Dizziness medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Dizziness}} | {{Dizziness}} | ||
{{CMG}} {{AE}} {{FB}} | |||
==Overview== | |||
The mainstay of treatment for dizziness is supportive, medical, and physical therapy. | |||
{{CMG}} | |||
==Medical Therapy== | ==Medical Therapy== | ||
Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case drinking water is quite dangerous) | ===Supportive therapy:=== | ||
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous) | |||
*Eating something sugary | |||
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees). | |||
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid. | |||
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights. | |||
*Cautious about driving or using machinery. | |||
*Salt restriction (less than 1 to 2 g of sodium per day) | |||
===Medication:=== | |||
Diuretics (such as hydrochlorothiazide/triamterene) | |||
*[[Antihistamines]] | |||
*[[Sedatives]] | |||
*Intratympanic gentamicin or dexamethasone | |||
*[[Methylprednisolone]] | |||
*[[Pills]] for [[nausea]] | |||
*Migraine prophylaxis [[serotonin]] 5-HT1 receptor agonists [[(triptans)]] | |||
*[[Midodrine]] | |||
*[[Pseudoephedrine]] | |||
*[[Beta blockers]] | |||
*[[Antianxiety agents]] | |||
===Approach to the Patient with Dizziness:=== | |||
{{familytree/start |summary=PE diagnosis Algorithm.}} | {{familytree/start |summary=PE diagnosis Algorithm.}} | ||
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s}} | {{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s}} | ||
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{{familytree/end}} | {{familytree/end}} | ||
===Physical therapy=== | |||
*[[Epley maneuver]] (canalith repositioning) | |||
*[[Vestibular rehabilitation]] | |||
*Breathing control exercises | |||
*[[Balance therapy]] | |||
*[[Psychotherapy]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:15, 30 August 2020
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Dizziness Microchapters |
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Treatment |
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Dizziness medical therapy On the Web |
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American Roentgen Ray Society Images of Dizziness medical therapy |
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Risk calculators and risk factors for Dizziness medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
The mainstay of treatment for dizziness is supportive, medical, and physical therapy.
Medical Therapy
Supportive therapy:
- Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of water intoxicationin which case the drinking water is quite dangerous)
- Eating something sugary
- Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
- Intravenous fluids in case of nausea and vomiting from drinking too much liquid.
- During attacks of vertigo from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
- Cautious about driving or using machinery.
- Salt restriction (less than 1 to 2 g of sodium per day)
Medication:
Diuretics (such as hydrochlorothiazide/triamterene)
- Antihistamines
- Sedatives
- Intratympanic gentamicin or dexamethasone
- Methylprednisolone
- Pills for nausea
- Migraine prophylaxis serotonin 5-HT1 receptor agonists (triptans)
- Midodrine
- Pseudoephedrine
- Beta blockers
- Antianxiety agents
Approach to the Patient with Dizziness:
| Patient with dizzinesss | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Presentation episodic or countinuous? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Episodic | Countinuous | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Triggered | Spontaneous | Is it associated with trauma or toxins or spontaneous? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Dix-Hallpike maneuver | Hearing loss | Migraine | Psychiatric Symptoms | Trauma or toxin | Spontaneous | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Positive | Negative | Vestibular Migraine | Panic attack | Barotrauma,Medication | HINTS Examination | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Benign Paroxysml Vertigo | Access for orthostatic hypotension | Saccade present Undirectional horizontal nystagmus Normal test of skew | No saccade,Nystagmus dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Peripheral etiology | Central etiology | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Vestibular neuritis | Stroke or transient ischemic attack | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Physical therapy
- Epley maneuver (canalith repositioning)
- Vestibular rehabilitation
- Breathing control exercises
- Balance therapy
- Psychotherapy