Ukuthola i-Culprit Behind Your Dizzy Spells Kudinga Ukuhlolwa KweDokotela
Abantu badinga izinto eziningi ezahlukene uma bethi bahlaziyekile. I-Vertigo yisisindo se- dizzy esihlotshaniswa nokuzungeza nxazonke embuthanweni ngokusheshisa, noma njengokungathi izwe lijikelezayo nxazonke.
I-Vertigo ingahle ingakhululekile futhi ngezinye izikhathi ingabangela ukucabangela noma ukuhlanza. Kungaba nzima ukuphuma embhedeni, kancane kancane uhambe futhi wenze imisebenzi esiyidingayo ukuze siyenze nsuku zonke.
Nakuba izimbangela eziningi ze-vertigo azikona ukuphila, ezinye ziyingozi kakhulu, njenge-stroke ngemuva kwengqondo eduze kwe-cerebellum. Ngakolunye uhlangothi, izinhlobo eziningi ze-vertigo zingaphathwa kalula ngezindlela ezilula ezifana nokubeka ikhanda.
Izimbangela ezivamile
Ngokuvamile, abantu abanobuhlungu be-vertigo noma isizungu bazoba nesinye sezimbangela ezivame kakhulu.
I-Benign Paroxysmal Positional Vertigo (BPPV)
Ingabe i-vertigo ishukunyiswe ushintsho ekhanda? Uma kunjalo, imbangela ingase ibe ne- vertigo engezansi enobungozi (BPPV), esinye sezimbangela ezivame kakhulu ze-vertigo. Le ngxabano ibangelwa i-crystal encane ebizwa nge-otolith evame ukuhlala engozini emkhatsini wezindlebe zomphakathi (i-utricle ne-saccule). Ku-BPPV, i-otolith ihlukana mahhala iphinde ingene komunye wamachiza amathathu ngokuvamile okukhombisa ukuthi umzimba wethu uphendukela isikhala. I-crystal ibangela ukuguqulwa kwengcindezi emgodini okhohlisa umzimba ukuba ukholelwe ukuthi uyaphenduka, ngisho nalapho umile.
Ukudideka okubangelwa kudala i-vertigo.
I-vertigo ye-BPPV ijwayele ukuvela ngeziqephu ezimfushane futhi ifakwe ikhanda ukuphenduka, ngoba ukuguqula ikhanda kungabangela i-otolith ukuba ihambe emgodini, idale izimpawu ezingalungile ebuchosheni. Izindaba ezinhle ukuthi uchungechunge lwezinhloko ezithile (olubizwa ngokuthi u- Epley maneuver ) lungasetshenziswa ukubeka kabusha i-otolith ngaphandle kwamakhansela lapho kungabangela khona ukukhathazeka okungaphezulu.
Ukusho okugcina okungaphansi kweminithi noma njalo kubangelwa i-BPPV. Izinhlamvu ezinde kakhulu ze-vertigo ezinzima kungenzeka ngenxa yenkinga ezindlebeni zangaphakathi, njenge- vestibulopathy yangaphandle noma i- Meniere's syndrome , noma i-vertigo ephakathi, okusho ukuthi inkinga nge-brainstem efana nokutholakala kwesifo sokushaya isisu noma i-vestibular migraines.
Izifo zikaMeniere
Indlebe yangaphakathi iqukethe isikhwama esingenalutho esithinta ngaphakathi kwendwangu encane yomswakama. Ngaphakathi kwaleso sikhwama kukhona uketshezi oluthe xaxa kodwa kohlobo oluhlukile. Isifo sikaMeniere sicatshangwa ukuthi sibangelwa ukungalingani phakathi kwesikhala somswakama ngaphakathi kwesikhwama kanye nomswakama ngaphandle kwesikhwama, futhi uketshezi oluningi kakhulu ngaphakathi ngaphakathi. Lokhu kwaziwa ngokuthi ama-hydrops endolymphatic.
