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The Scenario:
Clara was a hard worker. She was employed as an executive assistant, but unlike many of her co-workers she put in some very long hours. Mostly this was due to her fondness and respect for her boss, a woman with tremendous energy and skill who really seemed to value Clara's extra efforts.
One afternoon at work, Clara began to experience a runny nose and a tickling sensation in the back of her throat. She didn't think much of it, took some vitamin C and echinacea, and went to bed early that night. In the middle of the night she got up to go to the bathroom. As soon as she raised up off of the bed she got an intense spinning sensation. She caught herself from falling by holding onto the bedpost, then nearly threw up as a wave of nausea went through her. The symptoms lasted for a miserable ten or fifteen minutes before easing up. She went back to bed. But every time she tried to get up the same thing happened.
Questions:
Answer:
Clara has the symptoms of vertigo. Vertigo is an intense form of dizziness that causes a sensation of spinning: The whole room, or the whole world, seems to spin around you. Anyone who has gotten smashed drinking alcohol will likely know what this feels like. Vertigo is a bit different from plain dizziness, as dizziness usually refers to a condition of feeling lightheaded, or woozy, or unsteady on the feet. Dizziness is a milder, less specific, sensation and can be due to all kinds of different things.
Vertigo, because it causes this distinctive spinning sensation, is associated with a more limited list of possible diagnoses involving the ear or the brain. In Clara's case, her vertigo is likely caused by a viral upper respiratory tract infection (her runny nose and scratchy throat are the clues). Sometimes, these infections affect the labyrinthine gland in the middle ear chamber. The labyrinthine gland acts as a movement sensor. It is made up of a whorl of fluid-filled canals. The inner lining of the canals are made up of cells that have little sensing hairs attached to them. The movement of the fluid triggers the hair cells, which in turn send signals to the brain that indicate you are moving. The theory goes that when a viral infection gets into this gland, the irritation causes it to go haywire, sending false signals of rapid movement. In getting up out of bed or a chair, or in turning one's head rapidly, the hypersensitive gland will over-react and cause the vertigo.
Many people wondered if her symptoms were caused by a brain tumor. This is possible, but fortunately, unlikely. A few recognized that certain kinds of stroke (a blood clot or hemorrhage in the brain) may also cause vertigo. And Meniere's disease, a chronic condition that causes vertigo, loss of hearing, and ringing in the ears, is another possibility.
In the setting of someone young, with no previous symptoms, and with a typical respiratory infection, odds are very high that her symptoms are due to a virus, and will go away of their own accord.
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