Diagnosis and treatment of vertigo

This article is expertly consulted by Master, Doctor Bui Ngoc Phuong Hoa - General Internal Medicine - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Dizziness is a feeling of spinning, making you unable to keep your balance and prone to falls. Dizziness is not a disease but a warning symptom of a certain health condition.

If your doctor suspects that you are having or may be having a stroke, or you have been hit in the head, they will ask you to immediately perform an MRI or CT scan.
Cases of dizziness will usually be asked by the doctor about the symptoms, the medications being taken and then a physical examination will be performed. During a physical exam, your doctor will check how you walk and maintain balance, and how the major nerves of the central nervous system (mainly the vestibular-cochlear nerve) work.
You may also need hearing and balance tests, including:
Eye movement tests. Your doctor can monitor your eye (pupil) movement as you track a moving object. And you may have eye movements checked while water or air is placed in your ear canal. Check head movement. If your doctor suspects your vertigo is caused by benign positional vertigo, you will be asked to do a simple head movement test called the Dix-Hallpike maneuver to verify the diagnosis. Balancing barefoot: your doctor will know which part of your balance system you rely on the most and which may be causing you problems. You stand on bare feet and try to balance in a variety of conditions. Test with a swivel chair. In this test, you sit in a computer-controlled chair that moves very slowly in a circle. At faster travel speeds, the chair moves back and forth in a very small arc. In addition, you may have blood tests to check for infection, anemia, and other tests to check your heart (electrocardiogram, echocardiogram, ..), brain (CT or MRI).

Vertigo usually improves without treatment. Within a few weeks, the body will usually adapt to whatever is causing the vertigo.
If you want to treat vertigo, your doctor will base it on the cause of the condition and the symptoms you have. Treatment may include medication and balance exercises. Even if a cause is not known or if your dizziness does not improve, vertigo can be managed with medication prescribed by your doctor or other treatment options.

Drug treatment
Diuretics . If you have Meniere's disease, your doctor may prescribe a diuretic. Using a diuretic with a low-salt diet can help reduce dizziness. Medicines to relieve dizziness and nausea: Your doctor may prescribe medicine to help you get rid of dizziness and nausea right away, including antihistamines (Betahistamine). These drugs may cause drowsiness. Anti-anxiety medication. Diazepam (Valium) and Alprazolam (Xanax) are in a class of drugs called benzodiazepines, which can cause dependence. They can also cause drowsiness. Migraine preventive medicine. Certain medications can help prevent migraine attacks (Flunarizine,...). Therapy
Dynamic Head Positioning: A technique called Canalith repositioning (or Epley maneuver) often helps resolve benign postural vertigo more quickly than waiting for your vertigo to go away . It can be done by a doctor, audiologist, or physical therapist, which involves controlling the position of your head. This technique is usually effective after one or two treatments. Before this procedure, you should tell your treating doctor right away if you have problems with your neck or back, detached retina, or blood vessel problems. Balance therapy: You may be taught specific exercises to make your balance system less sensitive to movement. This physical therapy technique is called vestibular rehabilitation. It is used for people who have dizziness caused by conditions in the inner ear, such as vestibular neuritis. Psychotherapy: This type of therapy can help people whose dizziness is caused by an anxiety disorder. Surgery or other procedures
Injections: Your doctor may inject your inner ear with the antibiotic Gentamycin to disable the balance function. The unaffected ear will take over that function. Removal of the sensory organs inside the ear. A rarely used trick is called a maze. It disables the vestibular labyrinth in the affected ear. The other ear is responsible for the balance function. This surgery may be used if you have severe hearing loss and your vertigo doesn't respond to other treatments.

If you often experience repeated episodes of dizziness, you can refer to some of the following tips to improve this condition:
Be aware of your ability to lose balance, because this can cause you to fall and serious injury. Avoid sudden movements and walk with a cane for stability, if needed. To avoid the risk of tripping due to dizziness, you should use a waterproof mat on the bathroom floor. The bathroom should be well-lit. Sit or lie down immediately when you feel dizzy. Lie still and close your eyes in a dark room if you are experiencing a severe vertigo. Avoid driving or operating heavy machinery if you experience sudden dizziness frequently. Avoid caffeine, alcohol, high salt, and tobacco. Excessive use of these substances can worsen the signs and symptoms of dizziness. Drink enough water, eat a healthy diet, get enough sleep and avoid stress. If your dizziness is caused by medication use, talk to your doctor about stopping or reducing your dose. If your dizziness is accompanied by nausea or vomiting (from motion sickness), try an antihistamine, such as Meclizine (Dramamine) or Dimenhydrinate (Besttrip), Diphenhydramine (Nautamine). These drugs may cause drowsiness. If your dizziness is caused by overheating or dehydration, rest in a cool place and replenish electrolytes. If you tend to feel lightheaded when you stand up (postural hypotension), you should move slowly. If you experience dizziness while driving, stop the vehicle until your condition improves.

If vertigo makes you feel like you might fall, there are steps you can take to reduce your risk from this condition. Always keep your home well-lit and free of hazards that could cause you to trip. Place furniture where you are unlikely to bump it, and use waterproof mats in the bathtub and on the bathroom floor.
Master. Doctor Bui Ngoc Phuong Hoa has more than 24 years of experience in the field of neuropsychology. Doctor Hoa was formerly Deputy Head of the Department of Neurology - Quang Ngai Provincial General Hospital and participated in many continuous training courses on Epilepsy, Cerebrovascular Accident, Alzheimer's, Movement Disorders, Geriatrics. Endocrine Pathology.
To register for screening and treatment of neurological diseases at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE
References : Mayoclinic.org
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