Diagnostics
A complete physical examination should always be performed to make an accurate diagnosis. If no cause can be found, a further examination by a neurologist or ear, nose and throat specialist is often necessary. Here the vestibular and central system can be examined more specifically by imaging procedures or tests.
- Blood pressure and
- Pulse measurement,
- Blood glucose control,
- Testing of eye movements,
- Balance and
- Hearing test should be tested.
Therapy
Especially the undirected, unsystematic dizziness requires a therapy of the underlying diseases, for example a thorough blood pressure adjustment.Here, special treatment must be provided individually and depending on the underlying cause. Positional vertigo can be easily treated in most cases by the above mentioned positioning maneuvers, whereas Menière’s disease can only be treated symptomatically. The therapy of balance disorders is initially based on the underlying cause.
Exercise therapy often plays a more important role than drug therapy. Nevertheless, various drugs can be used symptomatically. These include, for example, the antivertiginosa (anti-v vertigo drugs) with antihistaminic or anticholinergic active ingredients.
Antihistamines include dimenhydrinate, diphenhydramine and betahistine. In cases of pronounced dizziness, so-called benzodiazepines can also be taken in the acute dizziness phase. Typical examples are diazepam and clonazepam.
These benzodiazepines have a sedative effect (attenuating effect) and may also have an antidizziness effect. However, some people with benzodiazepines also have the opposite effect and have increased dizziness. Other drugs may be used if the shingles are caused by infectious pathogens which lead to inflammation of the vestibular system (labyrinthitis). In this case bacterial infections can be treated with various antibiotics.
Summary
Vertigo is a very complex symptom with numerous causes and clinical pictures. For this reason, a thorough anamnesis and the most precise description of the vertigo by the patient is essential. Once the cause has been found, the dizziness can be treated in many cases, since it is often a treatable underlying disease. However, in most cases, vertigo that cannot be treated causally can only be treated symptomatically in order to alleviate the accompanying symptoms such as nausea and vomiting.
