Ukufumana i-Culprit emva kweentlobo zakho zeDizzy kudinga ukuVavanywa koDokotela
Abantu bathetha izinto ezininzi ezahlukileyo xa bethetha bahlaziyekile. I-Vertigo yintlungu ye- dizzy ehambelana nokujikeleza ngeenxa zonke kwisangqa, okanye ngathi ihlabathi lijikelezayo.
I-Vertigo inokungonwabi kakhulu kwaye ngamanye amaxesha ingakhokelela kwisicongciso okanye ukuhlanza. Kungaba nzima ukuphuma ebhedeni, ngaphantsi koko uhambahamba uze wenze imisebenzi esiyidingayo ukuyenza yonke imihla.
Nangona iimbangela ezininzi ze-vertigo aziyikusongela ubomi, ezinye ziyingozi kakhulu, njengesihlungu esicaleni kwengqondo ecaleni kwe-cerebellum. Ngakolunye uhlangothi, iintlobo ezininzi ze-vertigo zingaphathwa ngokulula ngeendlela ezilula ezifana nokuma kwentloko.
Izizathu eziqhelekileyo
Ngokuqhelekileyo, abantu abafumana i-vertigo okanye utywala baya kuba nesinye sezizathu eziqhelekileyo.
Benign Paroxysmal Positional Vertigo (BPPV)
Ingaba i-vertigo ishukunyiswa ngenguqu kwisimo sekhanda? Ukuba kunjalo, imbangela ingaba yi- vertigo ye- postoxysmal postigo (BPPV), enye yezona zizathu eziqhelekileyo ze-vertigo. Le ngxaki ibangelwa i-crystal encinci ebizwa ngokuba yi-otolith edla ngokuhlala kwingozi kwinqanaba leendlebe eziphakathi (i-utricle and saccule). Kwi-BPPV, i-otolith ikhehla ikhululekile kwaye ingena kwelinye leemingxube ezintathu eziqhelekileyo zibonisa ukuba umzimba wethu uphendulela kwisithuba. I-crystal ibangela ukutshintsha kwengcinezelo kumngcwabo okhohlisa umzimba ekubeni ukholelwe, nangona uhleli.
Ukudideka okubangelwa yi-vertigo.
I-vertigo ye-BPPV ijwayele ukuvela kwiipasisiti ezimfutshane kwaye iziswa ngokuguquka kwentloko, kuba ukuguqula intloko kunokubangela ukuba i-otolith ihambe kwinqanawa, ibangele iimpawu eziphosakeleyo kwingqondo. Iindaba ezilungileyo kukuba uluhlu lweentloko ezihamba phambili (ezibizwa ngokuba yi- Epley maneuver ) zingasetyenziselwa ukubeka kwakhona i-otolith ngaphandle kweemingxube apho kungabangela ukuba kungakhathaliseki.
Iintetho ezidlulileyo ngaphantsi komzuzu okanye njalo zihlala ngenxa ye-BPPV. Iimpawu ezininzi ze-vertigo ezinokuthi zingabangelwa yingxaki entle engaphakathi, njenge- vestibulopathy ye-peripheral okanye i- Meniere's syndrome , okanye kwi-vertigo ephakathi, nto leyo ithetha ingxaki kwi-brainstorms efana neyokufunyanwa kwi-stroke okanye kwi-vestibular migraines.
Izifo zeMeneere
Intloko yangaphakathi iqulethe isikhwama esilungeleyo esitshatiweyo ngaphakathi kwendawo engqinileyo yomlambo. Ngaphakathi kweso sigxobo sikhulu ngakumbi kodwa luhlobo oluthile. Isifo sikaMeniere sicingelwa ukuba sibangelwa ukungalingani phakathi kwesithuba somthamo ngaphakathi kwesikhwama kunye nomkhuhlane ngaphandle kwesikhwama, kunye nokwanda kwamanzi okwakhiwa ngaphakathi. Oku kwaziwa ngokuba yi-hydrops endolymphatic.
