The sky is spinning, tumbling and floating, unable to stand …… These are the magic of vertigo, yet most patients cannot distinguish vertigo from dizziness. Vertigo is a common symptom, especially in the elderly population, where it occurs in up to 30% of the population, and more women than men. Because vertigo is heavier than dizziness, many patients who experience it are fearful, and some even develop anxiety and other emotions because they have experienced vertigo once. The key to treating vertigo is to find the right cause. There are various causes of vertigo, and otoliths, vestibular migraine and psychogenic vertigo are the three common causes of vertigo. Otoliths: Sleeping on a high pillow can prevent otoliths, also known as benign paroxysmal positional vertigo, is the primary cause of vertigo. “The otolith is a “small stone” located inside the ear, which is the body’s balancer. Characteristics: It is related to the change of body position, such as turning over in the morning, sitting up from lying down, or changing from sitting to lying down, tilting the head or lowering the head. Vertigo caused by otoliths occurs for a short period of time, usually lasting for a few seconds or tens of seconds, and the sensation of spinning in the sky is felt in just one minute. “Some people may experience vertigo-related symptoms, such as nausea, pallor, vomiting, etc. Response: Reset the “stone” and let the “stone” return to its original place can be solved. According to Xie Longchang, the patient needs to be reset by a professional doctor or by machine. In addition, because the dislodged otolith is in a free state, it may come back again. To prevent the occurrence of vertigo, a high pillow should be used when sleeping, so that the otolith can stay in its original position. Vestibular migraine: avoid spicy food Vestibular migraine is a kind of migraine because the vestibule is a place to regulate the body’s balance. Features: Vestibular migraine causes vertigo with two main features: firstly, it is a recurrent headache; secondly, the headache is pulsating, and the patient will clearly feel the blood vessels pulsating. The duration of this type of vertigo varies from a few seconds to a few hours or even days. Response: To prevent the occurrence of vestibular migraine, it is important to maintain a regular life and not to stay up late. Pay particular attention to the diet. Chocolate, coffee, cheese, strong tea, tobacco, alcohol and spicy food are all factors that can easily trigger migraine and should be avoided as much as possible. Psychogenic vertigo: greatly influenced by emotions Psychogenic vertigo, as the name suggests, has a lot to do with the patient’s emotions, such as anxiety, depression and other bad emotions, which are often the “driving force” behind it. Characteristics: True vertigo is accompanied by symptoms such as sweating and nausea, and the more severe the vertigo is, the more powerful these symptoms become, while patients with psychogenic vertigo do not have these symptoms. Secondly, patients will feel the symptoms aggravated in special environments, such as crowded and noisy environments. In addition, in true vertigo, closing the eyes will reduce the vertigo some, while in psychogenic vertigo, sometimes the opposite is true, with the eyes open but feeling more comfortable, and the eyes closed but dizzy. Psychogenic vertigo can have persistent dizziness, which is aggravated in a particular environment. Response: Since it is caused by anxiety and depression, regulating your mood and avoiding bad emotions is one of the effective ways to prevent it. What should patients do when vertigo comes and the sky spins? When vertigo occurs, first of all, you should find a place to sit or lie down to rest, and if vomiting is obvious, lie on your side. Second, seek medical attention as soon as possible. If the vertigo is obviously better, and if there is tinnitus and hearing loss, most of the vertigo is caused by ear problems, so go to the otology department; if there is no hearing impairment, go to the neurology department. In addition, besides the above three common causes, some other diseases can also bring vertigo. For example, if vertigo is accompanied by dizziness, nausea, vomiting, weakness and numbness of one side of the limbs, unfavorable speech, choking on water, etc., the first thing to consider is the possibility of stroke, and then you should seek medical treatment immediately.