Lesi sifo ngokuvamile siba phakathi kweminyaka engama-30 no-50 futhi sibangela ukuhlaselwa kwe-vertigo, ukulahleka kokuzwa, nokukhala ezindlebeni. Ngokuphambene ne-BPPV, ukuhlasela kungadlulela amahora angu-20 kuya emahoreni amaningana ngesikhathi. Njengezinye izinhlobo ze-vertigo, kungenzeka ukuthi i- nystagmus ikhona. Ukuhlaselwa kungahlukahluka noma kuphi phakathi kwezikhathi eziningana ngesonto kuya ngaphansi konyaka kanye. Ngemuva kweminyaka emihlanu ukuya kweyishumi nanhlanu, isizungu siba nzima kakhulu kodwa sihlale siqhubeka njalo, futhi ukulahleka kokuzwa kungaba yinto engapheli, nakuba ukuzwa okungezwayo ezindlebeni ezithintekayo akuvamile.
Isifo se-Meniere singatholakala ngudokotela ngaphandle kokuhlolwa okungeziwe, kodwa ngezinye izikhathi i-audiometry iwusizo. Ayikho yokwelashwa etholakale ukuyeka izinguquko eziqhubekayo endlebeni yangaphakathi, kodwa imithi ingasiza ngezibonakaliso uma kwenzeka.
I-Vestibular Neuritis
Le disorder ihamba ngamanye amagama amaningi, kuhlanganise neuronitis ye-vestibular, i- labyrinthitis , i-labyrinthitis ye-neuro, kanye ne-vestibulopathy e-peripheral. Lesi sifo sivame ukuxazulula ngokuphelele kodwa sisenza i-vertigo enhle kakhulu okwamanje. Le ngxabano icatshangwa ukuthi ingenxa yokuvuvukala kwesibindi se-vestibulaus esilwe igciwane - nakuba, empeleni empeleni kuphela ubufakazi obuncane bokusekela le mbono.
Ukuxilongwa kwe-vestibular neuritis kuvame ukwenziwa udokotela ekuhloliseni futhi ekubuza imibuzo, nakuba ukuhlolwa kungenziwa ukuze kukhishwe ezinye izimbangela, njenge-stroke. I-Vertigo esuka ku-neuritis ye-vestibular ixazulula ezinsukwini ezimbalwa, kodwa ngezinye izikhathi kunokungalingani okuncane okuhlala isikhathi eside okuhlala izinyanga. Akucaci ukuthi noma yimaphi ukwelashwa okuwusizo kuyasiza, nakuba odokotela abaningi bazobeka inkambo emfushane ye-steroid prednisone ngokusekelwe kwedatha encane esekela lo mkhuba.
I-Paroxysmia ye-Vestibular
Ngezinye izikhathi ukuhlaselwa kwe-vertigo kugcina kuphela imizuzwana embalwa ngesikhathi kodwa kungase kwenzeke izikhathi eziningi ngosuku. Abanye odokotela bakholelwa ukuthi lokhu kungenxa yokucindezela kwesitsha segazi emndenini wesishiyagalombili we-cranial , okuholela ekuzizweni kwemizwa ye-vertigo.
Abanye odokotela baye bagxeka ukungabi namba kwedatha enhle yokusekela le mbono. Isibonelo, amaphesenti angaba ngu-30 abantu abanempilo banemithambo yegazi exhumana ne-vestibulocochlear nerve, ngokusho kwendaba e- Journal of Vestibular Research .
Abanye baye basikisela ukuthi ukuhlinzwa kungasetshenziswa ukususa ukucindezelwa okufakwe emgodini ngemithambo yegazi, kodwa abanye bathole ukuthi umthamo ophansi we-carbamazepine (i-anti-seizure) imithi ingasiza. Njengoba unikezwe ubufakazi obungaqinisekisiwe bokuthi umkhumbi wegazi uyingxenye yecala, ukusebenzisa imithi kungcono ukwelashwa kokuqala kokuqala.
I-Vestibular Migraine
Nakuba izimbangela ezandulele ze-vertigo ziholela kulokho okubizwa ngokuthi i-vertigo yangaphakathi, okusho ukuthi i-vertigo ibangelwa into engaphandle kwengqondo nobuchopho, kungenzeka ukuthi uthole i-vertigo ezinkingeni ngaphakathi kobuchopho ngokwayo, okuthiwa "iphakathi" vertigo. Esinye sezimbangela ezingathí sina zalesi vertigo esisezingeni eliyisisekelo i- vestibular migraine .
