Dizziness medical therapy: Difference between revisions
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===Physical therapy:=== | ===Physical therapy:=== | ||
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>: | |||
*[[Epley maneuver]] (canalith repositioning) | *[[Epley maneuver]] (canalith repositioning) | ||
*[[Vestibular rehabilitation]] | *[[Vestibular rehabilitation]] | ||
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*[[Balance therapy]] | *[[Balance therapy]] | ||
*[[Psychotherapy]] | *[[Psychotherapy]] | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:28, 30 August 2020
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Dizziness Microchapters |
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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] Norina Usman, M.B.B.S[3]
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:
Therapies for dizziness include[1]:
- Epley maneuver (canalith repositioning)
- Vestibular rehabilitation
- Breathing control exercises
- Balance therapy
- Psychotherapy
References
- ↑ Holmberg J, Karlberg M, Harlacher U, Magnusson M (2007). "One-year follow-up of cognitive behavioral therapy for phobic postural vertigo". J Neurol. 254 (9): 1189–92. doi:10.1007/s00415-007-0499-6. PMID 17676355.