That’s the twist! How to cope with dizziness when turning the head?
Even a healthy person can feel dizzy turning his head, if, for example, his neck is cramped. But if the cases are repeated and accompanied by other symptoms, this is always associated with disturbances in the organism. Most often with diseases of the vestibular apparatus, less often with disorders of a non-vestibular nature.
Vestibular and non-vestibular dizziness
When patients usually tell the doctor exactly how they feel dizzy, they describe a wide range of sensations: “like a merry-go-round, “the room seems to rotate”, “fog in the head”, “darkening in the eyes”, “walking unsteadily”.1,2
Vestibular (systemic, true) dizziness includes only the first two complaints. Another name is “vertigo”, which accurately describes the condition with such an attack. A person has a feeling that space revolves around him or he himself rotates in space. The illusion of not only circular movement, but also swinging back and forth or down (“elevator”) is possible. 2
If dizziness with a sharp turn of the head or another change of position causes such symptoms, this indicates a vestibular apparatus dysfunction.3 More often these are disorders of the peripheral part located in the inner ear, but there may also be disorders connected with damage of the central vestibular pathways, which are located in the brain. 4
Vertigo is accompanied by other symptoms: 5
- nausea;
- vomiting;
- imbalances;
- tinnitus;
- temporary hearing loss;
- nystagmus (oscillations of the eyeballs).
If a person is “led”, loses balance, has “brain fog”, “intoxication”, but there is no sensation of circling – this is caused by reasons of a non-vestibular nature. 6
Dizziness – causes of vestibular type
As it was said, most often vertigo is associated with diseases of the inner ear, where the peripheral part of the vestibular apparatus is located. 6
These are diseases such as: 6
- benign paroxysmal positional vertigo (BPPV);
- Meniere’s disease;
- vestibular neuritis.
All of these disorders respond well to treatment. 7 In this list only BPPV can be considered positional (dependent on a change in the position of the head or body).6
Also, the head may begin to spin because of vestibular migraine.8 During an attack, when the position of the head changes, headache and dizziness may increase.9
Less often, positional dizziness develops in diseases affecting the parts of the central nervous system that are responsible for coordination.6 Such disorders are usually accompanied by neurological symptoms – shakiness when walking, imbalance in coordination of movements, decreased sensitivity of the face and limbs, double vision of objects, and others.10 These are serious violations that require immediate medical intervention.
Benign paroxysmal positional vertigo
With this disease, the head begins to spin when changing the position of the head and body – this is clear by its very name.6 The attack develops abruptly, most often, at night or in the morning.3 This is a sudden dizziness when turning the head in the spine position, which occurs when a person tosses and turns in bed.3,6
Attacks are very intense and end quickly – their duration is about a minute.10 They are often accompanied by nausea and vomiting, especially if several attacks repeat in a short period of time.6 Also, nausea and vomiting occur if the patient often changes the position of the body and head.3,6 If you remain at rest or return to the starting position, the intensity of the attack decreases. People often feel what posture they need to take to feel better.10
With BPPV, there is no decrease in hearing, tinnitus or neurological symptoms.11 Episodes of dizziness can occur suddenly and last within few seconds, and sometimes several days.12 Some people with benign paroxysmal positional vertigo complain of the appearance of shakiness when walking.11 It usually passes if the patient is young, and in the elderly, it can persist even after the cessation, and even lead to falls.13 As a result, a person may develop anxiety and fear of walking.14
However, the prognosis for a patient with BPPV is favorable – this disease can be corrected even in its chronic form.15 For its treatment vestibular gymnastics is used, which a person can do on his own, and the Brandt-Daroff method also gives a good effect.16 Special maneuvers that are performed in clinics by a doctor or a specially trained physiotherapist are very effective.10 They are series of movements of the head and body in a sitting, lying position, flipping and returning to the starting position.10
With the development of anxiety, it is important to conduct sessions of psychological conversations with the patient.10
Non-vestibular causes
These can be disorders of the nervous system, lack of blood supply to the brain, deformation of the spine, high or low blood pressure, psycho-emotional disorders.17
Dizziness when getting up and turning the head can sometimes occur in a healthy person if he does it abruptly. But, if this happens systematically, it may indicate orthostatic hypotension – autonomic nervous system disorder. In this case, the body cannot maintain a normal level of pressure in an upright position.17
Diagnosis and treatment
As we can see, the head is spinning for a variety of reasons – this is only a symptom. The effectiveness of therapy will depend on the accuracy of the diagnosis.
Diagnosis is always comprehensive. The doctor focuses on the symptoms and results of the study of vestibular and auditory function – for this purpose, specialized tests are used.10 If necessary, MRI of the brain and spine, ultrasound of the vertebral arteries are performed.10
If you are concerned about dizziness when turning your head or changing positions, consult a physician. He will study the problem and refer you to a narrow specialist – a cardiologist, endocrinologist or neurologist.10 Accordingly, the doctor will establish the cause and prescribe treatment for the cause of unpleasant symptoms. You can consult a doctor in the clinic nearest to you.
It is useful to undergo sessions of manual therapy, physical therapy and cognitive behavioural therapy.
