Vertigo in the elderly
Summary/Definition
Vertigo is a fairly common symptom that affects 1 in 10 people. This symptom is most often observed in elderly people over 75 years of age. Since the causes and clinical manifestations of vertigo can be very diverse, accurate diagnosis and treatment are often a difficult task.
Usually our body maintains balance due to the interaction of various organs. Information about balance enters the brain through the nervous system from various sources, for example, the inner ear, the organs of vision, as well as in the form of signals from the muscles of the arms and legs. The brain then performs complex processing of this information to maintain the balance of the body and control movements. Thus, the occurrence of vertigo is due to a disruption of this balance information.
Common causes of vertigo can be diseases of the ears (peripheral) or diseases of the brain (central). In addition, Vertigo can be a consequence of various pathological states, for example, eye and heart diseases. It is important to note that vertigo caused by brain diseases can be a precursor of a stroke. In the elderly, vertigo can increase the risk of accidents such as falls and fractures. a quick and accurate diagnosis should be carried out in order to identify the cause of the symptoms and prescribe appropriate treatment.
Symptoms
The clinical picture of vertigo varies from patient to patient. Some describe feeling as if the ceiling is spinning, while for others it feels as if their own body is moving. In some cases, this condition is accompanied by loss of vision or nausea. Since the manifestations of vertigo can be diverse and depend on the underlying disease that caused it, it is important to conduct a differential diagnosis based on a thorough analysis of the anamnesis and physical examination.
Depending on the nature of the symptoms that the patient complains about, vertigo can be divided into four types.
Vertigo can be classified into four types depending on its nature:
- Vertigo: This type of vertigo is characterized by a sudden feeling as if a person is spinning himself or everything is spinning around him. There may also be a feeling of the earth moving up and down. These symptoms are associated with a disorder of the inner ear, which is responsible for maintaining the balance of the body.
- Faintness: in this case, patients complain of loss of consciousness and a feeling of weakness. This may be a sign of a decrease in blood flow in the brain, which may be caused, for example, by a cerebrovascular disease such as stroke. Therefore, it is recommended to conduct additional studies to identify such conditions.
- Vertigo due to imbalance: this type of vertigo can be associated with balance disorders and is often related to abnormalities in the cerebellum.
- Psychogenic vertigo: patients may complain of non-specific sensations, as if their body is floating or spinning. This is often due to such mental and psychological reasons as panic disorder, anxiety neurosis or depression.
Diagnostics
Vertigo is a symptom that can accompany various diseases and requires immediate diagnosis and treatment. It can occur as an early sign of a disease that can be successfully treated with timely detection. Since vertigo can have different causes, it is necessary to carry out a number of diagnostic procedures. To begin with, it is important to measure blood pressure and check blood sugar levels. It is also recommended to perform an electrocardiogram and study in detail the nature, duration and associated symptoms of vertigo. It is important to take into account the patient’s medical history, including information about fatigue, alcohol consumption, smoking and other aspects of their lifestyle. If necessary, an ear examination and neurological examination may be required, including checking balance function and vestibular function If the neurological examination reveals abnormalities, this may indicate a possible brain disease, in which case further diagnostic tests such as computed tomography (CT) or magnetic resonance imaging (MRI) are required.
Treatment and course of the disease
Standard treatment includes giving the patient complete rest and medication therapy to relieve symptoms such as nausea, vertigo and vomiting. In addition, it is necessary to begin treatment of the underlying disease that causes vertigo. In the case of benign paroxysmal positional vertigo, a special treatment method is used, which involves changing the position of the head and body in a certain order to eliminate the symptoms. Brain diseases, such as stroke, are common causes of vertigo and require immediate and comprehensive treatment.
Cases when it is necessary to go to the hospital due to Vertigo
- Presence of risk factors for stroke, such as high blood pressure and diabetes
- Pronounced imbalance depending on the degree of vertigo (inability to stand on their own)
- Diplopia (double vision), slurred speech, paresthesia of the face or half of the body, ataxia of the extremities, difficulty swallowing.
- Severe headache in the back of the head and other cases where vertigo is suspected due to a disease of a central nature.
If such symptoms appear, it is recommended to immediately go to the hospital for appropriate treatment.
