Vertigo (Dizziness): Therapy

Therapy for vertigo depends on the cause. Admission to the emergency room is required if the vertigo:

  • Could be an expression of a threatening condition requiring acute treatment.
  • 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

Eye gaze stabilization exercises alleviate dizziness. If you have vertigo, you can learn a number of methods to minimize the attacks of dizziness. 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 (benign) paroxysmal (“seizure-like”) 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.

Drug therapy

The use of antivertiginosa (drugs used to treat vertigo) may be considered in cases of unclear vertigo with marked symptomatology (e.g., nausea/nausea). For use:

For the following forms of vertigo, drug therapy can be found under disorders of vestibular function/medication therapy:

  • Benign paroxysmal positional vertigo (BPLS).
  • Bilateral vestibulopathy (BV)
  • Meniere’s disease
  • Neuritis vestibularis
  • Vestibular migraine
  • Vestibular paroxysmia

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:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • 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 dizziness – light endurance training (cardio training) if necessary.
  • 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