anonymously

Hello! The problem is this: It started about 2 months ago. I'm 32 years. In general, it all started with a severe headache and loss of vision (white flashes in the eyes, similar to the northern lights). The state became such as if I did not understand, I do not feel the situation and hardly understand people. The head seems to be floating in the air because of this, the legs are insensible and there is as if there is no understanding of where to step further, the feeling as if you are walking with your eyes twisted, but your eyes are open. Then a strange panic sets in and it is very difficult to walk. The condition deteriorates very much while standing and for some reason, with prolonged standing, it seems that you are standing on the edge of a skyscraper and for some reason all the weight is automatically transferred to your toes and you want to get up on them, as it were. I rode my bike very well and generally there are no symptoms of dizziness, but lying down everything goes away! Sitting there, but very little. I went to a neurologist. Did: MRI, ultrasound and X-ray of the neck. They said osteochondrosis of the neck. BUT I still had before all this strange throbbing of the heart when bending over the body. Bend down and how it goes up to the point of coughing ... The doctors did ultrasound of the heart, they found nothing ... The main thing is to bend down there is a yawning, and if you get up, no. In general, all examinations, except for osteochondrosis, found nothing. They prescribed a bunch of medications: Cytoflavin, Medacalm, Cavinton, Neuromultivitis ... Nothing helps from Medacalm Allergy, terrible from Cavinton, even more dizziness ... Cytoflavin helped a little, and then everything is the same. Thank. What to do? I do not know...

Hello! You have vertebral-basilar insufficiency syndrome. In the cervical spine, all the "communications" connecting the head with the rest of the body are very compactly packed. In this most vulnerable part of the spine, there is very little free space, so it is easy to pinch the nerves and blood vessels that feed the brain. With age, the vertebrae are displaced and the arteries experience compression, which is not difficult to recognize with ultrasound duplex scanning or magnetic resonance angiography. A compressed artery does not supply blood to the brain, hence the characteristic symptoms of vertebrobasilar insufficiency in the occipital region, dizziness, unsteady gait, impaired coordination of movement, blurred vision and darkening in the eyes, tinnitus, hearing loss, fainting. These complaints are often accompanied by neck pain, limitation of head movement when bending down, to the sides, throwing the head back, and tension in the neck muscles. The goal of treatment is to eliminate pain and restore normal spine biomechanics. The first prerequisite for treating neck pain is to rest the affected neck muscles to avoid prolonged tension. In the case of a spine with the involvement of nerve roots, it is recommended to fix the cervical spine with a cervical collar (Shants bus). It is designed for soft fixation and stabilization of the cervical spine. Partially unloading the musculo-ligamentous apparatus of the cervical spine, it allows you to keep the cervical spine in the correct position, limits the increased mobility of the neck vertebrae. Wear for 10-15 minutes up to 3 hours a day. For the treatment of cerebrovascular pathology, vasoactive drugs are widely used, the so-called "optimizers of cerebral circulation": trental, cinnarizine, stugerone, etc. In case of vascular insufficiency of the vertebrobasilar system, preference is given to stugeron, sibelium. betaserk. If the patient has a combination of atherosclerotic lesions of the vessels of the brain and extremities, the appointment is indicated. In your case, it is necessary to continue the selection of vascular therapy under the supervision of a neurologist.

The unsteadiness and unsteadiness in gait are usually described in different ways by patients. For some, this symptom is only mild dizziness, for others, a noticeable staggering while walking. And still others cannot clearly explain what they mean by talking about their condition and calling it "a feeling of instability in the head." However, such a manifestation is always unpleasant for patients; in some cases, a lack of understanding of what triggered it can cause people to have a strong fear for their health.

How does the feeling of unsteadiness and unsteadiness appear when walking?

The following signs may accompany the symptom:

Feeling unsteady can indicate the presence of many diseases. It can be osteochondrosis, atherosclerosis, traumatic brain injury, arthritis, diseases of the central nervous system, deformity of the foot, etc. In the event that the patient experiences a strong feeling of unsteadiness when walking, he is usually prescribed certain diagnostic methods.

