Systemvertigo

Systemvertigo is a term used in some medical discussions to describe vertiginous episodes that appear to be linked to systemic disturbances rather than primary inner-ear pathology. It emphasizes the role of whole-body physiology in triggering or modulating dizziness and imbalance.

The proposed concept views systemvertigo as resulting from interactions between the vestibular system and systemic factors such as blood pressure regulation, metabolic state, hydration, and systemic infections. Potential mechanisms include transient reductions in inner-ear perfusion, electrolyte or acid–base imbalances, and drug interactions that affect vestibular or central processing of sensory information.

Common triggers and associations include cardiovascular instability (orthostatic hypotension, arrhythmias), dehydration, hypoglycemia, electrolyte disturbances (sodium, potassium, calcium), thyroid or adrenal dysfunction, sepsis, and polypharmacy with vestibulotoxic or sedating medications. Symptoms typically include spinning or swaying vertigo, lightheadedness, imbalance, nausea, and sometimes visual disturbances, often worsening with changes in posture or systemic stress.

Diagnosis relies on a thorough clinical history focused on systemic illnesses and vital signs, targeted blood tests, and exclusion of primary peripheral vestibular disorders. Vestibular function testing and imaging may be used when indicated. The approach combines treating the underlying systemic condition with short-term symptom control.

Treatment generally centers on managing the systemic disturbance (fluid balance, metabolic stabilization, infection control) and, when appropriate, vestibular rehabilitation. Prognosis varies with the underlying cause; some cases resolve with correction of systemic factors, while others may persist if systemic disease is chronic or recurrent. See also vertigo, vestibular system, orthostatic intolerance.