8 months ago

Vertigo Exercises - Vertigo & Dizziness Treatment
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✔. The most important diagnostic tool is a detailed history focused on the meaning of “dizziness” to the patient. The simplest provocative test for vestibular dysfunction is rapid rotation and abrupt cessation of movement in a swivel chair.
✔. This always induces vertigo that the patients can compare with their symptomatic dizziness. A final provocative and diagnostic vestibular test, requiring the use of Frenzel eyeglasses (self-illuminated goggles with convex lenses that blur out the patient’s vision, but allow the examiner to see the eyes greatly magnified), is vigorous head shaking in the horizontal plane for about 10 s.
✔. The evaluation depends on whether a central etiology is suspected. If so, MRI of the head is mandatory. Such an examination is rarely helpful in cases of recurrent monosymptomatic vertigo with a normal neurologic examination.
✔. Treatment of acute vertigo consists of bed rest (1–2 days maximum) and vestibular suppressant drugs such as antihistaminics (meclizine, dimenhydrinate, promethazine), tranquilizers with GABA-ergic effects (diazepam, clonazepam), phenothiazines (prochlorperazine), or glucocorticoids.
✔. If the vertigo persists beyond a few days, most authorities advise ambulation in an attempt to induce central compensatory mechanisms, despite the short-term discomfort to the patient. Chronic vertigo of labyrinthine origin may be treated with a systematized vestibular rehabilitation program to facilitate central compensation.
✔. Prophylactic measures to prevent recurrent vertigo are variably effective.
✔. Antihistamines are commonly utilized but are of limited value. Ménière’s disease may respond to a diuretic or, more effectively, to a very low salt diet (1 g/d).
✔. Recurrent episodes of migraine-associated vertigo should be treated with antimigrainous therapy .

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