1. Study of patient steps with eyes open and closed.
2. Study of gait when moving to the side, as well as when moving back forward.
3. Identifying changes when moving around an object (for example, a chair).
4. Studying heel and toe steps, torso turns, slow and fast steps.
5. Observing the patient's gait up the stairs.

Consultations of various specialists (endocrinologist, otolaryngologist, neuropathologist) can also be prescribed and CT, MRI and other studies can be performed.

Psychological causes of unsteady gait and unsteadiness

Often, the appearance of a feeling of staggering when walking is provoked by such reasons as VSD, prolonged depression, stress, neuroses, and uncontrollable fears. It is known that psychoemotional stress can cause many unpleasant and even painful symptoms that have a negative effect on the patient's condition as a whole. Among them:

As a rule, with VSD, high anxiety in the patient often leads to jumps in blood pressure, which can lead not only to,,, dizziness and, but also to a feeling of instability and staggering when standing or walking.

With intense anxiety, which is a constant companion of VSD and phobias, various respiratory disorders often appear (choking, feeling of incomplete inhalation or exhalation, shortness of breath, weakness in the legs,), which can also affect the emergence of feelings of instability and insecurity.

Among the people there is such an expression "the earth is leaving from under their feet." That is, if a person is in severe stress, then he may experience a loss of support and thus a loss of stability, balance and self-confidence. Well, people with an anxiety disorder such as VSD are constantly under such stress. Therefore, it is not surprising that they develop dizziness and stagger when walking.

Treating unsteadiness while walking and unsteadiness

Treatment of a patient suffering from a feeling of instability, as a rule, begins with identifying the causes that provoked the onset of the symptom. So, depending on what caused the ailment, the patient may be prescribed various vitamin complexes, special diets, antibiotics (for infectious diseases), pain relievers or sedatives.

If dizziness and unsteadiness are caused by stress, then psychotherapeutic treatment is indicated to solve the problem, i.e. work with a psychologist aimed at restoring the psychological state. In severe cases, in addition to this work, to normalize the condition, it is required to take medications (tranquilizers, neuroleptics, nootropics, antidepressants). Mild sedatives, such as Valerian or Motherwort, are often prescribed.

As a preventive measure, with an unstable nervous system, the patient is advised to avoid stressful situations, exercise, take active walks in the fresh air and try to get as many positive emotions as possible. Sometimes a change in lifestyle alone can significantly reduce the excessive susceptibility of the psyche to "nervous" situations.

For any kind of instability and staggering, it is recommended to consult a specialist for the necessary examination. Regardless of the reason, with a feeling of instability, the patient is also shown proper rest and balanced nutrition with all the necessary vitamins and microelements.

Emergence spontaneous vestibular reactions may be due to various pathological conditions in different parts of the reflex pathway - from receptors to cortical representation. To one degree or another, spontaneous vestibular reactions can be caused by inflammatory, vascular, tumor, occupational diseases, intoxication, blood diseases, trauma, certain diseases of the nervous system (for example, syringomyelia, multiple sclerosis, neurosyphilis), etc.
Spontaneous vestibular reactions have a significant impact on the experimentally evoked vestibular reactions and determine their qualitative differences from those in the norm.

Spontaneous reactions of vestibular genesis can be conditionally divided into specific (dizziness, spontaneous misses, imbalance, coordination, spontaneous nystagmus) and nonspecific (nausea, vomiting, disorders of the endocrine-vegetative nature, etc.). In general, these reactions are very characteristic of vertebral artery syndrome.

Central vascular disorders associated with vertebral artery syndrome, are manifested, according to NS Blagoveshchenskaya, by the central vestibular syndrome, while vascular disorders are noted mainly in the brain stem and are not accompanied by impaired functions of the auditory analyzer. Central vascular disorders, as a rule, are accompanied by pathological afferent and efferent impulses, entailing reflex disturbances in the labyrinth, cerebellum, autonomic centers, thalamic associative mechanisms.

