Do you feel dizzy when watching 3D movies? Uncovering the mystery of dizziness caused by functional balance disorder

This is the 5125th article of Da Yi Xiao Hu

I once heard a friend describe his experience of vertigo when watching a 3D movie: he was deeply attracted by the realistic and dynamic images of this racing-themed movie. Unexpectedly, after concentrating for nearly an hour, this friend felt stomach discomfort, nausea, cold sweats, and a more obvious dizziness, almost vomiting. He thought that he had a cervical spondylosis attack because he sat in the first row and looked up at the big screen for a long time. He had to stop watching the movie and rest outside the theater with the help of his companions. However, unlike his previous cervical spondylosis vertigo attacks, the symptoms this time were relieved quickly. Soon after he stopped watching the movie, a series of dizziness symptoms were alleviated. Dear readers, have you ever experienced similar dizziness when watching 3D movies and TV, playing 3D games, or using VR (virtual reality) visual equipment? This feeling of dizziness is also very similar to the experience of motion sickness and seasickness, right? Today we will talk about this type of vertigo caused by dysfunction of balance.

1. Motion sickness, "3D vertigo" and functional balance disorder

Balance sense is the perception of the human body's position, posture and relationship with the surrounding environment when in motion or at rest. After the balance sense is transmitted to the nerve center, the center will make corresponding "countermeasures" to instruct the body's motor system to adjust its posture and maintain the body's balance. If the balance sense deviates to varying degrees, the human body will have a wrong perception of its own balance state. In severe cases, it will have a strong illusion of "spinning" and "about to fall", accompanied by nausea, vomiting, cold sweats, panic, fatigue and other symptoms. This is vertigo. The human body's balance perception system includes sensory organs → afferent nerves → central nuclei (relay stations for signal integration) → central "command center" (cerebellum and hypothalamus). If these structures remain intact and there is no obvious pathological damage, but deviations or incoordination occur in the process of sensory acquisition, transmission of nerve signals and integration and processing of information by the balance center, it is a functional balance disorder. Balance is not a single sense, it is composed of three senses: vestibular sense (the receptors are the vestibular apparatus in the inner ear, which mainly perceive the balance in motion), proprioceptive position sense (the receptors are located in the muscles and joints of the trunk and limbs, which mainly perceive the balance in a static state) and vision (the receptors are the retina in the eye, which mainly participate in supplementing and correcting the perception of balance when the ambient brightness is suitable and in high-speed movement); the afferent nerves of the three receptors are the vestibular nerves, the afferent nerves originating from the skeletal muscles and various joints, and the optic nerve; and these three afferent nerves all converge into the vestibular nuclei, which are a group of cell clusters located in the brainstem, responsible for integrating the incoming balance sensory signals and "reporting" the processed and summarized results to the balance centers of the cerebellum and hypothalamus.

When we take a vehicle (car, ship, airplane, etc.), the body moves with the vehicle relative to the external environment, so the vestibular sense comes into play, while the body is stationary relative to the vehicle, and the proprioceptive sense also comes into play. At the same time, visual perception further confirms that the body is in a state of both movement and stillness. The three kinds of balance sense work together, and the center issues instructions based on the summarized information to make the body respond correctly - maintain a balanced posture, sit or stand steadily, and do not feel uncomfortable. However, if the speed of vehicles and other vehicles is sometimes fast and sometimes slow, or if they are bumpy and swaying for a long time, or they keep turning, the vestibular apparatus may feel linear acceleration and rotation in all directions beyond a certain range, resulting in strong vestibular nerve impulses, while the proprioceptive sense is relatively stationary, and there will be an obvious mismatch when the vestibular nucleus integrates information. At this time, the role of vision will strengthen this mismatch, so that the cerebellum cannot issue correct instructions, and other central parts will also respond accordingly. The body will have an obvious sense of imbalance and a series of discomfort, causing dizziness. This situation is motion sickness.

In another situation, such as watching 3D movies, playing 3D games, using VR visual equipment, etc., our body almost or mostly remains motionless, the proprioceptive sense perceives a static state, the vestibular sense does not "collect" any information, and the high-definition simulated image allows our vision to perceive the objects in front of us to be constantly moving, which creates the illusion that we ourselves are constantly moving in all directions, even at high speed. This causes a mismatch when the vision, proprioceptive sense and vestibular sense are transmitted to the "information relay station" vestibular nucleus for integration. The stronger the visual stimulation, the more obvious the mismatch, and the greater the possibility of error in the balance center, which will also cause dizziness symptoms. This is the so-called "3D vertigo".

