Vertigo (cont.)

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What is the treatment for vertigo?

While some vertigo is self-limited and may be treated with medications, vertigo from BPPV or labyrinthitis is often treated with physical therapy. Using Epley maneuvers, the head is taken through a variety of positions and manipulated to clear debris (crystals) from the semicircular canals and to reduce the inflammation that the debris causes.

Medications like diazepam (Valium) and meclizine (Antivert) are used to decrease inflammation within the vestibular system.

Some patients are placed in a soft collar to limit range of motion of their heads while the vertigo gradually resolves.

If there is concern that there is a viral infection causing the labyrinthitis or neuritis, antiviral medications like acyclovir (Zovirax) or valacyclovir (Valtrex) may be considered.

Patients with acoustic neuroma or other structural problems of the ear may require surgery.

Patients with central causes of vertigo need further investigation and treatment will be tailored to their specific underlying diagnosis.

Can I care for vertigo at home, and can vertigo be prevented?

Balance disorders are often unpredictable. Depending on the cause, symptoms may occur at any time, even after long periods of without any symptoms. It is important to be cautious in order to avoid accidents that could be caused by a balance disorder.

People with vertigo symptoms or people that have a tendency to develop vertigo may reduce or eliminate the symptoms by doing the following:

  • Change your position slowly, especially when going from a lying or sitting position to a standing position. When you get out of bed, sit on the side of the bed for a few seconds to gain your orientation and allow your circulatory system to adjust.
  • When walking, focus on distant objects. Do not look down at your feet. Avoid walking in dark areas or on unstable ground. Falls at home occur when the floor covering changes from carpet to tile or linoleum.
  • When riding in a car, try to sit in the front seat. Look out the window at a fixed point. When going around curves, look at a distant object beyond the curve.
  • Make certain eye glass and hearing aid prescriptions are current.
  • Use a cane, walking stick, or walker for support and to give additional pressure and touch (tactile) orientation.
  • Avoid activities that move the head up and down repetitively.
  • Try to avoid keeping the head tilted back for long periods of time, for example painting or dusting above your head.
  • Be cautious when using medications that may cause balance problems as a side effect.

If a person is having an episode of vertigo, he/she should not drive or operate machinery until their doctor says it is safe to do so. People who are subject to sudden instances of vertigo should also avoid climbing ladders or participate in other situations that may be dangerous to themselves or others (for example, hiking alone or taking care of children), should they suddenly feel an episode of vertigo coming on.

Medically reviewed by Jon Glass, MD; American board of Psychiatry and Neurology

REFERENCES:

eMedicine.com. Dizziness, Vertigo, and Imbalance.
<http://emedicine.medscape.com/article/1159385-overview>

Goldman L. et al. Textbook of Medicine 23rd edition. Saunders Elsevier 2008


Medically Reviewed by a Doctor on 1/6/2014

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