Imigraines ivame ukucatshangelwa ukugqugquzela ikhanda, kodwa imithi ye-migraines ingabangela cishe noma yiluphi uphawu lwezinzwa zesikhashana, kufaka phakathi ubuthakathaka, ukugubha, ukuphazamiseka, kanye nesisu. Kodwa-ke, ikhanda elithile liyadingeka ukuze kutholakale ukuthi i-vestibular migraine isifo. Ezinye izibonakaliso ze-migraine, noma ukuqala kwe-vertigo ne-typical migraine , ziba usizo ekutholeni ukuxilongwa.
I-Vertebrobasilar I-Ischemic Attack Yesikhashana (TIA)
I-brainstem ithola ingxenye enkulu yegazi layo ngokubizwa nge-posterior circulation. Imishanguzo emibili ye-vertebral ihlangana ndawonye ukuze yenze umshini we-basilar, othumela amagatsha athumela igazi elilondayo ebuchosheni futhi ebuyela emuva ebuchosheni.
Uma imishanguzo ebuchosheni ivinjelwe okwesikhashana nge-clot yegazi, amangqamuzana ebuchopho angase aqale ukulamba. Uma i-clot yegazi ihlakazeka, izimpawu ziyaqhubeka, futhi umcimbi ubizwa ngokuthi ukuhlasela kwe-ischemic okudlulayo . Uma i-clot yegazi ihlala, khona-ke iholela ekushayweni ngokulahlekelwa okuhlala njalo.
Ngenxa yokuthi i-brainstem iqukethe izikhungo zomzimba wethu wokulinganisela, kufaka phakathi ukudluliselwa kolwazi lonke oluthunyelwe ebuchosheni kusukela endlebeni yangaphakathi, i-vertigo yisifo esivamile sokusakaza kokuhamba ngemuva. Nokho, mayelana nokunye, yiminye imisebenzi ebalulekile ye-brainstem, njengokuphefumula, ukunyakaza, nokuningi. Ngenxa yalesi sizathu, izimpawu zokukhathalela i-vertebrobasilar TIA zibhekwa njengesixwayiso sezinkinga ezinkulu ezizayo.
Ngenhlanhla, kuyinto engavamile ukuthi i-vertebrobasilar TIA izobangela kuphela i-vertigo futhi ayikho enye into. I-brainstem iyindawo encane efana nesithupha sakho futhi igcwele izisindo ezibalulekile. Uma umonakalo wenziwa engxenyeni eyodwa yobuchopho, ezinye zizophinde zithinteke, okuholela eminye izimpawu zesifo sezinzwa. Ngenxa yalesi sizathu, odokotela banesifiso sokuthola izimpawu ze "vertigo" ephakathi, okusho ukuthi i-vertigo evela ebuchosheni be-brainstem kunokuba i-vestibular nerve noma indlebe yangaphakathi.
Izingozi ze-TIA ze-vertebrobasilar zifana ncamashi nalabo bezinye izinhlobo zesifo se-ischemic vascular, njenge-stroke. Ukuze uthole ukwaziswa okwengeziwe mayelana nokunquma ukuthi i-vertigo yakho ingathí sina, funda ngokuthi uma udozzinzima bunzima kangakanani .
Izizathu Eziningi
Ngezinye izikhathi imbangela ye-vertigo yakho empeleni into engavamile. Ngisho noma lezi zimbangela ezingavamile ze-vertigo zenzeka kaningi kangako, kubalulekile ukuqaphela lezi ezinye izifo zokuhlola ukuze izimpawu zakho zingaphutha ngenye indawo evamile.
Ake sibuke lezi zimbangela ezingavamile ze-vertigo.
I-autoimmune Izifo Zendlebe Zangaphakathi
Ngezinye izikhathi, isimiso somzimba sokuzivikela siphutha ingxenye yomzimba wethu ngokutheleleka okuhlasela. Uma lokhu kwenzeka - uma umzimba uzihlasela ngokwawo - ubizwa ngokuthi yi-autoimmune disorder. Uma lokhu kwenzeka endlebeni yangaphakathi, kungabangela ukulahlekelwa kokuzwa okuqhubekayo kanye ne-vertigo.
Cishe ingxenye yesine yabantu abanjalo bayoba nezinye izifo ezizimele ngokuzenzakalelayo njenge- systemic lupus erythematosus , i-polyarteritis nodosa, noma i-Wegener granulomatosis. Cishe ingxenye yengxenye yalaba bantu bazophendula ku- corticosteroids .
