琳达·波斯特不到75岁. She is lithe, fair, active, and fit, a seeming picture of good health. 三年前, Post因为神经炎住进了医院, an inflammation in the nervous system that in her case was triggered by an infection. 经过治疗，她基本上康复了. She has not been able to resolve the dizziness that the infection seems to have triggered.
“这非常令人沮丧，”波斯特解释道 茱莉亚Noreika, PT, DPT她是一名物理治疗师 物理医学与康复.
波斯特并不是唯一一个挣扎的人
Dizziness is a common condition, particularly among women as they age.
究竟有多少人受苦尚不清楚，但是 研究 reported by the NIH notes that dizziness and/or vertigo (the terms are often used interchangeably) affect between one-fifth and one-half of the population at some point in their lives. 这种情况在50岁以上的人群中最常见, with women in that age group over four times more likely to suffer.
“随着年龄的增长，头晕是正常的，这是一种误解. 事实并非如此，”诺雷卡说.
找出病因，然后 治疗 这实际上是具有挑战性的.
她的病情
For almost three years, Post has been trying to address her dizziness. She has consulted with doctors, physical therapists, and homeopathic providers around the world. A cataract operation seems to have addressed her light sensitivity, 但她偶尔还是会偏头痛. She practices Pilates regularly and works to maintain her fitness. 她做眼颈运动. Despite all the recommendations and treatments, the dizziness persists.
波斯特说:“它已经减轻了，但并没有消失。.
晕眩的风险
Dizziness can be debilitating and affect one’s ability to function. 它是其中之一 最常见的原因 用于医疗咨询和账目 占总诊疗量的2%到3% 在急诊室.
近2600万人 in the United States needed to visit an emergency department for dizziness and vertigo over a period of 10 years (1995-2004).
Among the associated risks is a greater propensity to fall, which is the 第二大死因 在世界范围内.
幸运的是，波斯特的平衡还不错. 她已经找到了补偿的方法. 她可以闭着眼睛单脚站立. But, given she has osteoporosis, she is concerned that she is at increased 摔倒的风险尤其是随着年龄的增长.
找到头晕的根源
有三个系统影响我们的 平衡. 这些是前庭神经, 体感(即对触摸压力的感知), 疼痛, 温度, 位置, 运动与振动), 和视觉. 还有耳蜗, 前庭系统是内耳的组成部分, contributing to our sense of 平衡 and spatial orientation. Of the three systems, the vestibular is most closely associated with dizziness. Because most causes of Post’s dizziness have been ruled out through past consultations with other specialists, 波斯特在给诺蕾卡看前庭系统.
头晕测试
Noreika begins her consultation by posing a number of questions. 她请波斯特描述一下她的症状, 头晕让她有什么感觉, 是什么引发的呢?, 以及它能持续多久.
Post explains to Noreika that her dizziness worsens when she moves her head horizontally or looks up from a computer. 有时，当她醒来时，她的脖子会僵硬.
Noreika记录了这些信息, 又问了几个问题, 然后进行一系列的测试.
第一个, Noreika tests Post’s eye movement to determine if something is wrong within the brain, 脑干, 或小脑. She has Post focus on the tip of a pen and later, on the back of a wall. 她观察着波斯特眼睛的反应.
下一个, Noreika asks Post to put on goggles to test if she has benign paroxysmal 位置al vertigo (BPPV).
BPPV是由耳道内的大量晶体引起的, 导致我们耳朵里的液体流动不一样, 引起头晕. If she has the condition, Post will show abnormal eye movement when she moves her head. 她没有.
Finally, Post steps into what resembles a giant umbrella turned on its side. She puts on a harness with cords rising from her shoulders, as if she were hanging from a parachute. The machine is called a Bertec and tests all three systems of 平衡.
“It is very stressful,” says Post, who has been tested with a Bertec before. “You have no horizontal or vertical lines to tell you where you are in space."
Results show that her ability to 平衡 is above her age and gender cohort in all areas.
波斯特的诊断是什么?
“The final diagnosis is an uncompensated unilateral vestibular hypofunction,Noreika说, who believes that the neuritis from several years ago decreased the function of Post’s vestibular nerve on one side. Normally, she says, the body can compensate and adjust to some degree. 但在琳达的情况下, the brain did not and her previous therapy also did not give her the proper frequency and intensity guidelines for performing her exercises.
来解决她的问题, Noreika recommends that Post do vestibular exercises three to five times throughout the day for a total of up to 40 minutes. These gaze stabilization exercises work to fine-tune the reflex between the vestibular system and the eyes because when this vestibular-ocular reflex is not working properly, 大脑接收到的信息不匹配, 哪一种感觉是头晕.
And it is not just gaze stabilization exercises that will help Post. Noreika says she also will benefit from incorporating static and dynamic 平衡 and coordination exercises.
Results will not be immediate and Noreika believes that with added knowledge and the appropriate exercises, 情况会好转的.
如果你感到头晕
头晕可能是由内耳疾病引起的, 医疗状况, 或者其他问题，比如焦虑, 脱水, 低血糖, 药物, 晕车甚至一氧化碳中毒. 要解决这个问题，首先要找到原因. 如果你担心，可以和你的医生谈谈.
You should seek immediate medical attention if you feel dizzy and also have other symptoms. 这些可能包括:
- 疼痛, pressure, heaviness or tightness in the chest, shoulders, neck, arms, jaw, or back
- 呼吸急促（气促）
- 恶心或出冷汗
- 面部、手臂或腿部麻木或无力
- 说话、理解或吞咽困难
- 视力问题
- 混乱
如果你确实有持续的头晕，寻求帮助. 病因、预后和治疗方法各不相同. As Post has discovered, getting to the root and addressing the issue can take time.
Concludes Noreika: "A lot of people come to us having seen other providers and worry they'll live with their dizziness indefinitely. The best part of my job is when people have almost given up hope and, 通过治疗, 意识到他们可以控制和改善他们的头晕."