SHIHWA MEDICAL CENTER

Headache·Dizziness Clinic

Headache clinic

It is important to have an accurate diagnosis by a specialist for headaches of various symptoms.

Headache is a common symptom we experience in our daily life. As common as it is, many people misunderstand headache as a symptom rather than a disease and neglect treatment. However, headache is a disease that must be treated, and if left untreated, it can develop into a chronic headache and worsens the quality of life. In the Headache·Dizziness Clinic at Shihwa Medical Center, neurologists accurately identify the pattern and cause of headache based on abundant clinical experience and provide customized diagnosis and treatment to the patient.

Headache symptoms

Headaches have slightly different symptoms depending on the cause. Head pain may be accompanied by additional symptoms.

Meningitis and encephalitis are accompanied by symptoms such as fever and vomiting, and headaches tend to persist. In addition to headaches, brain tumors can also cause symptoms such as vomiting. If headache is accompanied by symptoms such as vomiting, care needs to be taken because an organic problem is highly likely to be in the brain.

Headache symptoms that must be examined

1In case of sudden onset of severe headache
2In case it is accompanied by paralysis of the body or sensory abnormalities
3The first headache after age 50
4In case of fever and nausea accompanied by severe headache
5If headache occurs while lifting heavy objects or using force

Types of headache

Primary headache A chronic persistent or recurrent headache with an unknown cause. Migraine, tension headache, cluster headache, headache of unknown cause
Secondary headache Unlike a primary headache, there is a disease that causes the headache, which is characterized by stronger pain than a primary headache and sudden symptoms and is often accompanied by neurological symptoms. Trauma, cerebrovascular disease, organic brain disease, facial disease, drug, infectious disease, medical disease

Diagnosis of headache

Headaches vary from person to person and are very complex and varied. Therefore, it is difficult to determine whether it is a secondary headache with the symptoms of the headache alone. A detailed history and accurate examination are needed to decide if it is a secondary headache. And, if there is any suspicion of a brain disease, it is essential to perform an appropriate examination such as CT or MRI. Usually, MRI is used to identify the cause of a headache, other than a brain hemorrhage. In addition, a cerebrospinal fluid examination and cerebrovascular examination are performed to diagnose meningitis and subarachnoid hemorrhage.

Headache Prevention

- Get regular sleep.
- Do light exercise regularly.
- Avoid overeating and eat on time.
- Try to think positively and optimistically.
- Try to properly relieve mental and physical stress.
- Do not continue working in a row, but take a break.
- Don't put up with the headache too much, and seek professional help whenever necessary.

Dizziness Clinic

We identify the cause of dizziness and provide proper treatment customized for the patient's conditions.

Dizziness, along with headaches, is the most common neurological symptom. In addition to a mild headache, repeated and continuous dizziness occurs, sometimes resulting in a serious disability. In case of chronic dizziness, it is important to identify the cause for proper treatment, since several factors often are involved in a complex manner.

Symptoms of dizziness

The symptom of dizziness is the illusion that surrounding things are felt to be spinning, which is very unpleasant, sometimes accompanied by nausea and vomiting.

Many patients visit the hospital for as nausea and vomiting, which are more difficult to deal with, than for dizziness itself, and postural and gait abnormalities are common. In severe dizziness in which surrounding things are felt to be spinning, the eyeball itself does not stand still and moves, and surrounding things are felt to be shaking left and right or up and down.

Dizziness symptoms that must be examined

1In case it is accompanied by numbness in the limbs or facial paralysis
2In case of high blood pressure or diabetes, or a family history of a stroke
3In case the ground is felt to be slightly tilted or wobbly even when standing still
4In case you suddenly feel dizzy and visit the hospital or an ENT clinic, but you hear that there is no abnormality in your ears
5In case of no improvement in symptoms after taking iron supplements for anemia
6If a dizziness-like symptom persists or it recurs when you turn your head

