Dizziness is a symptom encompassing terms such as vertigo, being wobbly, unstable falling over a lot, or being unable to walk a straight line or pass a drunkenness test.  Conditions like Meniere’s disease  (usually associated with hearing loss) are discussed.  The significance of symptoms under the Paill Spectrum model is discussed.

Dizziness

This symptom may often be referred to as vertigo, loss of balance, the spins, unsteady, syncope, sick in the head, funny in the head, woozy, unstable, instability, nystagmus wobbly or the wobbles. Some people use the terms faintness, faints or blacking out or washing out.

But terms suggesting “faintness” should probably be reserved for different circumstances to simple wobbles Back to Dizziness top

People use many of these terms interchangeably. I.e. Many people use the same words to describe different symptoms. Medical definitions of dizziness also often vary from patients’ definitions of the same term. So the term “dizziness” is a term that may mean different things to different people.

 

In general medical terms, dizziness implies a loss of balance or unsteadiness or instability. People are not faint. They do not have vision or hearing blackout, triggered by posture change such as standing up. People describe dizziness as feeling like they are moving or wobbling. They are a little unsteady. The symptoms of dizziness can indeed be very brief and may also be only present if triggered by specific circumstances such as movement, typically getting out of bed or rolling over in bed. If the movements of the head are rapid, the symptoms become much more likely to be experienced by the patient.

 

Dizziness arises from the balance organs of the inner ear. These are called the semicircular canals and the labyrinth of the ear. There are three semicircular canals, all positioned at mutual right angles to each other. These sense movement in different planes.  The planes sensed might be summarized as:

• forward – back
• Side to side
• Up and down. Back to Dizziness top

By sensing movement in these directions the balance organs of the body keep the body on a steady keel or balanced.   Although the body relies often on these organs for balance, vision is a much more sensitive indicator of position sense or balance, and many people learn to rely on this sense (vision) to stop them falling over. Problems then will only arise when people cannot use their vision to balance, such as may typically occur when someone goes to the toilet in the dark at night.

The symptom of dizziness become much more important as people age. Decreasing muscle strength and decreasing visual acquity (visual sharpness) result in a decreased ability to recover form a wobble. People fall over and may break bones: a very serious problem in the elderly if it affects the main leg bones such as in the hip or in the femur (thigh bone). Back to Dizziness top  

Dizziness

This symptom may often be referred to as vertigo, loss of balance, the spins, unsteady, syncope, sick in the head, funny in the head, woozy, unstable, instability, nystagmus wobbly or the wobbles. Some people use the terms faintness, faints or blacking out or washing out.

But terms suggesting “faintness” should probably be reserved for different circumstances to simple wobbles.

So what causes Instability?

Acute labyrinthitis is the most common diagnosis made in younger people; especially where there are short periods of instability of up to say two weeks. The condition is described as being due to a virus. The symptoms disappear and the patient recovers, with no suspected long term injury or damage. Back to Dizziness top  

 

Meniere’s Disease is the most commonly made diagnosis in older patients, especially where the symptoms keep on recurring in the long term. The syndrome or disease description also includes loss of hearing, typically affecting predominantly the higher frequencies.

Acute attacks often classically show a clinical or audiological (hearing test) response to treatment with osmotic diuretic agents such as glycerine. (People drink a solution with this chemical dissolved in it. It makes them get rid of fluid out of the body via the kidneys. This is thought to change the fluid saltiness and pressure in the inner ear, hence giving relief to the attack of Meniere’s). Because of this response to fluid generating agents, the instability arising in Meniere’s, is believed to related to changes in Sodium and Potassium salt levels in the labyrinth of the inner ear. It is apparent that Meniere's disease arises due to complex pathological changes that change how the inner ear works.

This entire complex pathological process in Meniere's Disease is generally attributed to “degeneration” of the inner ear. It all happens simply because of age. The Paill Spectrum model predicts that it all happens because of a slow disease process affecting the nerves of the inner ear. Back to Dizziness top  

 

There is another condition called Benign Positional Vertigo. This arises acutely, displaying very prominent symptoms exacerbated by head movements. It is thought to be due to the loosening of crystals (otoliths) in the inner ear. The condition is believed to resolve spontaneously, with no long-term injury or damage.

So what does the Paill Spectrum Model Predict?

Many patients have clinically assessable balance problems, of which they are totally or only peripherally aware. They do not see a doctor. Why should they see a doctor, when they have not noticed any symptoms of any problems. No one is looking (doctors, relatives or the patient) and no one is complaining.

Many patients experience very brief minor wobbles or dizziness. The symptom resolves. The patients are often reassured by the temporary nature of the symptoms, an assessment reinforced usually by medical personnel.

Patients with acute labyrinthitis more commonly seek medical help. Many patients resolve spontaneously, no matter what the doctor does or does not do. A percentage of the patients however, fail to settle over two weeks and may in fact have symptoms persisting up to 6 – 8 weeks. It is in these patients that it is obvious that Paill Spectrum type therapy could make a difference to the presence of symptoms. Paill Spectrum therapy can also make a difference to patients with early clinically assessable unsteadiness, but often typically once the damage is done, the damage is done. Back to Dizziness top  

 

 

The Paill Spectrum model predicts that dizziness at any level is a significant symptom. The symptoms may be temporary and erratic in presentation, but they may predict the presence of a long term and slowly progressing disease process.

 

 

The Paill Spectrum model predicts that signs of loss of balance, brief wobbles and acute labyrinthitis may all be symptoms of the same disease processes at different stages and different ages. In its end stages, this disease process destroys the nerves of the inner ear with a loss of balance and a loss of hearing becoming evident. This clinical scenario then begins to resemble Meniere’s disease. Back to Dizziness top

 

The Paill Spectrum model predicts that Meniere’s disease as the end stage of a long process of infection, will respond only to a minor extent to Paill Spectrum therapy. The nerves once damaged will not regenerate. Paill Spectrum therapy can stabilize the condition, but resolution of the symptoms may well be impossible.

 

If there is extensive Paill Spectrum involvement of the inner ear, Paill Spectrum therapy may well control the infection at the price of eliminating the infected nerve tissue.

So undertake Paill Spectrum therapy in older Meniere’s disease patients with extreme care, especially monitoring audiometry results (hearing tests) as treatment progresses. What problems develop, are likely to develop in time in any case.

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Discusses a new explanation of dizziness also known as vertigo, loss of balance, wobbles, unsteady. The condition is believed to affect the inner ear. The Paill Spectrum model of conditions like acute labyrinthitis or Meniere disease proposes new alternative treatments for illness. The Paill Spectrum model of disease also proposes a definition of the illness in terms of symptoms, signs, investigations and response to treatment. Download the clinical assessment file from the Download Page.

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