Isifo ngokuqhelekileyo sifika phakathi kweminyaka engama-30 ukuya kwe-50 kwaye sibangela ukuhlaselwa kwe-vertigo, ukulahlekelwa kwindlebe kunye nokukhalisa ezindlebeni. Ngokuphambene ne-BPPV, ukuhlaselwa kungagcina imizuzu engama-20 ukuya kwiiyure eziliqela ngexesha. Nje ngezinye iintlobo ze-vertigo, mhlawumbi i- nystagmus iya kuba khona. Ezi hlaselo ziyahlukahluka naphi na phakathi kwamaxesha amaninzi ngeveki ukuya ngaphantsi kweyodwa ngonyaka. Emva kweminyaka emi-5 ukuya kwe-15, ukuzondwa kwamanzi kuya kuba nzima kodwa kuninzi, kwaye ukulahlekelwa kwindlebe kunokuhlala isigxina.
Izifo zeMeniere zifumaneke ngugqirha ngaphandle kweminye imvavanyo eyongezelelweyo, kodwa ngezinye iinkqubo i-audiometry iyanceda. Akukho unyango oye lwafunyanwa ukunqanda utshintsho oluqhubekayo kwindlebe yangaphakathi, kodwa imichiza inokunceda ngeempawu xa zivela.
I-Vestibular Neuritis
Le ngxaki ihamba ngamanye amagama amaninzi, kubandakanya i-vestibular neuronitis, i- labyrinthitis , i-neuro labyrinthitis, kunye ne-vestibulopathy ephazamisayo. Ingxaki ihlala isombulula ngokupheleleyo kodwa idala i-vertigo engonwabi okwangoku. Ingxaki ichazwa kukuba ngenxa yokuvuvukala kwentsholongwane ye-vestibula ekhutshwe yi-virus-nangona, kukho ngokwenene kuphela ubungqina obuncinane bokuxhasa le ngqungquthela.
Ukuxilongwa kwe-vestibular neuritis ngokuqhelekileyo kwenziwa ngugqirha ekuhloliseni kwaye ekubuza imibuzo, nangona uvavanyo lunokwenzelwa ukukhuphela ezinye izizathu, ezifana nesifo. I-Vertigo esuka kwi-vestibular neuritis ihlala isombulula kwisithuba seentsuku ezimbalwa, kodwa ngamanye amaxesha kukho ukungalingani kwamanani okwehla okuhlala kwinyanga. Akucaci ukuba naluphina unyango oluncedo luncedo, nangona oogqirha abaninzi baya kunika ikhosi emfutshane ye-steroid prednisone ngokusekelwe kwidata elincinane exhasa ukusetyenziswa.
Paroxysmia yeVestibular
Ngamanye amaxesha uhlaselo lwe-vertigo luphela kuphela imizuzwana embalwa ngelixa kodwa linokuthi lwenzeke kaninzi ngosuku. Abanye oogqirha bakholelwa ukuba oku kungakho ngenxa yesitya segazi esicinezelayo kwintsimbi yesibhozo yesibhozo , ekhokelela kwimvakalelo ye-vertigo.
Amanye amagqirha agxeke ukungabikho kwedatha efanelekileyo yokuxhasa le ngqungquthela. Ngokomzekelo, ukuya kuma-30 ekhulwini abantu abanempilo banemijelo yegazi edibana ne-vestibulocochlear nerve, ngokubhekiselele kwinqaku kwi- Journal of Vestibular Research .
Abanye baye bacetyiswa ukuba ukuhlinzwa kungasetyenziselwa ukususa uxinzelelo olubekwe kwimbilini ngemithambo yegazi, kodwa abanye baye bafumanisa ukuba i-dose ephantsi ye-carbamazepine (i-anti-seizure medication) inokukunceda. Ngenxa yobungqina obuqinisekisiwe bokuthi umkhumbi wegazi unecala, ukusetyenziswa kwamachiza kuyona yonyango yokuqala yonyango.
Vestibular Migraine
Ngelixa iziganeko zangaphambili ze-vertigo zikhokelela kwinto ebizwa ngokuba yi-vertigo yembambano, oku kuthetha ukuba i-vertigo ibangelwa yinto engaphandle kwengqondo kunye neengqondo, kuyafumaneka ukuba ufumane i-vertigo kwiingxaki ngaphakathi kwengqondo ngokwayo, ebizwa ngokuba yi "vertigo" ephakathi. Enye yezona zimbangela ezincinci ze-vertigo yangaphakathi yintsapho ye- vestibular migraine .