I-Labyrinthine Ukucubungula
Izimpikiswano ngokuvamile zibangelwa ikhanda, inhlanzi, ukuhlanza, nesisu. Umqondo we-vertigo ngemuva komcibisholo ungabangela ukulimala ezithombeni ezithintekayo ngemva kokushaya ikhanda. Ngokuya ngesimo sokulimala, kungase kube negazi ezindlebeni zangaphakathi. Nakuba lokhu kuvame ukubi kakhulu emva kokulimala kwekhanda, i-vertigo ingase ifike futhi ihambe okwesikhashana ngemuva kwalokho. Ngezinye izikhathi, izinguquko ezithuthukisayo ngemuva kokucindezeleka phakathi kwezingxenye zendlebe yangaphakathi (i-endolymphatic hydrops), zingaholela kuMeniere syndrome.
I-Fistula ye-Perilymphatic
Ukulimala kwekhanda, ukuphakama okunzima, noma ukulimala ngenxa yokuguqulwa kwengcindezi (njenge-scuba diving) ngezinye izikhathi kungaholela ekuxhumaneni okungavamile phakathi kwezingxenye zendlebe okungahlosiwe ukuxhumeka. Ukuxhumeka okungavamile phakathi kwezifunda ezimbili zomzimba okungezona okuxhunyiwe kubizwa ngokuthi i-fistula.
Izimpawu ze-fistula ye-perilymphatic ivame ukuvuthwa kakhulu ngokushintsha kwengcindezi yangaphandle noma yangaphakathi, njengokunciphisa, ukucindezela, ukukhwehlela, noma ukukhala okukhulu.
Izinguquko ekukhuphukeni zingase zikhulise izimpawu, njengokushayela indiza noma ngisho nokugibela i-elevator.
Ukuxilongwa kwe-fistula ye-perilymphatic kungaba nzima ngaphandle uma kwenzeka isichazamazwi esikhuthazayo. Ukwelapha ngokuvamile kuhilela ukuphumula nekhanda eliphakeme futhi ugweme zonke izinhlobo zokucindezela. Kulabo abangaphuthuki ngokuphathwa okunjalo, ukuhlinzwa kungadingeka.
I-Canal Dehiscence
Esinye isenzakalo esilandelayo siyinto ehlehlisayo, lapho ukuxhumana phakathi kwamakamelo amabili kungagcwaliseki, kodwa amathambo angase abe mncane kunezinye izikhathi. Isibonelo sokwehliswa komsele omkhulu ongaphakathi wezindlebe ezenza izimpawu eziyingqayizivele njenge-vertigo enomsindo ozwakalayo.
Cishe ingxenye ibuye ibe ne-autophony, okusho ukuthi bayayizwa imisindo yangaphakathi njengezwi labo, ukushaya kwenhliziyo, noma ngezinye izikhathi ngisho nokunyakaza kwamehlo abo ngevolumu ephazamisayo.
I-otosclerosis
I-Otosclerosis i-disorder ezuzwa ngezinye izikhathi lapho amathambo evuselelwa khona, futhi ukwakheka kwamathambo amasha kwenzeka phakathi nendlebe ephakathi. Lokhu kuvame ukuqala phakathi kweminyaka engamashumi amabili nesine yokuphila. Umphumela wukulahlekelwa kokulalela okuqhubekayo kwamanye amazwe. Abantu abangamaphesenti angu-20 abantu abane-otosclerosis nabo bane-vertigo noma ukungalingani, okuphumela ekubhujisweni kwezindlebe zangaphakathi. Abanye bangase bahlakulele i-endolymphatic hydrops ne-Meniere syndrome. I- audiogram ingasiza ekutholeni ukuxilongwa.
I-Vertigo Epileptic
Ngokuvamile, iziphonso ze-vertigo empeleni zibangelwa ukuqubuka . Abantu abaningi bajwayele ukuqubuka kwe-tonic-clonic ejwayelekile (ukuhlukunyezwa okukhulu) kodwa kunenhlobo ehlukahlukene yezimpawu ezihlukile kakhulu. Umsebenzi ongavamile kagesi ungenzeka ezingxenyeni zobuchopho ezicubungula uhlelo lwe-vestibular.
