Dizziness therapy

Introduction

There are various treatment options to interrupt the unbearable effect of dizziness. If known, this depends on the causative disease of the vertigo. For this purpose, the family doctor or a neurologist should clarify the cause of the dizziness by talking to the patient and further diagnostics. The search for the exact cause can also take place in so-called vertigo outpatient clinics, a special consultation hour for the symptom dizziness.

Therapy options

First of all, drugs can help against nausea (antivertiginosa, antiemetics). These include metoclopramide (MCP, Paspertin®) and dimenhydrinate (Vomex®). However, these drugs only help symptomatically (against them symptoms of dizziness) and do not eliminate the cause of the disease.

In the most common form, Beningnen’s paroxysmal positioning vertigo (BPLS), so-called release maneuvers help. Physiotherapists (physiotherapists) can instruct the patient to carry out such maneuvers themselves regularly in the form of positioning exercises. The family doctor will critically search his patient’s medication list for substances that could trigger dizziness symptoms (e.g. drugs for high blood pressure, antihypertensives, beta blockers) and, if necessary, plan a new medication intake with the patient.

In the case of causes from the field of orthopedics, measures for posture correction, loosening of joint blockages, physical methods, massage for tension in the neck muscles and back training courses (back school) are offered. Inflammatory processes in the area of the balance organ or the balance nerve are treated either symptomatically, with antibiotics, antiviral drugs or in severe cases with cortisone. For acute symptoms of Meniere’s disease, drugs for nausea such as dimenhydrinate (Vomex®) are currently available.

Betahistine (Acqamen retard®) is given during the seizure-free interval. Before a drug therapy for dizziness can be initiated, a precise diagnosis must be made, since dizziness is after all merely a symptom. In order to be able to treat the patient successfully, the disease causing the dizziness must first be detected.

In any case, there is also the possibility to treat the dizziness symptomatically first. For this purpose, so-called antivertiginosa are often used, which may be taken for a maximum of three days. They have a calming effect on the vomiting center in the brain and on the organ of equilibrium in the ear.

In some cases, doctors have tried to control dizziness attacks with a local anesthetic injected into the neck (stellate blockade) to numb the nerve tracts located there, but this proved ineffective according to the latest findings. A suitable drug therapy for dizziness depends primarily on the type of dizziness. In the case of benign positional vertigo, for example, only a small dose of antivertiginosa is given to keep the nausea that can occur during the various positioning maneuvers as low as possible.

Anxiety-related (phobic) vertigo, on the other hand, is usually treated with selective serotonin reuptake inhibitors (SSRIs), a group of drugs that is also used to treat depression. The use of St. John’s wort is also possible here. When using St. John’s wort, however, the interaction with oral contraceptives such as the pill must be taken into account, which can lead to a limited effectiveness of the pill.

If a patient has vestibular migraine attacks, drug treatment in the form of beta-blockers or valproic acid should be initiated to prevent migraine, as it is believed to cause dizziness. There are several suitable drugs for Meniere’s disease: One is therapy with beta-blockers to prevent dizziness. It works by reducing pressure in the inner ear.

In addition, gentamicin is often used, an antibiotic which is injected via the eardrum to damage some of the hair cells in the inner ear that cause dizziness and thus inhibit dizziness. However, this procedure has a relatively high risk of damaging surrounding structures and should therefore only be performed by an experienced physician. Benzodiazepines, antivertiginosa for symptomatic therapy and cortisone are also used in acute dizziness attacks.

However, the exact mechanism of action of cortisone in the treatment of dizziness has not yet been proven.People who are prone to recurrent dizziness attacks can also use home remedies for treatment. These include above all sufficient sleep and regular exercise in the fresh air. In the case of dizziness caused by a disorder of the vestibular organ (usually rotary vertigo), special sports exercises can help to promote a sense of balance and balance in the body.

In the case of acute dizziness attacks, those affected should sit down slowly, as this usually helps the dizziness to subside quickly and dangerous falls are avoided. A healthy and balanced diet with fresh fruit and vegetables also promotes health and can alleviate the symptoms. Older people in particular often drink too little, which dries out (dehydrates) the body and causes dizziness.

Drinking enough water regularly can therefore help to prevent dizziness. As stress is a frequent trigger for dizziness, it can be helpful to avoid strong nervous tension and to carry out targeted relaxation exercises, especially of the neck muscles. The herbal healing substance Gingko biloba promotes the blood circulation in the brain and can therefore be used for dizziness attacks.

Gingko also helps with ringing in the ears, which often occurs in combination with dizziness. Another household remedy is ginger. The small tuber supports the body’s own immune system and has an invigorating effect due to its pungent action.

It is best to cut ginger into small pieces, pour hot water over it and let the tea steep for about ten minutes. Depending on taste, ginger tea can also be flavored with lemon and honey. Homeopathic remedies can be used especially in the case of recurrent dizziness.

In this case, a doctor should first clarify whether there are no serious illnesses causing the dizziness (for example, cardiological problems or structural changes in the brain). A doctor should always be consulted, especially in the case of frequently recurring dizziness or accompanying symptoms such as fever, fainting or palpitations. However, some forms of dizziness cannot be treated properly by conventional medicine.

In such cases, the dizziness attacks can be treated with homeopathic remedies. For the treatment of dizziness, the active ingredients Anamirta cocculus, Conium maculatum, Ambra grisea, Kalium phosphoricum, Belladonna, Arnica and Petroleum rectificatium are used. You can get good advice on the appropriate medication in any pharmacy and from naturopaths.

Experience shows that there are no suitable drugs for the treatment of benign, paroxysmal positional vertigo. Instead, special positioning exercises are intended to alleviate the symptoms. This type of vertigo is based on the detachment of small particles in the ear, which can migrate back to their place of origin through targeted movements of the head and body.

An important exercise is the positioning maneuver according to Sémont: At the beginning, the patient sits upright and has turned the head by 45°, so that the affected side faces the doctor. Now the patient is suddenly shifted sideways to the affected side, but without any head movement (the gaze is now directed upwards). In this position the patient is held for 2-3 minutes.

Then the patient is transferred to the other, unaffected side of the body; this time again without head movement. Finally, the patient is brought back into the starting position. Another frequently used positioning maneuver to relieve dizziness is the Epley maneuver.

Here, the patient initially sits upright with stretched legs. The head is also turned by 45°, but to the affected side, i.e. the healthy side faces the treating doctor. Now the patient is quickly brought into a supine position, with the head overhanging the examination table (also called head-hanging position).

The patient must remain in this position until the dizziness subsides. Usually this is done within a period of 1-2 minutes. Then the patient turns his head to the other, healthy side and pauses until the dizziness subsides.

Next, the patient turns his body completely to the healthy side, but without moving his head. After the dizziness subsides in this position, the patient can carefully sit up and the maneuver is finished. In case the Epley maneuver does not improve the symptoms, there is also the Brandt and Daroff positioning training.

Here the patient alternates between the right and left lateral position for 30 seconds each.In between it returns to the upright position. To compensate for slight differences in the function of the organ of balance in the right and left ear, it is also possible to carry out gait or balance training. In this way, the “functioning” organ of balance learns to cooperate for the “defective” one in order to counteract the development of dizziness. For more information on this topic, please read also:

  • Exercises for positional vertigo
  • Vertigo training