Ngokuqhelekileyo iMigraines icinga ukuba ivuselele intloko, kodwa i-migraines ye-atypical inokubangela ukuba phantse naziphi na iimpawu ze-neurological, eziquka ubuthathaka, ukugubungela, ukuphazamiseka, kunye nesisu. Noko ke, intloko isetyenziswe ngokusemthethweni ukwenza ukuxilongwa kwe-vestibular migraine. Ezinye iimpawu ze-migraine, okanye ukuqala kwe-vertigo kunye ne-typical migraine eziphazamisayo , zinokukunceda ekwenzeni ukuxilongwa.
I-Vertebrobasilar iTestamente ye-Ischemic Attack (TIA)
I-brainstem ifumana ininzi yegazi layo ngeendlela ezibizwa ngokuba yi-posterior circulation. Iingqungquthela zombini ze-vertebral zihlangene ukuze zenze i-basilar artery, ethumela amagatsha athumela igazi elondlayo kwingqondo ebuhlungu nangemva kwengqondo.
Ukuba iirriyiti kwindawo yengqondo zivaliwe nge-clot yegazi, iiseli zengqondo ziqala ukulamba. Ukuba i-clot yegazi ichithekile, iimpawu ziphucula, kwaye isiganeko sibizwa ngokuba yi- attackchemism . Ukuba i-clot yegazi ihleli, ngoko ikhokelela ekubetheni iinqweliso ngonaphakade.
Ngenxa yokuba i-brainstem iqukethe amaziko emzimbeni wokulinganisela, kubandakanywa ukudluliselwa kuzo zonke iinkcukacha ezithunyelwe kwingqondo evela kwindlebe yangaphakathi, i-vertigo iyimpawu eziqhelekileyo zokujikeleza kwangemva. Ngaphezu koko, malunga neminye imisebenzi ebalulekileyo yengqondo, njengokuphefumla, ukunyakaza, kunye nokunye. Ngenxa yoko, iimpawu zokukhathazeka nge-vertebrobasilar TIA zibhekwa njengesilumkiso seengxaki ezinokuthi zifike.
Ngethamsanqa, akunqabile ukuba i-vertebrobasilar TIA iya kubangela kuphela i-vertigo kwaye ayikho enye into. I-brainstem yindawo encinci malunga nokukhulula njengesithupha sakho kwaye ixutywe ngamathambo abalulekileyo. Ukuba umonakalo owenziwe kwicandelo elinye le-brainstem, abanye baya kuphazamiseka, okukhokelela kwiimpawu zengqondo ezongezelelweyo. Ngesi sizathu, oogqirha banqwenela ukufumana iimpawu ze "vertigo" ephakathi, ithetha i-vertigo ephuma kwi-brainstress kunokuba i-vestibular nerves okanye indlebe yangaphakathi.
Imiba yengozi ye-vertebrobasilar i-TIA iyafana neyezinye iindidi zesifo se-ischemic disease, njenge-stroke. Ukufumana ulwazi oluthe xaxa malunga nokuqwalasela ukuba i-vertigo yakho ibaluleke kangakanani, funda malunga nokuba utywala lunzulu kangakanani .
Iimeko eziqhelekileyo
Ngamanye amaxesha imbangela ye vertigo yakho yinto enqabileyo. Nangona ezi zinto ezingavamile ze-vertigo zenzeke kangangoko, kubalulekile ukuba uqaphele ezinye izifo ukuze iimpawu zakho ziphosakele ngenye into evamile.
Makhe sijonge ezi zizathu ezingavamile ze-vertigo.
Izifo zeNtlebe zeNdlebe ezenzekelayo
Ngamanye amaxesha, i-immune system iphosa inxalenye yomzimba wethu ngenxa yentsholongwane ehlasela. Xa oku kwenzeka - xa ukuhlaselwa komzimba ngokwawo-kubhekiselwa kuyo njengengxaki yokuzimela. Ukuba oku kwenzeka kwindlebe yangaphakathi, kunokubangela ukulahlekelwa kwindlebe yokuqhubeka kunye ne-vertigo.
Phantse kwikota yabantu abanjalo baya kuba nezinye izifo ezizimelayo ezifana ne- systemic lupus erythematosus , i-polyarteritis nodosa, okanye i-Wegener granulomatosis. Phantse isiqingatha sala bantu baya kuphendula kwi- corticosteroids .