I- electroencephalogram (i-EEG) ingasetshenziselwa ukucacisa ukuthi ngabe iziphonso zinesifo sofuba emvelweni. Abanye abantu bangaba ne- epileptic aura ngaphambi kokuqothulwa kwe-vestibular, engasiza ukukhomba ukuthi kungenzeka yini ukuxilongwa.
I-Chiari Malformation
I-Chiari I-malformation yinto engavamile yokuzalwa (into ozalelwe ngayo) lapho phansi kwe-cerebellum (ingxenye yengqondo elawula ukulinganisela nokuxhumanisa) ihamba kancane kunejwayelekile. Ngokujwayelekile, lokhu akubangeli izimpawu, kodwa ngezinye izikhathi kungaholela ekuhloleni ikhanda, ukungalingani, kanye ne-vertigo. Uma i-vertigo ikhona, ingase ibe nzima kakhulu ngokuguqa intamo emuva (ukunyakaza kwekhanda kuhoxisa i-vertigo.)
Ngenkathi i- nystagmus (ukunyakaza kwamehlo okungalawulwayo) kuvame ukuvela kunoma yiluphi uhlobo lwe-vertigo, ku-Chiari ukungasebenzi kahle, i-nystagmus ingase ishaye endaweni ephansi esikhundleni sohlangothi, okuyinto engavamile. Kungase kudingeke ukwelashwa uma izimpawu zinzima kakhulu nge-Chiari malformation. Lokho kusho ukuthi iningi labantu abanezinkinga zeChiari akudingi ukuhlinzwa.
I-Episodic Ataxia
I-Episodic ataxia, ne- episodic ataxia hlobo 2 , ikakhulukazi, ingabangela iziqephu ezinzima ze-vertigo nge-nausea nokuhlanza ebuntwaneni noma empilweni yabantu abadala. I-Nystagmus kungenzeka ibe khona kokubili phakathi nokuhlaselwa. Ukuhlaselwa kuvame ukuqhubeka kubi kakhulu, futhi izimpawu zingase ziqale phakathi kokuhlaselwa kanye.
Imithi
Inombolo enkulu yemithi ingabangela isizungu, futhi ezinye zibangele i-vertigo ngokuqondile. Ama-antibiotic eyaziwa ngokuthi ama-aminoglycosides ayinkinga enkulu, futhi angabangela nokulimala okungunaphakade. Uketshezi lwe-lithiamu nakho kungabangela i-vertigo. Ngaphezu kwalokho, i-Vertigo ingumphumela wehlangothini ongenakwenzeka ngemithi efana nalokhu:
- ama-anticonvulsants (izidakamizwa zokulwa nokuthumba)
- i-anesthetics
- ukucindezeleka
- ama-non-steroidal anti-inflammatory agents ( ama-NSAID )
- imithi yesifo sikashukela
- ama-sedative nama-tranquilizers
Izwi elivela
Ngokuvamile, i-vertigo ayilona uphawu okufanele lugcinwe. Nakuba ngokuvamile kungenjalo ngenxa yezinto ezinjenge-stroke noma ukuhlaselwa kwe-ischemic okudlulayo, kubalulekile ukwazi ngokuqinisekile ukuthi izinkinga ezimbi azivezi. Ngaphezu kwalokho, i-vertigo ayijabuli kakhulu, futhi kukhona amasu nemithi engasiza uma uthola iseluleko esifanele sezokwelapha.
> Imithombo
- Chimirri S et al. I-Vertigo / isizungu njengesenzo semithi esibi. J Pharmacol Pharmacother. 2013 Dec; 4 (Suppl 1): chiariS104-9.
- > Fernandez, A., Guerrero, A., Martinez, M. et al Malformations ye-craniocervical juncChiari uhlobo 1 kanye nesicringomiaa: Ukuhlukaniswa, ukuxilongwa, kanye nokwelashwa. Ukuhlukunyezwa kwe-BMC Musculoskeletal . 2009. 10 (Suppl 1): S1.
- > Jeong SH, Kim HJ, Kim JS. I-veurbular neuritis. Semin Neurol . 2013 Jul; 33 (3): 185-94.
- > Lempert T. Ukuhlaselwa okuzenzekelayo okuzenzekelayo kosizi. I-Continuum (Minneap Minn). 2012 Oct; 18 (5 Neuro-otology): 1086-101.
- > Strupp M et al. I-Vestibular paroxysmia: Indlela yokuhlola. J Vestib Res . 2016; 26 (5-6): 409-15.