According to L. Yu. Ratner, one of the most common complaints presented by patients with cervical osteochondrosis is dizziness (in 75% of cases). The author notes that in some cases it occurs at the height of a headache, paroxysmal, in others it constantly bothers a person, depriving a person of the opportunity to work fully. According to the author's data, systemic dizziness is observed in 6.6% of patients and non-systemic dizziness in 68.3%. Similar data are given by G.N. Grigoriev, Kunert, Krenkel and others.

It should be noted that with repeated surveys patients after a month, six months and a year, these indicators changed significantly, which is associated either with the phase state of the vestibular function, or with the dynamics of the main process - further progression of dystrophic changes in the cervical spine, atherosclerosis in the vertebrobasilar vascular system, or with the addition of ischemic processes, etc. Therefore, from a methodological point of view, it is practically impossible to conduct studies of the vestibular function according to some exact criteria, without taking into account the dynamics of the process and the patient's condition at the moment, and is probably wrong. Of 174 patients, 159 (91%) people complained of one or another type of dizziness.

In most patients dizziness accompanied by nausea and often vomiting, after which the general condition improved somewhat. In 60% of cases, dizziness could be provoked by sharp turns of the head or throwing it back; in 40% of cases, spatial illusions of movement arose when getting out of bed, driving in transport, watching movies, and the appearance of moving objects in the field of view.

Systemic vertigo, as a rule, was accompanied by auditory phenomena and therefore associated with the processes taking place in the ear labyrinth. Most often, this dizziness was in the nature of external autokinesis (with open eyes), with closed eyes, most patients also noted a feeling of internal autokinesis with "touch" of movement of the support area.

With non-systemic dizziness patients could not clearly indicate in which direction they were "moving". They characterized the experienced sensations as "swaying on the waves", -mighty-like swaying of surrounding objects "," indistinct sensations of floating in the air. " Patients can hardly tolerate systemic circular dizziness, as well as dizziness, accompanied by an absolute loss of spatial orientation, since in these cases they often received severe bruises. Such types of dizziness are probably due to instant angioreflex block at the level of the ascending activating system and the shutdown of the vestibulocerebellar and vestibulospinal connections.

Mixed type of vertigo (according to the classification of V.M.Salazkina et al.) was characterized by alternation of systemic and non-systemic dizziness, periodic occurrence of a false sensation of self-movement, indefinite in its direction, which intensified when the eyes were closed.

In sick cervical osteochondrosis with vertebral artery syndrome, one should distinguish between "small" seizures lasting from several minutes to several hours, and "large" seizures (similar to Mensra syndrome). The former, as a rule, could be provoked by various external causes, which were mentioned above, while the "large" attacks appeared as if by themselves (probably as a result of a general persistent decompensation of the central mechanisms of regulation, covering vestibulosensory, vestibulo-motor and vestibulo-vegetative connections ).

In general for dizziness with cervical osteochondrosis the following dynamics is characteristic; during the first 5 years of the disease - the severity of this symptom increases (with a general progression of labyrinthopathy); then it gradually stabilizes, and when the disease is more than 10 years old, the severity of dizziness decreases.

Shakes when walking

Asks: Andrey, Volgograd region, Zhirnovsk

Gender: Male

Age: 28

Chronic diseases: The diagnosis was earlier made, encephalopathy, and external, hydraciphaly, is moderate.

Hello, Tell me please, yesterday when I got up from my chair, I had unsteadiness of gait, when walking, it shakes strongly as if on a ship, my head does not spin, but as if it leads to the side, or as if I was going somewhere, there was no nausea, my head did not hurt, no tinnitus, no seizures and other disorders, was examined for mri with an geography of blood vessels, everything is normal, the cerebellar signal is normal, the vessels are also normal, ultrasound, the vessels of the neck are normal, the blood flow in the large vessels is normal , I'm wondering if it could be a pathology of the inner ear ?, and how to diagnose? Ears not when no discharge from the ears was not. The other day I was very nervous, can stress affect this condition? The pressure in this state was normal 125-79-70.

