We often hear the word vertigo in our life, and we may encounter people around us who are “dizzy”, “lightheaded” or “faint”, or even suffer from vertigo personally, so what exactly is vertigo? What is vertigo? How harmful is vertigo to the body? 1.What is vertigo? Vertigo is a disorder of orientation or balance of the human body in relation to space, a kind of motion hallucination, manifested by the surrounding environment and/or its own rotation, or a sense of swaying instability, swaying, head heavy. Just like coughing, sneezing, or headache, vertigo is just a symptom, not the name of a disease, but there must be some underlying disease behind it. There are many diseases that cause vertigo, and when it cannot be clearly classified as a disease, we often call it vertigo collectively for the time being. 2.How to distinguish dizziness, vertigo and syncope? Dizziness refers to the feeling of lightheadedness when a patient has an attack. For example, the feeling in the head of a patient with hypertension at the onset of the disease, the feeling of dizziness caused by lack of sleep and excessive alcohol consumption, etc. should be called dizziness. Those who suddenly stand up after squatting or sitting for a long time and feel black-eyed, blinding, unstable, or for some reason cause a brief loss of consciousness, sudden sudden collapse, etc., are fainting. Both dizziness and syncope are caused by various diseases related to the central nervous system and are essentially different from inner ear vertigo. Vertigo is a sensation that the patient feels like spinning in the sky or riding in a boat at the onset. When the symptoms are severe, the patient’s eyes are tightly closed and hands are clutching the edge of the bed for fear of falling off the bed, accompanied by nausea and vomiting, abdominal pain and diarrhea, pale face and cold sweat. Although the symptoms of vertigo are severe, the patient is conscious. Some patients may also feel the surrounding scenery swinging from side to side or floating up and down, which are symptoms unique to inner ear diseases. Strictly speaking, dizziness includes vertigo, and vertigo cannot be said to be dizziness in reverse. 3.Why does vertigo occur? The human body’s sense of spatial position and balance is mainly coordinated by the interaction of the following three systems: (1) Vision: If the patient has vision problems or ophthalmic problems such as glaucoma or cataract, naturally, he or she cannot rely on vision to assist the balance system; (2) Proprioception: This proprioceptive receptor is located in the muscles of the extremities, and this sensory system can assist in maintaining body posture and motor coordination; (3) Inner ear vestibule: The inner ear is located The inner ear is located in the deepest part of the ear, surrounded by the temporal bone, and can be divided into two parts: one called the cochlea, which is the auditory apparatus, and the other called the vestibule, which is the balance apparatus. The cochlea is the auditory system, while the semicircular canal and vestibule are the balance system. The vertigo caused by vestibular lesions in the inner ear is the most pronounced and seriously affects people’s quality of life. The vertigo illusion is mainly due to the excitability imbalance caused by the stimulation of the vestibule on the left and right sides, i.e. the excitability is high on one side and low on the other side, and when the gap between the two sides exceeds the physiological limit it is transmitted to the higher centers and the cognitive result of the brain produces the illusion of motion. This gap does not have a fixed value, but can vary from person to person and from time to time, and is related to the stability of the vestibular system, the excitability of the cerebral cortex and vestibular habituation. The higher the stability of the vestibular system, the higher the excitability of the higher nerve centers, the less the chance of vertigo and the weaker the degree of vertigo. This physiological characteristic of the vestibular system provides important ideas for the treatment of vertigo diseases, prevention of recurrence and vestibular rehabilitation. 