Don’t panic about vertigo.
In our life, we often encounter the phenomenon that we suddenly find ourselves or/and external objects rotating, turning, moving left and right or floating up and down in a certain direction while sleeping in bed, and it is aggravated when the head moves and the eyes are opened; it is accompanied by tilting, as well as nausea and vomiting and cold sweat. Due to the lack of knowledge in this area, it is very stressful to think that a big disease has occurred, and this aggravates the symptoms of the disease. In fact, this is a vertigo attack. However, there are many cases of vertigo that can be cured by repositioning.
What kind of disease is vertigo?
Vertigo is a clinical syndrome that is the second most complained of symptom after headache and ranks second in hospital outpatient clinics. The prevalence of vertigo is about 4.9% of the population, and the incidence is about 1.4%, involving various disciplines, with medical and surgical departments accounting for about 5%, otorhinolaryngology outpatient clinics for about 15%, and neurology and orthopedics for about 15%. Vertigo can occur in all age groups, and almost half of the elderly have vertigo. anderson reported that vertigo accounts for 81%-91% of geriatric outpatient visits. The lifetime prevalence of BPPV is 2.4% and the annual prevalence is 0.6%, based on this rate, the national population of 1.3 billion people is estimated to be nearly 8 million people per year. The incidence of BPPV is 2.4% lifetime and 0% annual.
What is benign paroxysmal positional vertigo?
Benign paroxysmal positional vertigo is a self-limiting peripheral vestibular disorder that occurs when the head moves to a specific position. The pathogenesis is the dislodgement of the otolith from the ellipsoidal capsule and its drift to the semicircular canal. Since the specific gravity of such alkaline particles is different from that of the endolymphatic fluid, when the head position is changed with excitation, the movement of the otolith in the semicircular canal stimulates the flow of the membrane semicircular canal and endolymphatic fluid causing vertigo and nystagmus. Therefore, it is clinically classified into four types: posterior semicircular canal BPPV, horizontal semicircular canal BPPV, superior semicircular canal BPPV, and mixed BPPV.
How to determine benign paroxysmal positional vertigo?
Vertigo is a clinical syndrome that can occur in many diseases, mainly divided into vestibular peripheral vertigo, vestibular central vertigo and non-vestibular vertigo. Peripheral vestibular vertigo mainly includes: Meniere’s disease, vagus infection (virus), vagus stroke, inner ear injury, inner ear tumor, inner ear drug intoxication, pontocerebellar angle tumor or arachnoiditis, benign positional vertigo, motion sickness, vestibular neuritis; central vestibular vertigo mainly includes: transient ischemia or thrombosis of vertebrobasilar artery, subclavian artery steal syndrome, infarction (hemorrhage) of pontocerebellum, cervical vertigo, brain tumor vertigo, intracranial infection, head and neck traumatic vertigo, demyelinating vertigo, degenerative disease vertigo, hereditary ataxia, medullary cavitation, epileptic vertigo, intracranial hypertension; non-vestibular vertigo mainly includes: ocular vertigo, cervical vertigo, circulatory system diseases, hematological diseases, endocrine and metabolic diseases, psychiatric vertigo, etc. It can be determined by detailed medical history and physical examination. Benign paroxysmal positional vertigo is characterized by brief (seconds) paroxysmal vertigo in a specific head position, accompanied by nystagmus, without tinnitus, deafness or other symptoms.
How is otolith manipulation performed?
Otolith repositioning is the process of moving the otolith from the semicircular canal to the lowest point of the oval sac through certain position changes. Different methods are used for different semicircular canals. The main ones are.
1.Harvey method: carried out for patients with upper or posterior hallux valgus type: the patient hangs his head supine, the head is turned to the affected side 450, the affected ear is down, after 2 min the head is slowly turned to the opposite side in parts at an angle of 150~200 each time, each turn stays for 30 seconds, observe the nystagmus until the head cannot be turned again, then turn around in the healthy side lying position, continue to turn the head until it becomes 1350 with the horizontal plane. the patient sits up straight and The head returns to the starting position. As shown in Figure.
2. Semont design – for horizontal hallux valgus canal stone or jugular crest stone
The patient is rapidly reclined to the affected side and turned 450 upward, at which point the canal stone is gravitationally shifted to the lowermost part of the semicircular canal, causing a downward deviation of the crestal apex and inducing a typical BPPV episode. After observing the nystagmus until it disappears, the patient sits up quickly and immediately turns to lie on the opposite side, turning the head downward by 450, the tubular stone moves to the outlet of the semicircular canal, and the endolymphatic flow again causes the crista parietal deviation and nystagmus. 5 min later, the patient turns to lie supine and sits up straight slowly, and the tubular stone enters the ellipsoidal sac. As shown in the figure.
How to reduce the occurrence of vertigo?
First of all, we should develop good living habits, take proper exercise, and pay attention to the rule of life of “doing it at sunrise and resting at sunset, and the unity of heaven and man”. Secondly, we can do some self-care massage as follows.
(1) “Yingzhi Chengkou”: two hands press the earwheel, an up and down friction, each time do about 15 minutes.
(2) “sounding the drums”: the palms of both hands against the ears, the index finger, middle finger, ring finger, pinky finger on both sides of the occiput, the two middle fingers in contact with each other, the two index fingers cocked and folded on top of the middle finger, slide down hard, heavy knocking on the occipital area behind the head, you can hear a loud and clear sound like hitting a drum. Knock 48 times with both hands at the same time. It has the effect of unblocking the meridians and running qi and blood.
Then you can carry out some food therapy such as.
(1) asparagus porridge: raw materials: asparagus 10 grams, 100 grams of round-grained rice. Method: Wash the japonica rice, put it into a casserole with asparagus, add an appropriate amount of water, and cook it into a porridge with a gentle fire. Dosage: take it warm, one serving a day, divided into two servings.
(2) Astragalus congee: raw materials: 30 grams of astragalus, 20 grams of atractylodes, 10 grams of hemp, 10 jujubes, 60 grams of round-grained rice, brown sugar appropriate amount. Method: First, the three drugs together in a pot, add the right amount of water soaked for 30 minutes, decocted into a thick juice with a gentle fire to remove the dregs, and then cleaned japonica rice, dates into the juice, add the right amount of water and boil into a thin porridge, add brown sugar can be boiled. Dosage: One dose a day, divided into morning and evening.
In conclusion, vertigo is a clinical syndrome, and only by fully understanding it can we find the appropriate department for standardized treatment. Our department adopts manual repositioning and vestibular rehabilitation training to immediately relieve the pain of many vertigo patients, which is well received by many patients and colleagues, and is a good, simple and effective method worth promoting.