Vertige

En deux mots :

Quand on a l'impression que ça tourne autour du corps ou bien la sensation que le corps tourne alors que rien ne tourne.

 

Explications :

 

Le vertige n’est pas une maladie. C'est un symptôme, de même que la fièvre ou bien la douleur.

Un vertige est donc le reflet de différentes affections des plus bénignes aux plus graves. Des dizaines de causes existent, pouvant se cumuler l'une à l'autre.

Les plus fréquent des vertiges sont des VPPB (Vertige Positionnel Paroxystique Bénin). Relativement bénins, ils représentent environ 70 % des cas (voir ici les 5 caractéristiques du VPPB postérieur). Ils se traitent en ostéopathie vestibulaire.

Pourtant, 80% des diagnostics initiaux de vertige évoquent la « maladie de Menière ». Elle ne représente en réalité que 10% des vertiges. Les vertiges liés à une diminution de l’apport sanguin du cerveau à cause d’une arthrose cervicale existent, mais sont encore plus rares. Il faut aussi citer les causes métaboliques, comme l’anémie par exemple, qui nécessitent un diagnostic et un traitement médical (oral ou local). Certaines malformations donnent des vertiges, etc. Dans certains cas, le traitement est chirurgical. Il est incontournable lorsque son rôle est de sauvegarder l’appareil vestibulaire. La kinésithérapie vestibulaire est aussi souvent proposée. Si l'inconfort persiste malgré tout, on peut compléter avec de l'ostéopathie vestibulaire.

 

Comment s'orienter ?

Lorsque, malgré une approche médicale complète, les traitements proposés sont insuffisants, il faut alors penser à la composante fonctionnelle des vertiges. C’est le rôle du posturologue d’établir un bilan progressif des dysfonctions du patient pour déterminer les actions à mener pour y remédier. L’ostéopathie est alors souvent nécessaire, en complément et en accompagnement d’autres traitements (dentaire, psychologique, ophtalmologique, …)

Arborisation diagnostique : Vertige, comment s'orienter ?

Exemple : Le « vertige du carreleur » se produit lorsqu’une personne ayant accompli une tâche au sol se relève brutalement. Considéré comme physiologique par la communauté médicale, il signe néanmoins un retard transitoire de l’adaptation cardio-pressionnelle à la verticalisation souvent confondue avec une hypotension orthostatique. Cette anomalie fonctionnelle est très souvent liée à un syndrome postural pour lequel l'ostéopathie vestibulaire est indiquée.

 

À retenir :

 

Références scientifiques :

Lindner et al. - Ginkgo biloba Extract EGb 761 Improves Vestibular Compensation and Modulates Cerebral Vestibular Networks in the Rat. Front Neurol. 2019 Feb 25;10:147. doi: 10.3389/fneur.2019.00147. eCollection 2019.

Allum JHJ1,2, Langewitz W1, Sleptsova M1, Welge-Luessen A2, Honegger F2, Schatz TH3, Biner CL3, Maguire C3, Schmid DA1,2. - Mental body transformation deficits in patients with chronic balance disorders. J Vestib Res. 2017;27(2-3):113-125

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