Dizziness, nausea, headache, fatigue: What you need to know

The article is professionally consulted by Master, Doctor Nguyen Thi My - Department of Medical Examination & Internal Medicine - Vinmec Danang International Hospital.

Sudden dizziness and nausea are very common in public life. Everyone meets them at least once in their life. However, in some people, the ongoing condition is actually a medical condition. The information below will give more knowledge about this disease, its causes, as well as its treatment and prevention.

One morning, the patient woke up, opened his eyes, was about to get up to get out of bed, but suddenly felt a strong dizziness. The patient feels that everything around him is spinning, houses are collapsing, tables and chairs are moving or somersaulting. This will naturally come to them, causing them to inevitably panic and fear. At this time, the more they worry, the more intense they will feel dizzy and dizzy. In some cases, there are also nausea, vomiting, headache, fatigue.
This condition is very common in the population, especially in middle-aged people, more women than men. The prominent feature is that dizziness is often related to posture, increases when the patient sits up, turns the head and decreases, completely relieved if they lie still, close their eyes. That's why this condition is called "benign paroxysmal postural vertigo" in medicine. Episodes of vertigo often appear in series that last for a few days to a few weeks, then go away on their own and will return after several months to several years.
However, in some cases, the symptoms of headache, dizziness, nausea, vomiting do not change or decrease with the position and rest, it is necessary to think of a more dangerous neurological disease: cerebral infarction, In this case, the patient should go to a medical facility for examination, monitoring and emergency treatment.

As the name suggests, benign postural vertigo does not cause serious complications.
In the case of vertigo, the patient is very scared, extremely worried, feeling that the house is spinning like upside down, tilted. However, they will find themselves that when turning their head, looking around will make symptoms worse, promote nausea, vomiting, so they tend to close their eyes and lie still. After that, the dizziness will subside on its own for a minute or two before disappearing completely.
In other words, the disease is completely benign if the patient rests on the bed, be careful not to fall, get injured if trying to walk.
Besides, when examining, doing tests, brain imaging will not record any abnormal signs. The patient is completely free of paralysis or has any focal neurological signs; Ear examination was also normal, with no changes in hearing.

To date, there have been many theories about the cause of benign paroxysmal vertigo, but most of them have not been clearly proven. Of these, the hypothesis of the presence of small stones in the cochlea seems more convincing.

The vestibule is considered a sense, sensing posture in space, thereby helping to maintain stability, body balance, posture as well as coordination of eye, head and trunk movements. The vestibular system includes a receptor, the semicircular canal located in the cochlea, nerves that conduct and analyze signals in the brain.
The cochlea attaches with three rings of semicircular canals, arranged in three different spatial planes. The circulation of fluid in the semicircular canals helps the body to orientate the posture. Therefore, when the body changes in a certain direction, the stone particles moving in the semicircular canal in that plane will stimulate the vestibular system, send signals to the brain, and initiate the sensation of dizziness. . As a result, the body has a reflex to lie still, keeping the head position where it feels most secure. The pebbles do not move anymore, the feeling of dizziness will subside.
Besides, it is necessary to make a differential diagnosis with other diseases that also have symptoms of dizziness when central and peripheral vestibular organs are damaged such as inflammation, sclerosis, degeneration to ischemia, bleeding or trauma. The difference, however, is that the vertigo in these conditions has nothing to do with posture.
See more: Is it dangerous to have frequent headaches, nausea, and dizziness?

Benign paroxysmal vertigo is exactly what the name suggests if the patient knows how to avoid triggers, adhere to vestibular stabilizers, and perform maneuvers to reposition the semicircular canal.

At all times, always remember not to change positions suddenly and quickly. Specifically, when changing from a lying position to sitting up, standing up or turning the head, bowing and tilting the head must also be done slowly and slowly. It is best to close the eyes to limit the visual reception of spatial change signals, reducing vestibular stimulation. After establishing the pose at the new position, slowly open your eyes.
If you notice that dizziness often occurs when you wake up, then in your sleep, you should use many pillows to prop your head up, should lie on your back, avoid leaning to one side.
In addition, do not sit in a swivel chair or chair with a headrest that leans back too much, limit excessive leaning and bending movements such as picking up things, tying shoelaces.

Groups of drugs can assist in the correction of dizziness during acute attacks as well as the relief of symptoms of nausea and vomiting.
Antihistamines should only be used when the patient has severe dizziness that does not improve much after stabilizing the posture. Some sedative drugs can be added if the person is overstimulated, anxious, scared.
However, drugs acting on the central nervous system will have side effects such as drowsiness, lethargy, and dizziness that are difficult to completely go away. Therefore, it should only be used when absolutely necessary and adhere to the dosage as directed by the doctor.

Currently, the treatment of benign paroxysmal vertigo tends not to use drugs but to apply exercises to reposition the stones in the semicircular canal, helping the vestibular system to recover and adapt to the displacement in the air. body space.
Exercises can be done at the clinic with the support of physiotherapists or the patient can practice at home. If done correctly and patiently, unpleasant symptoms will improve significantly.

When dizziness occurs, it is necessary to stay calm, close your eyes, limit your head rotation and find a suitable position to rest. If you feel nauseous, you should control it by taking deep breaths and focusing on your breathing. Just follow this, the dizziness will quickly subside in a few minutes.
Do not walk long distances, do heavy work, climb, operate vehicles or machinery when dizzy. Because these things cause more severe dizziness, lasting longer, and can even cause accidents for yourself and others. Keep the space in the room, the aisle clear, avoid messy and indiscriminate items. Add handles in bathtubs and toilets. Drink enough water every day, eat a balanced, varied diet rich in vitamins and minerals. Avoid drinking coffee, alcohol, carbonated soft drinks. Do not use stimulants, smoke or be exposed to secondhand smoke. Get enough sleep, rest in moderation, think optimistically. Have appropriate and moderate exercise habits. In summary, benign paroxysmal positional vertigo is a common disease in the community. Information about the disease, how to respond and prevent it is essential to overcome these unpleasant symptoms and enjoy life confidently.
Master. American doctor has more than 6 years of experience as an internal medicine doctor at Hue Central Hospital, Hue University of Medicine and Pharmacy Hospital; Tam Tri Da Nang Hospital; Danang Hospital. Currently, he is a General Internal Medicine Doctor at Vinmec Da Nang International General Hospital.