Every winter is a high season for dizziness and vertigo, and this year is no different. Since the beginning of winter, the number of dizziness and vertigo patients has been increasing with the cold. They walk slowly with sad faces, eyes slightly open, weak, or supported by others, and some old dizzy patients who have been absent for many years also come to “join the fun”, most of them also have different degrees of headache. Why are there so many dizzy patients in winter, and is it possible to prevent them early so that they will have fewer or no attacks? –Yes, that is the idea of this article. (a) Why does dizziness occur? The most common cause of dizziness in my headache and vertigo clinic is “cervical dizziness and vertigo”, including cervical spondylosis in middle-aged and elderly people and soft tissue (muscle, tendon, etc.) damage in the neck in adolescents, which is caused by the head and neck being in a passive and fixed position for a long time. Fixed posture (e.g. accountants, car drivers, computer users, etc.). Both the former and the latter are caused by hyperplastic bone or stiff “inflamed” tendons that irritate the sympathetic nerves in the epicardium of the blood vessels underneath (vertebrobasilar artery – supplying blood to the occipital lobe at the back of the brain) → causing an increase in the tension of these vessels → a decrease in blood flow → occipital lobe ischemia Ischemia of the vestibular nucleus, its pathways and the visual center at the occipital lobe. The former is the control of the body’s balance, the latter is the visual center, both ischemia results in foggy vision, dizziness, instability, heavy feeling as if falling into the abyss, panic and fear or nausea and vomiting, a few also have tinnitus (common in middle-aged and elderly people). In addition, there are benign episodes of postural vertigo, ophthalmogenic, otogenic and cardiogenic vertigo, which are less common and are not described here. 2. Factors contributing to dizziness and vertigo in winter (1) Cold weather, tightening of human skin muscles, tightening of blood vessels of the whole body, especially the relatively exposed muscles of the neck and collar, directly affect the blood supply to the occipital lobe of the brain from the vertebrobasilar artery below it → insufficient blood supply to the brain (posterior circulation). (2) Due to cold weather, blood viscosity increases → slow blood flow, (such as with “three high” more obvious). Dizziness and vertigo attacks may occur when the body changes position from a quiet state (such as turning over or turning the head sideways). This is the main reason why middle-aged and elderly people often have transient vertigo or vertigo lasting for several minutes or hours when they turn over at night or get up in the morning. (2) Simple and easy prevention methods 1. All middle-aged and elderly people with a history of dizziness and vertigo should pay more attention to neck protection, in addition to general warmth, and wear high-collared tops and scarves when going out. 2.For high blood viscosity in winter, drink a glass of warm water and one (0.1g) aspirin enteric tablet before going to bed. 3, rub the ear shell and neck in the morning and evening Rub the ears (auricle), the superficial temporal artery in front of the ear screen, the carotid artery in front of the neck (under the jaw) and the vertebral artery behind the neck with a towel when washing your face in the morning and evening, to warm the ears and neck. This not only relaxes the neck muscles, but also promotes the expansion of the cervical blood vessels, blood flow more smoothly, so that the ears and eyes feel clear, flexible mind. 4, scientific and rational use of pillows used to supine pillow is best: pillow lower side slightly convex, the height of 10 ~ 14 cm slightly Toupo, the neck in the convex part, so that the head position to maintain a slightly backward posture; used to side sleepers, it is appropriate to adjust the pillow to shoulder height, keep the head and neck in a plane. This can maintain the normal physiological curvature of the cervical spine and allow the muscles of the neck and scapular belt to fully relax. Do not “high pillow without worry”. 5, cold weather more to avoid neck and shoulder muscles persistent tension long time low desk work (sewing workers, students, etc.) or have to keep the head and neck inherent posture (car drivers, computer people, etc.), can be in the original position intermittently tilt (stretch) head, shrugging shoulders, transport square lookout, pat rubbing neck and shoulder. Reminder: ① When the cause of dizziness and vertigo is not clear, do not inject large doses (20%) of mannitol intravenously. Mannitol is a strong diuretic, after sedation, the patient will be dehydrated by urination → blood concentration → increased blood viscosity → slower blood flow → reduced blood supply to the brain, which is like adding insult to injury. Currently, non-professional (mostly primary care) doctors often misdiagnose dizziness and vertigo as “Meniere’s disease” (due to edema of the ear vagus) and prefer high-dose mannitol sedation. In fact, classical Meniere’s disease is rare, and even if it is, there is no need to “kill the chicken with a bull’s-eye”.