Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Balance is defined as a state of equilibrium. It takes significant amount of
work for this to occur in the body. The brain uses inputs from many sources to
understand where the body is located in relationship to the world and to allow
it to function. Sensory information from the eyes, ears, and position receptors
in the rest of the body help keep the body upright and allow it to move in a
coordinated fashion.
Information comes to cerebellar lobes located in the base of the brain from
the vestibular system in the inner ear, vision from the eyes, and proprioception
(position) receptors located throughout the body that send signals through the
spinal cord. The cerebellum uses that information to maintain posture,
coordinate body motions like walking and also coordinate fine motor skills like
using a pen to write.
Vertigo, a feeling of spinning movement and sometimes accompanied by nausea
and vomiting, occurs when any part of the system breaks down. However,
people
tend not to use that word to describe their symptoms but instead use the word
dizziness or lightheadedness. It is up to the health care practitioner to understand the
person's symptoms and define vertigo as the cause of the their situation.
Dizziness is a difficult word to understand and needs to be divided into two
categories, either lightheadedness or vertigo. Lightheadedness is the feeling
that a person might faint while vertigo is most often described as a spinning
sensation with loss of balance. The direction of care is markedly different
since lightheadedness may suggest to the health care practitioner to investigate
decreased oxygen or nutrient supply to the brain due a variety of causes
including heart rhythm disturbances or
dehydration, while vertigo sends the
health care practitioner looking for a neurologic or inner ear cause.
The most important initial step in helping a person with vertigo is to take
a history and understand that the person is complaining of spinning symptoms
that may be associated with nausea and vomiting
and loss of balance among other symptoms.
What is vertigo?
Vertigo is an abnormal sensation that is described by the person as a feeling
they are spinning or that the world is spinning around them. It is most often
associated with an inner ear problem.
The inner ear has two parts, the semicircular canals and the vestibule, that
helps the body know where it is in relationship to gravity. There are three
semicircular canals that are aligned at right angles to each other and act as
the gyroscope for the body. The canals are filled with fluid and are lined with
a nerve filled, crystal encrusted membrane that transmits information to the
cerebellum, the part of the brain that deals with balance and coordination. The
cerebellum adds information from sight and from nerve endings in muscles that
deal with proprioception, the perception of movement, to help the brain know
where it is in relationship to gravity and the world.
Normally, when the head moves, fluid in the semicircular canals shifts and
that information is relayed to the brain. When the head stops moving, the fluid
stops as well. There may be a slight delay and is the basis for the vertigo
experienced after people participate in many children's games and carnival
rides. When a person goes on a merry-go-round or spins quickly around in
circles, the fluid in the canals develops momentum and even though the head
stops spinning, the fluid may continue to move. This causes vertigo or a
spinning sensation and may cause the person to fall or stumble in a crooked
line. It also may be associated with vomiting.
In patients with vertigo, inflammation of the fluid or irritation of the
crystals on the nerve membrane that lines the walls of the semicircular canals
may cause the spinning sensation even without much head movement. Often, only
one canal is involved and the person may be symptom free if they don't move.
Vertigo (Dizziness and Vestibular Balance Disorders) - CauseQuestion: How was the diagnosis as to the cause of your vertigo (dizziness and vestibular balance disorders)?
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
A brain tumor can be either benign (non cancerous) or malignant (cancerous), primary, or secondary. Causes and risk factors include age, gender, family history, and exposure to chemicals. Symptoms range from headaches, leg and feet numbness to seizures. Treatment is dependant upon the type and location of the brain tumor.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Multiple sclerosis (MS) is a disease which progressively injures the nerves of the brain and spinal cord, reflected by alterations of virtually every sensory or motor function in the body. The cause of MS is primarily unknown. There are different types of MS including relapsing-remitting MS, primary-progressive MS, and secondary-progressive MS. Symptoms of MS rang from mild to severe and examples include visual disturbances, muscle weakness, spasm, and fatigue. Decreased concentration, memory loss, and impaired judgment. Treatment for MS is generally with medications.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Middle ear infection or inflammation (otitis media) is inflammation fo the middle ear. There are two types of otitis media, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Seventy-five percent of children in the U.S. suffer from otitis media at some point. Treatment depends upon the type (chronic or acute).
Motion sickness, often referred to as car sickness, sea sickness, or air sickness, is a very common disturbance of the inner ear that is caused by repeated motion. The cause of motion sickness is complex. Symptoms of motion sickness include vomiting, nausea, dizziness, vertigo, sweating, and a feeling of malaise. Treatment of motion sickness include antihistamine medications such as meclizine (Bonine, Antivert, Dramamine), and scopolamine (Transderm Scop) a skin patch.
Orthostatic hypotension symptoms include lightheadedness, weakness, blurred vision, and syncope or passing out. Causes of orthostatic hypotension include dehydration, anemia, medication, blood loss, low blood pressure, heat related illnesses and more. Treatment of orthostatic hypotension depends on the underlying cause.
Trichinosis is a food-borne disease caused by ingesting parasites (roundworms) in undercooked pork or wild-game meat. Symptoms of trichinosis include diarrhea, nausea, muscle aches, itching, fever, chills, and joint pains. Trichinosis usually resolves without treatment, but more severe cases are treated with thiabendazole, albendazole, or mebendazole.
Meniere disease (idiopathic endolymphatic hydrops) is an inner ear disorder with symptoms that include vertigo, tinnitus, hearing loss, and the sensation of ear fullness. Diuretics, anti-vertigo, anti-nausea and low salt diets are the primary treatment for Meniere disease. Surgery may be recommended if the vertigo cannot be controlled with medication.
Balance is a state of body equilibrium or stability. We often take for granted how dependent we are on a healthy balance system. When the system breaks down, however, patients will describe symptoms such as dizziness, vertigo, lightheadedness, or motion sickness.
Arsenic comes in two forms, inorganic and organic. Organic arsenic poisoning is usually not poisonous to humans; however, inorganic arsenic in large enough amounts can lead to shock and death. Symptoms of arsenic poisoning include nausea, abdominal pain, diarrhea, dehydration, dark urine, vertigo, delirium, shock, and death. Treatment for arsenic poisoning includes Hemodialysis and a variety of drugs.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
Blood pressure is the force exerted by circulating blood on the walls of blood vessels. It constitutes one of the critically important signs of life or vital signs which include heart beat, breathing, and temperature. Blood pressure is generated by the heart pumping blood into the arteries modified by the response of the arteries to the flow of blood.
An individual's blood pressure is expressed as systolic/diastolic blood pressure, for example, 120/80.The systolic blood pressure (the top number) represents the pressure in the arteries as the muscle of the heart contracts and pumps blood into them. The diastolic blood pressure (the bottom number) represents the pressure in the arteries as the muscle of the heart relaxes following its contraction. Blood pressure always is higher when the heart is pumping (squeezing) than when it is relaxing.
The range of systolic blood pressure for most healthy adults falls between 90 and 120 mil...
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