Disorders of Vestibular Function: Therapy

Therapy for vertigo depends on the cause. Referral to the emergency department is required:

  • When the vertigo may be an expression of a threatening condition requiring acute treatment.
  • If the dizziness could result in or has already caused a threatening secondary complication (e.g., fall).

Inpatient therapy is required if:

  • There is an acute disease requiring treatment as the cause of the vertigo and its therapy cannot be carried out or monitored on an outpatient basis.
  • When potentially serious illnesses cannot be definitively ruled out in the emergency room and further diagnostics must be performed promptly
  • In elderly patients due to a dizziness-related limitation/disease.
    • There is a high risk of falling and therefore a risk of further subsequent complications
    • Home care is no longer guaranteed in single patients and socio-medical measures must be initiated

In the presence of a fall or a fall risk, see below “Fall propensity / prevention”.

General measures

  • Bed rest should be maintained for a maximum of one to two days for acute onset of rotary vertigo. Thereafter, the patient should mobilize.
  • Checking the visual acuity (due topossibility of mismatched glasses).
  • Nicotine restriction (refrain from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight.
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Psychological stresses
    • Stress
  • Avoidance of environmental stress:
    • Explosion trauma, blast trauma.

Training methods

If you have vertigo, you can learn a number of methods to minimize the attacks of vertigo. Among these methods is the Epley maneuver. In this maneuver, the affected person lies on his back and hyperextends his head. The head is tilted to the affected side at the same time. After 30 seconds, the head is turned to the other side. After another 30 seconds, the patient lies down on the healthy side. The forehead is placed on the couch. After another 30 seconds, the patient sits up. Benign paroxysmal positional vertigo (BPLS) is a common cause of attack vertigo. Treatment is with the appropriate freeing maneuver (e.g., rolling maneuver and Guffoni maneuver for horizontal BPLS) depending on the arcuate pathway affected (posterior, horizontal) and is very successful when performed correctly. Also, for patients with acute neuropathia verstibularis, it makes no difference in the long term whether patients are treated with a corticosteroid or undergo balance training (exercises that accelerate central compensation and promote recovery of the vestibular organ).

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
  • Other specific dietary recommendations depending on the cause of vertigo (dizziness).
  • Selection of appropriate foods based on the nutritional analysis.
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • The patient should exercise to activate central mechanisms that the body has against the dizziness – if necessary, light endurance training (cardio training).
  • Establish a fitness plan with appropriate sports disciplines based on a medical check (health check or athlete check) depending on the cause of dizziness.
  • For detailed information on sports medicine, please contact us.

Physical therapy (including physiotherapy)

  • Activating physical therapy with gait and balance exercises and head rotations in all three planes, to train the vestibulo-ocular reflex (VOR training) as a longer-lasting therapy – for many form of chronic vertigo (including bilateral vestibulopathy, acute unilateral vestibulopathy).

Psychotherapy