It can be seen that the occurrence of motion sickness and "3D vertigo" is related to the mismatch and disharmony among the three senses of balance under certain conditions, which leads to temporary central function disorder; because there are individual differences in the tolerance of the balance system to stimulation signals, not all people will experience balance dysfunction under the same conditions and environment. Even the same person may not always suffer from motion sickness or "3D vertigo" under different physiological and psychological states, or the severity of the symptoms may be different.

2. How to prevent and relieve vertigo symptoms caused by functional balance disorders

As vertigo caused by dysfunction of the balance sensory system, motion sickness and "3D vertigo" can often be relieved quickly after leaving the stimulating environment. For example, when the vehicle driving becomes stable and steady, or the ship is no longer affected by the wind and waves or anchored, the symptoms of motion sickness patients are quickly alleviated and relieved; "3D vertigo" patients can quickly relieve vertigo by closing their eyes or removing 3D simulation equipment, suspending visual stimulation, taking a rest, or cooperating with small body movements. For those susceptible individuals who have multiple attacks of motion sickness or "3D vertigo", or patients with more obvious vertigo and accompanying symptoms during attacks and longer duration, you can also refer to the following relief and prevention measures.

1. Medication

Motion sickness tablets (phenobarbital/scopolamine compound preparations), dimenhydrinate, diphenhydramine, meclopramide, metoclopramide tablets, etc. are commonly used drugs to prevent and relieve dizziness, nausea, vomiting and other symptoms of motion sickness; it is generally recommended to take them about half an hour before driving/boating/flying, and they can usually prevent or relieve the symptoms of motion sickness in the next four or five hours. However, it should be noted that these drugs often have side effects such as dry mouth, blurred vision, drowsiness, and difficulty urinating/defecation. Therefore, it is important to remember: outdoor activities should be reduced within a few hours after taking the medicine, and driving, riding a bicycle or performing dangerous work operations is strictly prohibited; do not overdose on the drug; the elderly, children, pregnant women and those with glaucoma, severe prostatic hyperplasia, severe constipation, intestinal obstruction and other diseases are contraindicated or used under the guidance of a physician. If the patient's motion sickness-related symptoms are severe and last for a long time, especially if serious complications such as hypotension and arrhythmia occur, professional medical emergency help should be sought in a timely manner. Generally speaking, the symptoms of "3D vertigo" are relatively easy to relieve and usually do not require drug intervention. However, it should be noted that people with underlying diseases may suffer from acute attacks of existing underlying diseases such as cardiovascular and cerebrovascular diseases.

2. Acupoint massage and application

When taking a car, boat or plane for a long time, you can often press and massage the temples, Hegu, Zusanli and other acupoints, and use some essential oils that have the effect of calming the mind and relieving tension (such as lavender, vetiver, lemon balm, frankincense, rose, etc.). You can also try applying ginger slices or ginger powder to the navel in advance, which can prevent and alleviate the symptoms of motion sickness, and is also suitable for "3D vertigo".

3. Other prevention suggestions

① Work and rest, diet

Make sure to get enough rest before a long journey, as fatigue can easily induce or aggravate balance dysfunction; do not eat too much before taking public transportation or watching 3D movies, and avoid greasy, high-sugar foods that are difficult to digest and irritating foods. Stomach discomfort can also aggravate dizziness symptoms.

②Emotional control and behavioral habit adjustment

Avoiding emotional fluctuations and excessive mental tension is an important part of preventing balance dysfunction. In particular, those who have had multiple symptoms should relax and not be too afraid or worried, so as to avoid strong negative psychological suggestions. When riding in high-speed transportation, you can move your body and limbs slightly from time to time. At the same time, do not read books or electronic products in bumpy and shaking vehicles, and do not stare at high-speed moving objects outside the window for a long time. When watching 3D movies and using realistic visual equipment, you don’t have to be too focused. You can take off your 3D glasses and head-mounted devices intermittently to let your vision return to the real world. You can also move your body and limbs frequently. In the theater, you can choose a back seat that is a little farther away from the screen.

③Exercise

People who regularly participate in physical exercise generally have relatively strong balance regulation abilities, and are also more tolerant and adaptable to stronger stimuli; at the same time, practicing yoga, Tai Chi, Ba Duan Jin, etc. can enhance the central nervous system's balance regulation ability; children can also enhance the function of their balance system by practicing swinging, forward/backward rolling, etc.

Author: Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Ning Ying, head nurse of the emergency department