Dizziness is a very common symptom, and almost everyone gets dizzy a few times. Of course, this has a completely different connotation from the current Internet language “I’m dizzy”. In conversation, “I’m dizzy” is just an expression of a mental state or attitude, and a doctor says “I’m dizzy” is a disease.
According to statistics, dizziness accounts for the second highest number of people visiting outpatient clinics. More people, because the dizziness is not very serious, although work or life is affected, but can still tolerate, also do not go to the doctor, and endure the torture of “dizziness” by themselves. You can see how annoying “dizziness” is a problem!
A few years ago, a popular folk saying, “Beware of dizziness as a time bomb in your body”, really caused a panic. Life is precious, and no one wants to have a time bomb in their body! So all kinds of treatment, such as doing all kinds of tests, flushing blood vessels, eating all kinds of drugs and supplements, dizziness patients are trying. A lot of money is spent, but the effect is not as good as imagined. Some patients, as usual, do not miss.
In fact, there is a kind of dizziness, said simple is really simple, reset treatment, 1 minute can return dizzy people a clear and clear world. If you look at the wrong doctor or find a doctor who does not specialize in vertigo, no matter what tests are done, how much blood-boosting medicine is used, or how many drips are given, it will not get better and even get worse. I call this kind of vertigo: “trouble caused by stones”.
We know that the body sometimes produces various kinds of stones, such as gallstones, kidney stones and stomach stones. When you have stones in your body, you are sick, and when you have an attack, it hurts so much that you can hit your head against the wall, and you really “want to die”. Clinically, stone colic is so severe that sometimes morphine is needed to relieve the pain.
So where is this stone? Does it also require an operation?
When many patients hear “ear stone”, their first reaction is whether there is a life-threatening condition and whether they should have surgery. In fact, the stone grows in the ear, inside the inner ear, which is our normal structure (not the “cerumen” formed by the secretion inside the external ear canal). Since it is a normal structure, there is no need to operate to remove it! The stone in the ear, which we call the otolith, is also called “bit of sand”, called it otolith, because its composition and stone is the same: it is the crystallization of calcium carbonate. The human otolith is so small that it is invisible to the naked eye. But it has a very important function, which is to manage our position, movement, speed and balance.
Not only do we humans have otoliths, but the fish we often eat, also have otoliths, also called fish stones. If you are careful when eating fish head, you can find it inside the fish ear hole near the fish bone, a pair of tough structures similar to bone, which is the fish stone. Our ancestors recognized it a long time ago, for example, in the “Shang Shu Da Zhuan” Zheng Xuan note “fish stone, (fish) head in the stone also”. The fish’s stone has the function of helping the fish to maintain balance, and we also have “ear stones” in our inner ear to help us maintain balance.
Let’s look at what vertigo is. Vertigo refers to an illusion of motion. In layman’s terms, it means that something outside is stationary, but the person who is dizzy appears to be in motion. Or if you are sitting or lying down and not moving, you may feel like you are moving. Severe cases are accompanied by nausea, vomiting, sweating and other symptoms. So which systems, or which parts of our body, manage our sense of balance?
In medicine, there is a term called “balance triad”, which is the visual system, the proprioceptive system, and the vestibular system. They are all related to the maintenance of balance, hence the name “balance triad”.
The maintenance of the body’s balance and normal orientation depends on the coordination of the visual system, the proprioceptive system and the vestibular system. Various external stimuli are transmitted to the brainstem through the sensory apparatus of the balance triad, and are integrated in the brainstem reticular formation, which firstly coordinates the sensory impulses of the three and cooperates with each other to produce the correct orientation cognition. reactions. This explains why when we feel dizzy, we look at things around us or feel ourselves spinning, accompanied by nausea, severe vomiting, and in some cases, a special posture that prevents us from moving around. The “vestibular system” in this case includes the peripheral vestibular system and the central vestibular system. The central vestibular system refers to our intracranial system. The peripheral vestibular system refers to our “inner ear”. The otolith is located in the “inner ear”.
The two main organs of the inner ear are the cochlea, which governs hearing, and the hemidiaphragm, the ellipsoidal sac, and the balloon, which governs balance. “The cochlea
The diagram below
The otolithic membrane is a gelatinous membrane containing calcium carbonate particles that covers the surface of the ellipsoidal and balloon sacs, in which the calcium carbonate particles are called otoliths. When various reasons such as insomnia, rage, external impact on the head, poor blood supply to the inner ear in the elderly, etc. occur, the otolith will break away from its original position and roll into the semicircular canal, which is called otolith dislocation.
The semicircular canal is filled with water, which we call “lymphatic fluid”. The dislodged otolith floats freely in the water. When the head moves, the otolith moves in the semicircular canal and drives the lymphatic fluid to flow improperly, causing the hair cells in our inner ear to send false signals to our brain through the vestibular nerve (also called the locus coeruleus), which creates the illusion of motion and vertigo. Since our head movements and body position changes are relatively brief, the vertigo induced is also brief, often not more than a minute. However, people with the first onset of vertigo can have intense dizziness, which can last for tens of minutes or even an hour or more, and is very painful. It is also called benign paroxysmal positional vertigo (BPPV) because it is associated with head and body movements, especially when the head is turned in a certain direction.
Our inner ear has three pairs of semicircular canals: the posterior semicircular canal (inferior semicircular canal), the horizontal semicircular canal (external semicircular canal) and the superior semicircular canal, one on each side. Any detached otolith may enter any of the semicircular canals, the most common of which is the inferior semicircular canal.
Treatment of otoliths
From the above explanation, we understand that benign paroxysmal positional vertigo is caused by dislodged otoliths, not by ischemia as we often say, so taking drugs to activate blood and remove stasis, improve circulation, and nourish nerves cannot solve the problem. In some patients, the more they are treated, the worse it gets. Because it is not related to cerebral ischemia or infarction, it is not caused by it, so a lot of brain CT and MRI are done, but no lesion can be found, which cannot explain the problem. This is the reason why many patients, who have done a lot of tests to find the lesion, take a lot of drugs just do not work.
The correct treatment for otolithiasis
Although otolithiasis is painful, there is a good treatment method available. This method does not require medication, and the effect is so strange that it can be said to be immediate. This treatment is called “repositioning therapy”. This treatment is called “repositioning”, which means that depending on the location of the dislodged otolith and its entry into the semicircular canal, the doctor will reposition the dislodged otolith so that it can no longer stimulate the nerve endings and send the wrong “movement information” to our brain, and we will not get dizzy.
Many doctors are not aware of this disease, and only doctors who specialize in vertigo or who focus on this area can do the repositioning, so it is no wonder that people have such a deep misunderstanding about vertigo.