18 replies

Do not forget to rate the doctors' answers, help us improve them by asking additional questions on the topic of this question.
Also, don't forget to thank the doctors.

Hello Andrey. You need a neurological examination. Have you done an MRI of the brain before this episode?

Andrei 2015-05-15 11:10

Yes, I did, because in August of that year I woke up and my head was spinning, I get up, I don't get dizzy, I lay down again to spin, I feel dizzy when I tilt my head, there is no noise in my ears and no nausea, I was diagnosed with DPG by a neurologist, I did an MRI of the head and blood vessels, as well as ultrasound of the vessels of the neck, everything is normal, but somehow I doubted the diagnosis of DPH because it was very stuffy in the summer and it was very stuffy in the quarter too, I wrote it off for the heat and all the time, but now again only now it shakes and leads to the left when walking, now I think that after all it is DPG and pathology of the center of balance in the labyrinth, I was prescribed to drink Betaserc, I did not drink it. Tell me, DPH can be cured with medication, and in general, am I in danger of surgery on the inner ear? Ears do not hurt, I can hear normally.

As far as I understand, you are now in a different state compared to August. What you describe was in August was really similar to BPG, it does not require special treatment, except that vestibular gymnastics + salt restriction, and sometimes you can also betaserc course. Your current description corresponds to the manifestation of non-systemic vertigo, and it is usually of central origin, that is, an MRI of the brain should be repeated.

Please tell me, repeat the mri with blood vessels? Or just an MRI of the brain? Maybe it's better to do an MRI of the thoracic or cervical spine? And how to understand the central origin and is it dangerous? Or could it be pinching of the vertebral arteries?

Just do an MRI of the brain. Central origin means associated with the defeat of the central nervous system. Less commonly, it can be a vertebral artery syndrome, but the cause is not pinched, but irritated artery. If everything is normal on the MRI of the brain, but it will be necessary to do an MRI of the cervical spine

Andrei 2015-05-15 22:21

I will try to describe my condition in more detail, on the eve before the attack, I had a strong fight with the boss, and I was very nervous and slept badly, just before the attack I ate two heads of garlic a day for two days, maybe he played something, in the evening before going to bed I decided to eat , after I got up to wash the dishes and feel it swaying slightly, took a warm shower, went to bed, but I could not sleep as I felt discomfort as if I was going somewhere, I got up and went to the toilet and that's when I started to swing to the sides, but mostly why then he went to the left, maybe because his head was spinning to the left? She seemed to be dizzy and at the same time as if I was going in front of her, but at the same time her head was light, there was no tension, there was no noise in her ears, her vision was clear, she did not nausea, her head was apparently not very dizzy, in the dark of course faster but without nausea, there was simply a feeling of loss of orientation, and such a feeling as if the head was spinning in the center of the crown (crown of the head). Today is much better than yesterday, although I slept badly, but I had dreams, I lie normally, I get up, I sit on the bed, my head seems to be spinning a little and stops, and my head seems to be a little fogged. Was the neurologist advised to drink Betaserc and Tenaten, they told the MRI not to do as I did in August, but on your advice I will do it, advise what departments? Is this what caused me dizziness? Due to stress? Or is there something wrong in your head?

I can say what's wrong in my head after an MRI of the brain. Vertigo can also be psychogenic. Why do I recommend MRI, because I think it's better to play it safe than to miss something serious, especially since I have enough experience to make such statements

