Vertigo medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S [2]


Treating Peripheral Vertigo
Ménière’s disease	Treatment is focused on preventing acute attacks and controlling the excess fluid build-up. Non-invasive: Low-sodium diet, hearing aid, positive pressure therapy. Medications: Meclizine, diazepam, promethazine, diuretics Steroid^[1] or gentamicin^[2] injections in middle ear. Surgery: Decompress endolymphatic sac, labyrinthectomy, Vestibular nerve section^[3].
Acoustic neuroma	Observe if the tumor is small, asymptomatic, not growing, or in elderly with comorbidities. For large, symptomatic, growing tumor one of the following treatment is helpful after weighing risks and benefits: Radiationtherapy Radiosurgery Surgical removal
Benign positional paroxysmal vertigo	Effective maneuvers:Epley maneuver, Semont maneuver, Brandt–Daroff exercises, Roll maneuver.^[4] Medical: Antihistamine(meclizine) and anticholinergic(scopolamine).^[5] Surgical: For resistant and severe cases occlusion of semi-circular canal may be helpful.
Acute labyrinthitis	Depends upon the etiology: Viral: hydration, bedrest.^[6] Bacterial: Antibiotic depending on the origin of infection that led to labyrinthitis.
Acute vestibular neuritis
Cholesteatoma
Otosclerosis
Perilymphatic fistula
Treating Central Vertigo
Brainstem Stroke
Vestibular Migraine
Multiple Sclerosis
Cerebellar tumors
Lateral medullary syndrome

↑ 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.
↑ . doi:10.1002/14651858.CD003162. Check |doi= value (help). Missing or empty |title= (help)
↑ "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.

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