I-Labyrinthine Ingqungquthela
Iingqungquthela zivame ukubangelwa intloko, isicathulo, ukuhlanza, kunye nesisu. Ingqiqo ye-vertigo emva kwengqungquthela inokubangelwa kukulimala kwimizimba ye-vestibular emva kokuba intloko ibetha. Ngokuxhomekeke kwimeko yokulimala, kunokuba negazi ngaphakathi kwindlebe yangaphakathi. Nangona oku kudla ngokugqithiseleyo emva kokulimala kwentloko, i-vertigo ingafika ize ihambe ixesha elide emva koko. Ngamanye amaxesha, utshintsho olusemva kokutshatyalaliswa kwintlupheko yecala phakathi kwezinto zendlebe yangaphakathi (i-endolymphatic hydrops), ingaholela kuMeniere syndrome.
I-Perilymphatic Fistula
Ukulimala kweNtloko, ukuphakamisa okunzima, okanye ukulimala ngenxa yokutshintshwa kwengcinezelo (njenge-scuba diving) ngamanye amaxesha kunokukhokelela ekuxhulumeni okungavumelekanga phakathi kweendlebe zengaxhomeki ukuba zidibaniswe. Unxibelelwano olungavumelekanga phakathi kwemimandla emibini yomzimba engaxhunyiwe ngokuqhelekileyo kuthiwa yi-fistula.
Iimpawu ze-fistula ye-perilymphatic zidla ngokugqithiseleyo ngenguqu yongcinezelo lwangaphakathi okanye lwangaphakathi, njengokunciphisa, ukuxubha, ukukhwehlela, okanye ukukhala.
Utshintsho ekuphakameni lungaphinda lunyuse iimpawu, ezifana nokushayela kwinqwelo okanye ukugibela i-elevator.
Ukuxilongwa kwe-fistula ye-perilymphatic kunzima ngaphandle kokuba isiganeko esichukumisayo sichazwa. Unyango lubandakanya ukuphumla nentloko ephakamileyo kunye nokuphepha zonke iintlobo zokuxhatshazwa. Kulabo abangaphuculanga ngolo hlobo, unyango lunokuba luyimfuneko.
Dehiscence Canal
Enye into edibeneyo yinto echazayo, apho ukudibanisa phakathi kwamagumbi amabini akugqibekanga, kodwa ithambo linokuba lincinci kunokuba lisoloko liba. Umzekelo ngu-dehiscence yomtya ongasentla wendlebe yangaphakathi eyenza iimpawu eziyingqayizivele njenge-vertigo enesandi.
Phantse isiqingatha sine-autophony, ithetha ukuba ziva izandi zangaphakathi njengezwi labo, intliziyo, okanye ngamanye amaxesha kunye nokunyuka kweeyame kwivolumu ephazamisayo.
Otosclerosis
I-Otosclerosis ngenye indlela i- distilence inherited by the bones, kwaye amathambo amathambo ayenzeka ngaphakathi kwindlebe ephakathi naphakathi. Oku ngokuqhelekileyo kuqala phakathi kweyesibini neyesine eminyaka yobomi. Isiphumo kukuba ukulahlekelwa kwindlebe ekuqhubela phambili . Phantse iipesenti ezingama-20 zabantu abane-otosclerosis nazo zine-vertigo okanye ukungalingani, okubangelwa kukutshabalalisa indlebe yangaphakathi. Abanye bangahlakulela i-endolymphatic hydrops kunye neMeniere syndrome. I- audiogram ingaba luncedo ekwenzeni ukuxilongwa.
Epileptic Vertigo
Ngokuqhelekileyo, iintetho ze-vertigo zinokwenene ngenxa yokubamba . Abantu abaninzi bayaziqhelana ne-tonic-clonic seizures (inkulu enkulu yokubamba) kodwa kukho ngokwenene iintlobo ezahlukeneyo zempawu ezahlukileyo. Umsebenzi ongaqhelekanga kagesi ungenzeka kwiindawo zengqondo eqhuba inkqubo ye-vestibular.