Types of dizziness

Peripheral dizziness

Cupulolithiasis (Benign Paroxysmal Positional Vertigo) It is dizziness that occurs when you suddenly change the position of your head or body. Rotary vertigo usually ends within 30 seconds, but after that, you may feel dizzy for a few hours or all day. Also, it is usually worse in the morning and improves in the afternoon. It occurs more frequently in older people and is caused by small stone fragments in the semicircular canal. A treatment called canalith repositioning procedure is performed in which the stone fragments of the semicircular canal are returned to their original position.
Meniere's disease It is a disease in which the endolymph fluid in the semicircular canals accumulates, causing damage to the auditory nerve cells. Symptoms include recurrent dizziness and reduced hearing. In case of reduced hearing, hearing for low sounds is initially diminished and progresses slowly. As the disease progresses, hearing for all high and low sounds gradually deteriorates. Accompanying symptoms include ringing in the ears and stuffiness in the ears. However, sometimes while the symptoms are just repeated, they get better on their own. A low-sodium diet and medication may help.
Vestibular neuritis Deep in the human ear, there are the vestibular organs and semicircular canals, which are responsible for balancing the body posture. The nerve that receives sensation from this structure is called the vestibular nerve. For some reason, the vestibular nerve becomes inflamed, causing severe dizziness and nausea, and difficulty in balance. This is called vestibular neuritis.

Central dizziness

Central dizziness is caused by abnormalities in the central nervous system, including the brainstem, and can result in serious sequelae if diagnosis and treatment are delayed.

Brainstem ischemia Dizziness may appear as a precursor to stroke without other symptoms. It is difficult to distinguish it from simple peripheral dizziness for ordinary eyes. In particular, when dizziness and staggering persist for several minutes in patients with stroke risk factors such as high blood pressure, diabetes, and hyperlipidemia, the possibility of stroke should be considered. Therefore, it could be a life and death situation, so stroke examination is a must.
Cerebellar disease The cerebellum is functionally closely related to the vestibular nervous system. Strokes, tumors, hemorrhages, and inflammatory diseases of the cerebellum are also common causes of dizziness. Dizziness is also seen in brainstem tumors that affects the vestibular nervous system.
Migraine Rarely, migraine patients also experience recurrent headache and dizziness. Some patients complain of only dizziness without a throbbing headache, so migraine should be checked.

Dizziness examination

- Videonystagmography
- There are many cases in which brain and vestibular system diseases cause dizziness, but the organs are not visible, hidden inside the body. So there is no way to check it from outside the body. Because there are many cases of dizziness causing abnormal eye movement, close observation of the eye movement can help determine the cause and help with treatment.
- Frenzel test
- Nystagmus is when both eyes move quickly and regularly in one direction at the same time. Frenzel goggles are put on to accurately observe and analyze these eye movements. So, we analyze the nystagmus in different postures, when you are still, when you change your posture, and when you shake your head, to identify the cause.
- Vestibular evoked myogenic potential (VEMP) test
- The VEMP test records information about the contraction of the cervical muscles due to stimulation of the saccule in the ear during auditory stimulation. This test is used to evaluate the function of the vestibular nerve, which is responsible for the balance and position sense in our body. Attached electrodes are used to measure the reaction. This test is used to precisely examine the otolith organs that cause dizziness and Meniere's disease.
- Rotatory chair test
- This is a test performed to check the function of the semicircular canal, which is responsible for the equilibrium, while the chair is rotated in an enclosed room. This test is used to distinguish between unilateral and bilateral disorders of balance function and between central and peripheral disorders. It also helps to identify the degree of compensation in case of vestibular disorders and is used to determine the effectiveness of vestibular rehabilitation exercises.

Treatment of dizziness

There are symptomatic therapy, specific therapy, and vestibular rehabilitation therapy. Symptomatic therapy uses vestibular inhibitors and antiemetics to relieve the symptoms of dizziness and vomiting. Specific therapies include special drugs or surgery for each disease. In vestibular rehabilitation therapy, semicircular canal stone reduction surgery and vestibular rehabilitation exercise are performed according to the disease to promote the functional recovery of the damaged vestibular system, thereby improving the symptoms. As dizziness has various causes and treatments, it is important to consult a neurologist.

(15034) 381 Gunjacheon-ro, Siheung-si, Gyeonggi-do, Republic of Korea
(Medical Corporation) Namchon Medical Foundation Shihwa Medical Center

Representative: Choi, Byeong-Chul / Business Registration Number: 807-82-00237

Inquiries: 82-31-5189-0594