“I was on vacation a few days ago, and I stayed up late to watch the show. But when I woke up the next morning, I rolled over and was about to get my phone when I felt I felt dizzy and felt that the whole ceiling was spinning, and I couldn’t stand and fell backward, I was so scared that I hurried back to the bed, and I had to lie in one direction to not get dizzy…although it was only for a few seconds. It still scares me enough.”
Early in the morning, Xiaomei complained to her colleagues about her recent experience.
“Are you low blood sugar? Low blood sugar will make you dizzy, and you will be fine after eating breakfast.” Colleague Xiaofu said she is very “experienced” in this regard.
“But in the next few days, as long as I wake up in the morning and turn over, I will still feel dizzy. I went to the hospital yesterday. At first, I went to the neurology department. After a while of examination, the doctor actually suggested me I went to see an otologist. I thought, could the dizziness still be an ear problem? After the otologist checked, they said that the ‘stone’ in the ear had fallen off, and I had otolithiasis, which is why I felt dizzy.”< /p>
Source: Zhanku Hailuo
Well, how come there are stones in the ears? Why does falling stone in ear cause dizziness?
We all know that the ear is the organ of hearing, but it also has a “hidden identity” – the organ of balance. Did not expect it? In the inner ear, there are structures that sense and adjust the balance of the body, including the balloon and the utricle. They have a substance that helps the human body feel the change in the center of gravity – calcium carbonate crystals, which look like stones, so they are called “otoliths”.
If this “stone” falls off for some reason, enters the semicircular canal of the inner ear, and swims in the lymph fluid of the inner ear, it will cause dizziness as the position of the human head changes. symptom. [1]
Source: Zhanku Hailuo
Medically, otolithiasis, also known as benign paroxysmal positional vertigo (BPPV), is the most common peripheral vestibular disease, accounting for about 60% of peripheral vertigo, accounting for all 1/4-1/3 of stun [2]. According to the cause, it can be divided into two types:
Idiopathic BPPV: The etiology is unknown, about 50%-97%;
Secondary BPPV: Secondary to other otologic or systemic diseases such as Meniere’s disease, vestibular neuritis, idiopathic sudden deafness, Otitis media, head trauma, migraine, post-surgery (middle ear and inner ear surgery, oral and maxillofacial surgery, orthopedic surgery, etc.) and application of ototoxic drugs, etc. [3]
Otolithiasis may have a loud medical name, but it is “as its name suggests” and has the following characteristics:
The so-called benign, is treatable and self-healing, and most people get better within a few days or weeks;
The so-called paroxysmal, most people experience dizziness for a short period of time, it is estimated that it is only a few seconds or tens of seconds, and rarely more than 1 minute. Although the time is short, it may occur repeatedly and repeatedly, which is also very annoying.
By positional, the onset of dizziness is associated with head and neck rotation. Sometimes you may turn over on the bed when you are resting or getting up, which will cause the world to spin, and may also cause nausea and vomiting; some people have the seizures when they get up or fall back on the bed, and nothing happens when they walk. [4]
In addition to dizziness, otolithiasis may also have other symptoms, including: nausea, vomiting, feeling top-heavy, unsteady balance, etc. Symptoms such as ear fullness.
Many people have encountered diseases such as dizziness, but most people don’t take it seriously. Just like the colleague Xiaomei mentioned at the beginning, many people will “self-diagnose” and think that dizziness is caused by low blood sugar and so on.
Even clinically, since there are relatively few objective signs during vertigo, and more than 80 diseases have been proven to cause vertigo, it is not easy to diagnose and identify. If the doctor in the non-vertigo clinic is not familiar with otolithiasis, it may be misdiagnosed as “vertebrobasilar insufficiency”, “cervical spondylosis”, “Ménière’s disease” and so on.
Source: Zhanku Hailuo
Father Zhang, who was nearly eighty years old, suffered a tossing experience in seeking medical treatment. When he was sleeping, he suddenly appeared unable to turn over to one side. As long as the body is turned to one side, there will be a few seconds of dizziness, accompanied by nausea and vomiting, but conscious; when the sleeping position returns to the center, the dizziness will disappear immediately.
Family took him to the hospital to see a doctor, went to the neurology department, cardiovascular and cerebrovascular department, etc., checked the head, cervical spine, heart, etc., and did CT and other inspections, but no problems were found.