I- electroencephalogram (i-EEG) ingasetyenziselwa ukuchonga ukuba iifethi zinesifo senyama. Abanye abantu banokuba nera epileptic ngaphambi kokutshatyalaliswa kwe-vestibular, enokukunceda ekubhekiselele kwi-diagnostic.
Malunga Malformation
I-Chiari I-malformation yinto engafanelekanga (into ozalelwe ngayo) apho i-bottom of the cerebellum (inxalenye yengqondo elawula ukulinganisela kunye nokulungelelanisa) iyancipha ngaphantsi kunokuba iqheleke. Ngokuqhelekileyo, oku akubangeli nayiphi na impawu, kodwa ngamanye amaxesha kunokukhokelela kwintloko yesifo, ukungalingani kwamanani kunye ne-vertigo. Xa i-vertigo ikhona, inokuba yingozi kakhulu ngokuguqa intamo emva (intshukumo yentloko yenzelwe i-vertigo.)
Nangona i- nystagmus (ukuhamba kwamehlo okungalawulwayo) ihlala ikhona kwiyiphi indlela ye-vertigo, e-Chiari, i-nystagmus inokubetha kwisalathiso esingaphantsi kwecala, elingaqhelekanga. Kufuneka unyango lube lukhuseleko xa iimpawu zinzima kunye ne-Chiari malformation. Oko kwathiwa, abaninzi abantu abane-Chiari ukungalungi akudingi ukuhlinzwa.
Episodic Ataxia
I-episodic ataxia, kunye ne- episodic ataxia hlobo 2 , ngokukodwa, inokubangela iziqabana ezinzulu ze-vertigo kunye ne-nausea kunye nokuhlanza ebuntwaneni okanye ebomini beminyaka yabantu abadala. I-Nystagmus inokuthi ibe khona ngexesha kunye naphakathi kokuhlaselwa. Izihlaselo zihlala zibi kakhulu, kwaye iimpawu ziqala ukuvela phakathi kokuhlaselwa kwakhona.
Mayeza
Inani elikhulu lamachiza linokubangela utywala, kwaye ezinye zibangele i-vertigo ngokukodwa. I-antibiotics eyaziwa ngokuba yi-aminoglycosides iyingxaki ngakumbi, kwaye iyakwazi ukukhokelela kumonakalo ongunaphakade. I-lithium inetyity ingabangela i-vertigo. Ukongezelela, i-Vertigo yinkqubela echaphazelekayo kunye namachiza afana ne:
- i-anticonbulsants (izidakamizwa ezichasayo)
- i-anesthetics
- ezixinzelelekileyo
- ii-non-steroidal anti-inflammatory agents ( NSAIDs )
- isifo sikashukela
- izidalwa kunye noxolo
ILizwi
Ngokubanzi, i-vertigo ayilona uphawu olufanele lugcinwe. Nangona kaninzi kungekhona ngenxa yento efana nokubethelwa okanye ukuhlaselwa kwe-ischemic esingaphantsi kwexesha, kubalulekile ukwazi ngokuqinisekileyo ukuze iingxaki ezimbi zingabikho. Ukongezelela, i-vertigo ayixhatshazi kakhulu, kwaye kukho iindlela kunye namachiza anokunceda ukuba ufuna uncedo olufanelekileyo lwezonyango.
> Imithombo
- Chimirri S et al. I-Vertigo / utywala njengesiphatho sonyango. J Pharmacol Pharmacother. 2013 Dec; 4 (iSiza 1): chiariS104-9.
- > Fernandez, A., Guerrero, A., Martinez, M. et al Malformations ye-craniocervical juncChiari uhlobo 1 kunye ne-syringomiaa: Ukwahlula, ukuxilongwa, kunye nonyango. Iingxaki ze-BMC zeMisculoskeletal . 2009. 10 (iSiza 1): S1.
- > Jeong SH, Kim HJ, Kim JS. Vestibular neuritis. Semin Neurol . 2013 Julayi; 33 (3): 185-94.
- > Lempert T. Ukuhlaselwa okuxhamlayo kwintlanzi. Continuum (Minneap Minn). 2012 Oct; 18 (5 i-Neuro-otology): 1086-101.
- > Strupp M et al. I-Vestibular paroxysmia: Inkqubo yokuchonga. J Vestib Res . 2016; 26 (5-6): 409-15.