4.What are the common diseases that cause vertigo? How to distinguish them? Some people have counted as many as 69 diseases that cause vertigo, which belong to ENT, neurology, orthopedics, ophthalmology, internal medicine and other departments, and can be generally divided into the following categories: (1) Periventricular vertigo 73-87% (2) Vestibular vertigo (3) Vertigo vestibular central vertigo 7-10% (4) Non-vestibular vertigo 6-15% Among them, the most common vestibular vertigo, there are benign paroxysmal positional vertigo, Meniere’s disease, sudden deafness, vestibular neuritis, auditory neuroma, Hunt’s syndrome, delayed membranous vagal effusion, exolymphatic fistula, acute and chronic otitis media, large vestibular aqueduct syndrome, otosclerosis, vagal concussion, drug-induced vertigo, etc.; central vestibular vertigo commonly includes: posterior circulation ischemia, cerebellar hemorrhage, brainstem tumor, brainstem encephalitis, petit mal seizures, etc. Common non-vestibular vertigo include eye diseases such as ophthalmic myopathy, glaucoma, refractive error, etc., proprioceptive diseases such as spinal consumption, chronic alcoholism, blood, endocrine and digestive system diseases can cause vertigo, and vertigo caused by neck diseases. 5.Is vertigo harmful to the body? Which departments should I consult if I have vertigo? Many patients with vertigo have this confusion: they are very anxious when they have vertigo, worrying that something is wrong with their brain, suspecting that they are having a stroke or paralysis, and rushing to the hospital in a great hurry, but they don’t know which department to see when they come to the hospital. In fact, vertigo is a disease that involves many disciplines, and in order to know which department to see, we must first understand the classification of vertigo. As mentioned above, vertigo is divided into vestibular vertigo and non-vestibular vertigo, and vestibular vertigo has obvious external objects or self rotation, while non-vestibular vertigo is caused by systemic diseases, with symptoms of dizziness of varying severity and no clear sense of rotation. Non-vestibular vertigo is usually caused by internal diseases, and patients may choose to visit the internal medicine department, and the doctor will make the appropriate examination according to the situation. While vestibular vertigo is caused by otologic and neurologic diseases, patients can choose ENT or neurology. 6.Why should vertigo be promptly seen in ENT department? According to the literature, about 90% of people aged 50-70 have experienced vertigo no less than once. Among them, about 70% of patients with vertigo symptoms are caused by diseases of the peripheral vestibular system, called peripheral vertigo, which means that the semicircular canal and/or vestibular nerve in the ear are faulty and belong to otolaryngology, the most common of which is benign paroxysmal positional vertigo (i.e. otoliths), about The most common of these is benign paroxysmal positional vertigo (i.e. otoliths), which accounts for about 34%, Meniere’s disease, which accounts for about 30%, and other diseases of otolaryngology, such as vestibular neuronitis, middle ear lesions that damage the semicircular canals, vestibular neuropathy, etc., which account for 36%. So what kind of vertigo should be seen in otorhinolaryngology? We can refer to the following points: (1) Peripheral vertigo has a clear sense of spinning and a sense of instability in oneself or in the sensation of peripheral things. (2) The onset of peripheral vertigo is often accompanied by symptoms of parasympathetic excitation, such as increased salivation, pale face, cold hands and feet, cold sweat, nausea and vomiting, the severity of which varies from person to person; (3) Regardless of the severity of the symptoms of vertigo, the patient is awake during the whole process of its onset ( (3) Regardless of the severity of vertigo, the patient is awake throughout the whole course of the attack (except for those with traumatic brain injury secondary to a fall), and all cases with impaired consciousness, limb positioning (e.g. hemiparesis) and other neurological positioning disorders (e.g. abnormal speech, choking and coughing) generally belong to neurology; (4) Peripheral vertigo attacks come quickly, with symptoms gradually relieving, and have the characteristic of recurrent attacks, and the patient cannot walk during the attacks; (5) Peripheral vertigo can be accompanied by tinnitus and hearing loss (5) Peripheral vertigo can be accompanied by tinnitus and hearing loss, and most patients with tinnitus and hearing loss may eventually be diagnosed with Meniere’s disease. However, many patients with peripheral vertigo have no symptoms of tinnitus or hearing loss. Benign paroxysmal positional vertigo accounts for about 34% of patients with peripheral vertigo who do not have tinnitus or hearing loss during or between episodes of vertigo.