After tossing and turning several times, in the vertigo specialist, the doctor diagnosed Mr. Zhang’s disease as “otolithiasis”, which solved the “dizziness” of the old man. Mystery”. [5]
Generally speaking, otolithiasis mostly occurs in middle-aged and elderly people, and it is most likely to occur when there is a sudden change in body position, such as hanging up to dry clothes, picking up high things, getting up, etc. However, as young people are under high work pressure, stay up late, and play with mobile phones and work for a long time, the incidence of otolithiasis among young people is getting higher and higher.
Especially young people who bow their heads are more likely to suffer from otolithiasis, because long-term bowing will affect the blood supply to the ears, if suddenly raise the head or change the direction of the head, it may cause the otoliths to fall off, causing symptoms such as dizziness.
Although otolithiasis is not fatal, it has a great impact on people’s lives. Once the attack occurs, you will be dizzy, and it will not be uncomfortable if you change it!
Especially the elderly, if they accidentally fall after dizziness, the harm and hidden danger to the body are very great. In addition, repeated episodes of dizziness will also make people feel irritable and anxious. Lying down and worrying about dizziness, they dare not sleep when they sleep, which may affect their physical and mental health in the long run.
Therefore, in the event of short-term sudden dizziness, vomiting, nausea and other symptoms, it is best to go to the hospital in time to clarify the cause of the disease and treat it as soon as possible.
What should I do if I am diagnosed with otolithiasis? There are two main methods of treatment of otolithiasis:
1. Reposition of otoliths:
Otolith repositioning is the main method for the treatment of otolithiasis at present. It is easy to operate and can be done by the doctor by hand or with the aid of instruments.
The principle of otolith reset is somewhat similar to the ball maze that I played in my childhood. In the maze, the balls will roll around, requiring us to move the balls to the target position. Doctors treat otolithiasis by turning the patient’s head by hand, and returning the “wandering otolith” in the “maze road” to its original position [6]. The specific reset method is as follows:
Step 1: Extend the head in a hanging position and turn the head 45 degrees to the affected side
Source: Ask Doctor Jo-youtube
Step 2: Turn your head back to midline and turn your head 45 degrees to the unaffected side
Source: Ask Doctor Jo-youtube
Step 3: Turn your body to a lying position on the unaffected side, while turning your head down 45 degrees from the horizontal
Source: Ask Doctor Jo-youtube
Step 4: Maintain this head position and return to the sitting position, with the chest bowed 30 degrees
Source: Ask Doctor Jo-youtube
In each of the above positions, hold until the vertigo and nystagmus disappear.
For the treatment of otolithiasis, regardless of the simple movements, the experience of the doctor is very important. Don’t try to reset yourself! Otherwise, otoliths may run around, causing ectopic otoliths and causing more serious conditions.
Don’t rush home immediately after the reset is successful. It is best to keep the head upright in the hospital and rest for about half an hour before leaving. It is best not to lie down and sleep within three days after repositioning. You can take a high pillow position, raise the pillow, and raise your head about 30 degrees to facilitate recovery.
2. Medication
If symptoms such as vomiting and nausea are accompanied in addition to dizziness, appropriate drug treatment can be prescribed according to the doctor’s advice.
Finally, I would like to remind everyone that although otolithiasis is a bit troublesome, it is not difficult to treat, so if you have symptoms, don’t worry too much.
Source: Tencent Medical Illustrator
References
[1][6] Yuan Hongyan, Zhang Shuxiang. Efficacy analysis of drugs and otolith reduction in the treatment of benign paroxysmal positional vertigo in the posterior semicircular canal[J]. Journal of Audiology and Speech Diseases , 2015(1):82-84.
[2] Wu Ziming. Introduction of American Academy of Otolaryngology Head and Neck Surgery BPPV diagnosis and treatment guidelines[J]. Journal of Audiology and Speech Diseases. 2009.17:502
[3-4] Editorial Board of Chinese Journal of Otolaryngology Head and Neck Surgery, Chinese Medical Association Otolaryngology Head and Neck Surgery Branch. Guidelines for the diagnosis and treatment of benign paroxysmal positional vertigo (2017). 2017 :80-86.
[5] Jiang Zidong. Otolithiasis—a type of vertigo that is easily misdiagnosed. China Medical Journal. 2014.11.28.003.
*The content of this article is for the popularization of health knowledge. It cannot be used as a specific diagnosis and treatment recommendation, nor can it replace the face-to-face consultation of a licensed physician. It is for reference only.
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