Tuesday, 17 June 2014

Dizziness Part III :Management

Dizziness...like fever or pain is just the symptom of an underlying pathology.Hence for effective treatment ,we need to diagnose the underlying cause.As I have already mentioned,sometimes appropriate diagnosis needs few visits.

The treatment of vestibular or inner ear related vertigo is divided into immediate symptomatic relief & to promote vestibular compensation.

Medications for vertigo mainly provide symptomatic relief.Drugs like antiemetic (for nausea & vomiting ) & anti vertigo drugs are given for short duration (3-5 days).In Meneire's disease Histamine agonists drugs are used for longer duration.

The mainstay of management is to promote vestibular compensation.Vestibular compensation is a natural process that allows the brain to regain balance, and minimise dizziness when there is damage to the inner ear.These include various exercise manuvers specific to a diagnosis.For example in BPPV, we usually perform Semont's Manuver or Epleys Manuver. There are also certain eye movements,neck & head exercises.I am not describing them here as I do not want any patient to perform them without doctors advice.

Appropriate referrals to neurologists,cardiologists,endocrinologists or other specialities if suspected cause is not the inner ear.

Finally lot of reassurance & regular follow up.Also concentrate on the concomitant psychological & cognitive impairment for a holistic recovery.

Picture of a rainbow over a volcanic eruption in Tanzania.....courtesy National Geographic


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