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Dizziness when moving or changing position

Dizziness is a common phenomenon and not necessarily pathological. The decisive factor is whether and, if so, by which head and body positions or movements it is triggered or intensified. If dizziness occurs almost exclusively with certain movements and positions, the doctor speaks of Movement dizziness or Positional vertigo. Two diseases are particularly common:

Benign positional vertigo is a common, harmless condition. When the head is positioned sideways, the smallest stones (otoliths) shift in the balance organ of the inner ear and lead to violent attacks of vertigo that last for seconds. They become weaker if they are provoked several times in quick succession. Even without treatment, the disease usually subsides after 6–8 weeks, but it can recur.

In old age, i.e. from around 75 or 80 years of age, a great many people suffer from dizziness in movement or positioning, without a tangible reason for it being found. These are often called Old age vertigo This form of dizziness is often, but not always, the result of physical changes in old age in combination with age-typical diseases and the side effects of medication.

Symptoms, their causes, measures and self-help

  • Recurring, short-term vertigo, with nausea when changing the position of the head; usually when the head is tilted or turned sideways; especially in the morning, even when getting up or sitting down

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  • Dizziness v. a. with head movements; possibly neck tension, headache, shoulder and / or arm pain; rarely sensory disturbances and / or symptoms of paralysis in the shoulders and / or arms

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  • Sudden, violent vertigo with reinforcement with head movements; often severe malaise, nausea; Improvement after hours to days, normalization usually after 2 to 3 weeks; possibly repeated occurrence

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  • Vertigo when changing position as when standing up; Sweating, nausea, palpitations; possibly turning black in front of the eyes, unconsciousness

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  • Dizziness and nausea with passive exercise, z. B. in the car or on the ship

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  • Spinning or swaying vertigo when changing position and / or head movements; Numbness; Paralysis (also of the face); Speech, swallowing and / or vision disorders; a headache

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  • Dizziness when taking medication, often intensified when changing position and / or moving the head

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  • Dizziness symptoms when changing position such as when standing up, with abrupt head movements and without any trigger v. a. in the very elderly and taking medication at the same time

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Recurring, short-term vertigo, with nausea when changing the position of the head; usually when the head is tilted or turned sideways; especially in the morning, even when getting up or sitting down

Causes:

Measure:

  • In the next few days to the family doctor

Self-help with benign positional vertigo:


Dizziness v. a. with head movements; possibly neck tension, headache, shoulder and / or arm pain; rarely sensory disturbances and / or symptoms of paralysis in the shoulders and / or arms

Root cause:

Cervical spine syndrome, e.g. B. in the case of incorrect loading and incorrect posture, for example

Activities:

  • In the case of paralysis, go to the family doctor or orthopedic surgeon on the same day
  • Otherwise to the doctor in the next few days

Self help:

  • Heat applications in the neck, e.g. B. hot role
  • Improvement of workplace ergonomics, compensatory movements
  • Back school
  • Relaxation procedure
  • Recreational sport

Sudden, violent vertigo with reinforcement with head movements; often severe malaise, nausea; Improvement after hours to days, normalization usually after 2 to 3 weeks; possibly repeated occurrence

Root cause:

  • Acute vestibulopathy (vestibular neuronitis; one-sided failure of an equilibrium organ, e.g. caused by a local circulatory disorder or a viral infection)

Measure:

  • In the event of severe symptoms, a visit by a family doctor

Self help:

  • Initially bed rest, keep your head still
  • Later balance exercises

Vertigo when changing position as when standing up; Sweating, nausea, palpitations; possibly blackening before eyes, unconsciousness

Root cause:

Measure:

  • Immediately to the family doctor after brief loss of consciousness
  • In the next few weeks to the doctor if the symptoms reappear

Self help:

  • Avoid rapid changes of position
  • Alternating showers and brush massages
  • Get enough sleep, preferably with your upper body elevated
  • Regular exercise
  • Get treatment for low blood pressure

Dizziness and nausea with passive exercise, z. B. in the car or on the ship

Root cause:

Self help:

  • Keep your head motionless, watch the vehicle move or lie down
  • Suck candy, chew gum
  • Possibly tablets or suppositories against nausea

Spinning or swaying vertigo when changing position and / or head movements; Numbness; Paralysis (also of the face); Speech, swallowing and / or vision disorders; a headache

Causes:

First measure:

  • In the event of a sudden occurrence, call an emergency doctor or go to the nearest clinic if the cause is not (yet) known

Dizziness when taking medication, often increased when changing position and / or head movements

Root cause:

Common side effect, e.g. B. from

  • Antihypertensive agents
  • Sedatives (tranquilizers) and other psychotropic drugs
  • Anti-epileptic drugs
  • Antidepressants

Measure:

  • In the next few days to the doctor or neurologist

Dizziness symptoms when changing position such as when standing up, with abrupt head movements and without any trigger v. a. in the very elderly and taking medication at the same time

Root cause:

Measure:

  • In the next few weeks to the doctor

Self help:

  • Caution and full concentration when changing position
  • As much exercise as possible
  • Circulatory stimulating measures such as alternating showers, Kneipp exercises
  • Discontinuing and changing medication (e.g. high blood pressure medication, sedatives) only in consultation with a doctor

Your pharmacy recommends

Gait and balance training.

Gait and balance training with targeted exercises and practiced positioning maneuvers improves balance reactions. For this purpose, stance and gait insecurities are caused in the affected person in a controlled manner and corrective movements are practiced until these can be called up at any time if necessary. This avoids relieving postures and avoidance behavior. Gait and balance training can take place as part of physiotherapy and may be prescribed repeatedly if necessary.

Storage training.

During positioning training, the patient repeatedly assumes a very specific body position, whereby the brain learns to suppress the nonsensical symptoms of dizziness.

Medication.

We recommend antivertiginous drugs, i.e. drugs against dizziness such as betahistine or dimenhydrinate, only for a short time and on a doctor's prescription, as they often have significant side effects such as nausea. They also improve the symptoms of acute attacks of dizziness, but do not eliminate the cause.

Ginkgo biloba extract EGb 761 offers a herbal alternative in higher doses (240 mg per day).

Liberation maneuvers.

If deposits of small calcite stones in the semicircular canal of the ear are suspected to be the cause of the dizziness, the so-called liberation maneuver helps. The stones are shifted through a practiced sequence of movements in less dizzy regions of the inner ear. The patient learns the appropriate sequence of movements from the ENT doctor and can then perform it independently at home.

Fall prevention.

Acute dizziness threatens to fall. Fall prevention measures help prevent falls and the resulting injuries. These include:

  • Use walking aids such as walking sticks and rollators
  • Adapt living space, e.g. B. attach handles and handrails to stairs and secure steep stairs, for example with protective grilles or stair nosing protectors; a change of residence may be necessary
  • Strengthen muscles through light sport or gymnastic exercises.

Authors

Dr. med. Arne Schäffler; Dr. med. Brigitte Strasser-Vogel; Section "Your pharmacy recommends": Dr. med. Arne Schäffler; Sandra Göbel | last changed on at 09:16


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.