acute inflammation" of the auditory nerve. The symptoms can be preceded by inflammations of the upper respiratory tract (rhinitis, pharyngitis, flu) so that a viral cause is possible. Patients experience a sudden violent rotatory vertigo which can last from a few days to two/three weeks, accompanied by nausea, vomit, tachycardia, and no symptoms concerning the ear and the central nervous system.
• Ménière syndrome: caused by an alteration in the production and reabsorption of labyrinthine fluids of the inner ear. Vertigo is rotatory, intense and sudden, besided by nausea, paleness, sweating, tachycardia and hypoacusis; there aren't any neurological symptoms. It can last from few minutes up to 12/24 hours.
• Central vertigo: mild outbreak, fickleness. The perception concerns unsteadiness and walking insecurity, as if the patient was under the influence of alcohol.

Dizziness in the elderly

Dizziness can occur in the elderly as an instability of posture, disorientation or head-spinning; these symptoms can create a remarkable discomfort in the patient. The high chances of downfalls require a peculiar care by the doctor. The conditions that can cause these symptoms in the elderly are diverse.

The occurence can be occasional or constant. If the occurence is occasional, we must look for the root-cause, even if it's not always easy; amongst those causes are blood pressure variations, abrupt neck vessels strain, possible toxic effects, hypoglycaemia or heart rate disorders.

Amongst the main causes, the most common one is the alteration of blood flow that can arise from arteriosclerosis and heart diseases (especially if related to risk factors such as arterial hypertension and/or diabetes) or the vasoconstriction of terminal arteries bedewing the ear.

Even though the symptomatology is usually mild, in the elderly it can be disabling and thus in need of a continuous or intermittent therapy with anti-dizzying medication.

In some cases dizziness is related to antihypertensive treatments, due to a lower functioning of compensatory mechanisms, or a therapy based on neuroleptic medicines.

We can also assume that the disease has a phychological basis, therefore it is necessary to evaluate the state of tension/anxiety, hyperventilation syndrome and the neuroses that can trigger dizziness and unsteadiness. In older people, the anxious-depressive neurosis appears to be the most comm cause.