Diagnosis
The causes of a rotary vertigo can be as varied as its clarification can be extensive. If it is not possible for the general practitioner to classify the patient in a certain specialty, it may be necessary to consult different specialists. In most cases, a thorough anamnesis, i.e. the doctor-patient conversation, provides a whole range of information.
Of particular interest here are the duration and frequency of the individual vertigo attacks and the situations in which they occur. Useful information for the doctor is also whether tinnitus or ringing in the ears, hearing loss and other symptoms such as headaches or earaches occur. A physical examination then provides a range of additional information.
This usually involves writing an ECG (measuring heart activity) and measuring blood pressure. Other typical examinations are balance and coordination tests. Depending on which disease the medical history and physical examination indicate, additional technical examinations can then be used. These include imaging procedures, such as CT or MRI, but also, for example, hearing tests (audiometry).
Therapy
The therapy of rotational vertigo depends very much on the underlying disease. Depending on the exact cause, there are a number of different, sometimes very specific therapies available. Benign paroxysmal positional vertigo can usually be treated very quickly.
For this purpose, the attending physician performs one of several positioning maneuvers that eliminate the cause of the vertigo. The symptoms and their after-effects usually subside quickly. Vestibular neuritis primarily requires drug therapy.
Glucocorticoids are the most commonly used drugs, with cortisol being the best known representative. These suppress the inflammatory reaction at the vestibular nerve, which is most likely the cause of the dizziness symptoms. The prognosis in the context of this disease is usually very favorable.
In the course of glucocorticoid therapy, the symptoms disappear completely in the majority of patients, and in most cases there is at least a significant improvement in symptoms. For Meniere’s disease, on the other hand, no causal therapy exists to date.For this reason, the main aim is to bring the symptoms to a tolerable level by using antivertiginosa (drugs to treat dizziness) and antiemetics (nausea-reducing drugs) and glucocorticoids. If the disease is too stressful for the patient, it is also possible to anesthetize the organ of balance.
On the one hand, this can be done by injecting a local anesthetic into the tympanic cavity. On the other hand, the last therapeutic option is the irreversible elimination of the organ of equilibrium by introducing the antibiotic gentamycin into the inner ear, which has a damaging (ototoxic) effect on the sensory hair cells of the ear. In addition to these causal therapies, symptomatic therapy using antivertiginosa and antiemetics is often indicated.
However, depending on the cause of the vertigo, these drugs are not always appropriate in every case and are not suitable for permanent treatment. You can find further information under Dizziness TherapyThere are various medications available to reduce the symptoms of dizziness and the accompanying symptoms. Depending on the cause of the dizziness, drugs from the group of antivertiginosa (drugs to treat dizziness) and antiemetics (nausea-reducing drugs) are primarily used for symptomatic treatment.
Vomex® (dimenhydrinate) is the most common over-the-counter antiemetic. MCP (metoclopramide) is also frequently prescribed, although not over the counter. Antivertiginosa such as betahistine, on the other hand, are always available only on prescription.
Depending on the cause of the spinning dizziness, various homeopathic remedies can be taken. Arnica can be used for dizziness after concussions. Even if the vertigo is so severe that it leads to falls, Arnica can help.
Potassium phosphoricum is used if the dizziness occurs when getting up from a sitting or lying position. If the rotary vertigo is caused by circulatory problems, Ferrum phosphoricum can also be used. Acute attacks of vertigo, such as those that occur after turning around in bed or a quick turn of the head, can be relieved with Belladonna. If nausea and vomiting also occur, nux vomica can also be taken. Bryonia and Spiraea ulmaria can be taken to relieve dizziness and headaches.