Andrei 2015-05-21 19:21

Good afternoon, dear Ekaterina Sergeevna.
I would like to inform you about additional studies of my disease, I am beginning to better and better understand the symptoms and the disease itself. Not long ago, a neurologist had a woman of an age that seemed to have a lot of experience with higher education, but when I told her about BPPV, she asked me again what was it ?! I explained what kind of disease it is, its symptoms, I know for sure that I do not have a vertebral artery syndrome, because I understand perfectly well that when a spasm of this artery occurs, dizziness occurs; headache, in the occiput, tinnitus, and so on, I have this is not, for which there is an objective confirmation of ultrasound of the vessels of the neck and the head for which I was prescribed a direction, I attach the conclusion below, and also wrote out a direction for an MRI of the cervical spine, and according to the conclusion of the data, studies, I was diagnosed with a syndrome of the vertebral vertebral artery, having doubted this diagnosis, I turned to another neuropathologist, the man turned out to be a professional in his field, after listening to my complaints, conducting a total Rum Berg test, a pollen-bearing test, got acquainted with the studies that I went through, and diagnosed vistibulopathy, this diagnosis is more suitable, but still I want to find the true the cause of dizziness, since dizziness is a symptom and not a disease, I am more inclined to a disease of the labyrinth of the inner ear, as I noticed when I enter a dark room at night, my head starts to feel a little stormy, not dizzy, but just shakes and starts to lose balance a little, on the light and balance comes back to normal, I was given an exercise in vestibular gymnastics, so I'll start doing it, and drink Betaver, I don't know how much it will help, but I will try. I would like to ask you what kind of disease do you think I have? Since my head doesn’t hurt, now I’m not dizzy but shakes a little in the dark, it’s probably something else with the visual analyzer, apparently there is a mismatch with the somatosensory system, and I still have an increased nervous state. And I also wanted to say that as a child I was rocked very badly in the car in the bus, it became very bad, I was born at 7 months with fetal hypoxia, doctors diagnosed encephalopathy and cranial pressure.
P. S. Communicating with you, I am sure that you are a good doctor, and I understand that everything is not free, for your help I would also like to pay for your correspondence consultation, how much will it cost? Thank.

MRI of the cervical spine is very decent, but MRI of the brain, fresh, after your dizziness is there?
Unfortunately, many neurologists do not know BPPV and other types of peripheral vestibulopathies, as a rule, vertebro-basilar insufficiency is usually diagnosed as standard and without much disassembly. But, also, most ENT doctors do not know such a diagnosis and problems with the labyrinth, the presence of a perilymphatic fistula, the onset of Meniere's disease, etc. are not able to identify and all the troubles are attributed to long-suffering osteochondrosis and sent back to the neurologist. Therefore, if you find it, it is better to consult an otoneurologist.

Good evening Ekaterina Sergeevna. Thank you for the answer, but that is the question of how to find exactly a good one from a neurologist, I have an old MRI conclusion made after the first attack of dizziness, but in the future I will definitely do it, now I am fine, my head does not hurt, it is light, there is no noise when I had no ears, the back of my head never hurt or pressed, I don't know what it is, the only thing is dizziness only in the mornings after sleep, but they are still rare, I don't have dizziness spontaneously in a waking state, only after sleep, I drink Betaver and I feel better, since there is no dizziness, but after the dizziness comes a state as if I had a little drink, it seems to shake a little, but it seems not, it’s not clear, the accuracy of movements in my mind I can perform difficult coordination movements, I can ride a bike without hands, walk right along the line, this is all the norm, but in the dark it kind of shakes, I understand that it is connected by the visual sensory system. Now everything is fine, I wake up cheerfully, my head does not get dizzy, it does not hurt, I take a contrast shower, only sometimes I feel sluggish like fatigue, but everything is fine, tomorrow I will do for the prevention of vestibular gymnastics, its effectiveness has been proven, I would of course still have Cenrezin for the prevention of drank, but it weakens the action of histamine, so I will drink it after a course of Betaver. Please tell me a neurologist prescribed to drink Cortexin, as far as I know this drug is used after a stroke, it sets synoptic conductivity improves the growth of neurons, and improves brain activity, I'm afraid to drink it, won't it harm me? And I also prescribed Phenibud, the drug is also embarrassing because it is psychotropic and I am also afraid to drink something, what would you advise to drink or not drink? And how do you think I have BPPV? or Vistibulopathy? Or maybe the VSD? Thank. Judging by the MRI of the cervical spine and the conclusion of the ultrasound of the vessels of the neck, we can conclude that there is no pinching of the vertebral artery?

