Vertigo medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*[[Acute]]/severe attacks of vertigo usually subsides in a day or two after brainstem compensation.<ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref> | *[[Acute]]/severe attacks of vertigo usually subsides in a day or two after brainstem compensation.<ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref> | ||
*Supportive therapy includes bed rest, [[antihistamine]], [[antiemetic]] to relief the [[symptom]]. | *Supportive therapy includes bed rest, [[antihistamine]], [[antiemetic]] ([[prochlorperazine]], [[metoclopramide]]), [[benzodiazepines]] ([[diazepam]],[[lorazepam]]) to relief the [[symptom]]. | ||
*[[Meclizine]] is the common [[antihistamine]] used and is safe in [[pregnancy]]. Other [[antihistamines]] used are [[betahistine]] and [[dimenhydrinate]].<ref> Khilnani, AK; Thaddanee, R; Khilnani, G (July 2013). "Anti vertigo drugs-Revisited". National Journal of Integrated Research in Medicine. 4 (4): 118–28.</ref> | *[[Meclizine]] is the common [[antihistamine]] used and is safe in [[pregnancy]]. Other [[antihistamines]] used are [[betahistine]] and [[dimenhydrinate]].<ref> Khilnani, AK; Thaddanee, R; Khilnani, G (July 2013). "Anti vertigo drugs-Revisited". National Journal of Integrated Research in Medicine. 4 (4): 118–28.</ref> | ||
*[[ | *[[Scopolamine]] ([[hyoscine hydrobromide]]) is a common [[anticholinergic]] used to treat the symptom.<ref> Khilnani, AK; Thaddanee, R; Khilnani, G (July 2013). "Anti vertigo drugs-Revisited". National Journal of Integrated Research in Medicine. 4 (4): 118–28.</ref> | ||
*Due to the [[sedative]] effect of these drugs they should be used carefully in the elderly. | *Due to the [[sedative]] effect of these drugs they should be used carefully in the elderly. | ||
*These drugs should not be used for a long period of time as it may delay the compensatory mechanism in the [[brainstem]] and result in the prolongation of vertigo [[symptom]]. | *These drugs should not be used for a long period of time as it may delay the compensatory mechanism in the [[brainstem]] and result in the prolongation of vertigo [[symptom]]. | ||
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![[Benign paroxysmal positional vertigo]] | ![[Benign paroxysmal positional vertigo]] | ||
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*Effective [[maneuvers]]:[[Epley maneuver]], [[Semont maneuver]], [[Brandt–Daroff exercises]], [[Roll maneuver]].<ref>{{cite journal|journal=Cochrane Database of Systematic Reviews|issn=14651858 | *Effective [[maneuvers]]:[[Epley maneuver]], [[Semont maneuver]], [[Brandt–Daroff exercises]], [[Roll maneuver]].<ref>{{cite journal|journal=Cochrane Database of Systematic Reviews|issn=14651858</ref> | ||
*Medical: [[Antihistamine]]([[meclizine]]) and [[anticholinergic]]([[scopolamine]]).<ref>"Meclizine Hydrochloride Monograph for Professionals". American Society of Health-System Pharmacists. Retrieved 22 March 2019</ref> | *Medical: [[Antihistamine]]([[meclizine]]) and [[anticholinergic]]([[scopolamine]]).<ref>"Meclizine Hydrochloride Monograph for Professionals". American Society of Health-System Pharmacists. Retrieved 22 March 2019</ref> | ||
*Surgical: For [[resistant]] and severe cases [[occlusion]] of [[semi-circular canal]] may be helpful. | *Surgical: For [[resistant]] and severe cases [[occlusion]] of [[semi-circular canal]] may be helpful. | ||
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==Reference== | ==Reference== | ||
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Latest revision as of 16:23, 11 January 2021
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Vertigo Microchapters |
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Vertigo medical therapy On the Web |
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American Roentgen Ray Society Images of Vertigo medical therapy |
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Risk calculators and risk factors for Vertigo medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
Single drug therapy is usually not effective to minimize the symptom, a combination of antihistamine and antiemetic are used to control vertigo. Definitive therapy is treating the underlying cause of vertigo.
Medical Therapy
- Acute/severe attacks of vertigo usually subsides in a day or two after brainstem compensation.[1]
- Supportive therapy includes bed rest, antihistamine, antiemetic (prochlorperazine, metoclopramide), benzodiazepines (diazepam,lorazepam) to relief the symptom.
