That spinning feeling
One group consults him directly because they are dizzy and suffering from tinnitus, a condition where the patient has persistent ringing in the ears.
The other, the larger group, consists of those who have symptoms such as nausea and have already undergone through treatment in various departments, without being cured or even diagnosed.
One of his patients was a 70-year-old man who felt dizzy and nauseous whenever he turned over on his left side in bed.
His family sent him to the emergency room, fearful that it could be a stroke.
It was not a stroke, but there was no clear diagnosis, and the old man went through various checks and tests in the neurology, otolaryngology, and orthopedics departments in many hospitals.
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He finally came to Jiang and was diagnosed with benign paroxysmal positional vertigo (BPPV), a condition caused by faulty nerve signals sent by the dislodged otolith, a sensory organ in the middle ear that is part of a system that senses gravity and linear movements.
Liu Bo, another ear, nose and throat specialist at Beijing Tongren Hospital, says the differences in intensity and duration of the giddy spells, coupled with the appearance of other symptoms, will help doctors decide what causes the dizziness.
For example, if one feels only vertigo or a fear of falling, the problem is probably in the ear.
If there are also symptoms of headaches, double vision, numbness in the limbs and so on, the underlying condition is probably in the nervous system.
If the patient feels dizzy only when he turns his head at a certain angle, he is probably suffering a problem with his inner ear.
But if he is dizzy whenever he turns his head, no matter which angle, then it is probably something wrong with his cervical vertebrae.
"Most patients come to the department of neurology first. We cannot say this is wrong, because dizziness is linked with stroke and can be very dangerous," says Chai Bin, a neurologist with Beijing Tiantan Hospital, a leading neurological center in China.
Chai says about 15 percent of her patients suffer dizzy spells.
Among them, many more senior patients are likely to have cerebrovascular diseases, when the body cannot function properly due to a faulty blood supply to the brain, like in hypertension.
Most younger patients who complain of being giddy, however, are suffering from depression or anxiety.
"In China, there are hospital departments specializing in pain, but there is no department dealing with dizziness," says Li Zhongshi, director of the orthopedics department at the China-Japan Friendship Hospital, Beijing.
So while it is still very much a hit-and-miss process in the diagnosis of one of the most common symptoms to afflict patients, the ultimate advice is still to seek treatment early, and not to dismiss the dizziness as mere inconvenience that may go away on its own.
Contact the writer at liuzhihua@chinadaily.com.cn.