All my speculations about your disease have already been stated by me Above, read carefully. As for cortexin, I don't see any point in it. Phenibut - it is possible to try - this is not a psychotropic drug, it is a nootropic with a sedative effect, it can reduce the excitability of the vestibular nuclei, so it can help. I emphasize once again that the feeling of a state as if I drank a little is also dizziness.

Andrei 2015-07-06 10:37

Good afternoon, Ekaterina Sergeevna. I am writing to you again because I believe that you are the smartest doctor and give a correct assessment of my disease. During this period of time, I followed everything I could, the MRI passed several times, I will soon glow in the dark,) I would like to inform you that my swing and wobble went away as soon as I started to take Adaptol, my concentration of attention sharply increased, I quickly began to buzz and mastering new knowledge, pitching when walking is gone, everything became normal, now I will throw off the conclusion of my research and would like you to comment on them, please, conducted an MRI of the brain with an examination of the cerebellum, performed an MRI of the ears, and did an MRI with contrast as set questionable pituitary adenoma. All analyzes were prescribed edocrinologo in the norm I attach all the studies. I would like to note that the MRI of the ears was carried out without contrast, this is a blunder, now I do not have dizziness, everything is fine, my head does not hurt, but I still wake up with fear that dizziness will suddenly appear, tell me moderately pronounced external hydrocephalus is this the norm? Or you can drink something? And I also think I had dizziness because I do not sleep well, I do not get enough sleep, I wake up broken, I can’t fall asleep for a long time. I asked our neuropathologist for the drug Sibazon so that I would be prescribed, she said he was a narcotic drug and I didn’t need it, although we have this drug at home, I drank half a pill, somehow it didn’t work on me, she had an ENT doctor. the head of the department, having examined me, having examined the MRI images, said that I had no BPPV at all, explaining this by the fact that neuropathologists, having not understood the situation, like to put DPPG, she says I don’t see it, now I don’t know what and whom to believe, I only see probably the problem with sleep disturbance is that I don't get enough sleep feeling of depression and depressed mood, apparently this is how a factor could provoke this attack. We do not have an otoneurologist in Volgograd.

Hello again. There are no major changes in the presented studies. It is possible to reliably establish BPPV only upon examination at the time of an attack, since there are special tests and symptoms. Outside the attack, the diagnosis is probable. Dizziness can also have a psychogenic character, in favor of this is the fact that Adaptol helped you. I advise you to try not to focus on dizziness, to reassure yourself that you are doing well on research and enjoy life.

Valentine 2015-10-21 11:50

Hello, dear Ekaterina Sergeevna, I hope that you will help me to save myself. She retired in 2010 and began, in life, hypotonic, and then the pressure began to jump to 200, in 2013 I was in the psychotherapy department with depression, then from anxiety that only I was not attributed, but for the appointment I had to go to the regional hospital for 200 km, dripped 2 times a year, now they are diagnosed with astheno-neurotic syndrome, I am strong by nature, for 42 years I worked as the chief technologist of a sugar factory, but here I cannot cope. And now, with these reforms in health care, the departments in the hospital have been closed, it is difficult to get for a burial. I am trying to adapt myself, now my condition is much better, I am treated with the "typing" method, I try one thing, then another, the pressure does not jump, the state of anxiety has not passed at all, and before that they put me on Elenium and even phenazepam, began to sprinkle myself with phenotropil, glycine , pentovit, and before that I just drank, there was a whole pharmacy in the house, it dripped in the spring, and then drank all sorts of sedatives and in September drank glycine and pentovit, my condition was good, maybe it was even self-hypnosis, drank for a month, threw it and became light again alarm and on the street. It kind of rocks at times, especially if I focus on it. How to get rid of it completely? Tell me what to drink and how long? Now I would have to adapt, take a pill and so that everything is normal. People constantly drink some kind of vasodilator, nootropics, I myself do not know what combination to drink. Thank you in advance.