- Meclizine is the common antihistamine used and is safe in pregnancy. Other antihistamines used are betahistine and dimenhydrinate.[2]
- Scopolamine (hyoscine hydrobromide) is a common anticholinergic used to treat the symptom.[3]
- Due to the sedative effect of these drugs they should be used carefully in the elderly.
- These drugs should not be used for a long period of time as it may delay the compensatory mechanism in the brainstem and result in the prolongation of vertigo symptom.
- Some patients may be a candidate for vestibular rehabilitation, it improves balance and decreases dizziness by exercises that stabilize gait and gaze.
Treatment for Common Causes of Vertigo
| Treating Peripheral Vertigo | |
|---|---|
| Ménière’s disease |
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| Acoustic neuroma |
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| Benign paroxysmal positional vertigo |
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| Acute labyrinthitis |
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| Acute vestibular neuritis |
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| Cholesteatoma |
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| Otosclerosis |
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| Treating Central Vertigo | |
| Brainstem Stroke |
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| Vestibular Migraine |
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| Multiple Sclerosis |
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| Cerebellopontine angle tumors |
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Reference
- ↑ Kuo CH, Pang L, Chang R (2008). "Vertigo - part 2 - management in general practice". Aust Fam Physician. 37 (6): 409–13. PMID 18523693.
- ↑ Khilnani, AK; Thaddanee, R; Khilnani, G (July 2013). "Anti vertigo drugs-Revisited". National Journal of Integrated Research in Medicine. 4 (4): 118–28.
- ↑ Khilnani, AK; Thaddanee, R; Khilnani, G (July 2013). "Anti vertigo drugs-Revisited". National Journal of Integrated Research in Medicine. 4 (4): 118–28.
- ↑ Phillips, John S; Westerberg, Brian (2011). "Intratympanic steroids for Ménière's disease or syndrome". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD008514.pub2. ISSN 1465-1858.
- ↑ Postema, Rolf J.; Kingma, Charlotte M.; Wit, Hero P.; Albers, Frans W.J.; Van Der Laan, Bernard F.A.M. (2009). "Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial". Acta Oto-Laryngologica. 128 (8): 876–880. doi:10.1080/00016480701762458. ISSN 0001-6489.
- ↑ Syed, I.; Aldren, C. (2012). "Meniere's disease: an evidence based approach to assessment and management". International Journal of Clinical Practice. 66 (2): 166–170. doi:10.1111/j.1742-1241.2011.02842.x. ISSN 1368-5031.
- ↑ {{cite journal|journal=Cochrane Database of Systematic Reviews|issn=14651858
- ↑ "Meclizine Hydrochloride Monograph for Professionals". American Society of Health-System Pharmacists. Retrieved 22 March 2019
- ↑ Seemungal, B M; Bronstein, A M (2008). "A practical approach to acute vertigo". Practical Neurology. 8 (4): 211–221. doi:10.1136/jnnp.2008.154799. ISSN 1474-7758.
- ↑ Muncie HL, Sirmans SM, James E (2017). "Dizziness: Approach to Evaluation and Management". Am Fam Physician. 95 (3): 154–162. PMID 28145669.
- ↑ Fishman, Jonathan M; Burgess, Chris; Waddell, Angus (2011). "Corticosteroids for the treatment of idiopathic acute vestibular dysfunction (vestibular neuritis)". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD008607.pub2. ISSN 1465-1858.
- ↑ de Oliveira Penido, Norma; de Oliveira Vicente, Andy (2018). "Medical Management of Otosclerosis". Otolaryngologic Clinics of North America. 51 (2): 441–452. doi:10.1016/j.otc.2017.11.006. ISSN 0030-6665.
- ↑ Mahafza T, Al-Layla A, Tawalbeh M, Abu-Yagoub Y, Atwan Sulaiman A (2013). "Surgical Treatment of Otosclerosis: Eight years' Experience at the Jordan University Hospital". Iran J Otorhinolaryngol. 25 (73): 233–8. PMC 3846245. PMID 24303446.
- ↑ Sargent, Eric W. (2013). "The challenge of vestibular migraine". Current Opinion in Otolaryngology & Head and Neck Surgery. 21 (5): 473–479. doi:10.1097/MOO.0b013e3283648682. ISSN 1068-9508.
- ↑ Huang, May Y; Vermeulen, Sandra (2003). "Clinical perspectives regarding patients with internal auditory canal or cerebellopontine angle lesions: Surgical and radiation oncology perspectives". Seminars in Ultrasound, CT and MRI. 24 (3): 124–132. doi:10.1016/S0887-2171(03)90034-5. ISSN 0887-2171.