Which medication do I need to manage dizzy patients?

  title={Which medication do I need to manage dizzy patients?},
  author={Doreen Huppert and Michael Strupp and Harald M{\"u}ckter and Thomas Brandt},
  journal={Acta Oto-Laryngologica},
  pages={228 - 241}
Abstract Vertigo and dizziness are not independent disease entities, but instead symptoms of various diseases. Accordingly, a variety of treatment approaches are required. Here we review the most relevant drugs for managing dizziness, vertigo, and nystagmus syndromes. It is important to differentiate symptomatic treatment of nausea and vomiting with, for example, dimenhydrinate and benzodiazepines, and prophylactic treatment of motion sickness with scopolamine from a causal therapy of the… 

Vertigo and dizziness in children.

Pediatricians and neuro-otologists should be aware of the full spectrum of causes of vertigo and dizziness in children and adolescents and take specific approaches for somatoform vertigo, the most frequent diagnosis in adolescent girls.

Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus

Although progress has been made in the treatment of vestibular neuritis, some forms of pathological nystagmus, and EA 2, controlled, masked trials are still needed to evaluate treatments for many Vestibular and ocular motor disorders, including betahistine for Ménière’s disease, oxcarbazepine for vestibULAR paroxysmia, or metoprolol for vestIBular migraine.

Management of peripheral vertigo with antihistamines: New options on the horizon

Encouraging outcomes in an induced vertigo model in healthy volunteers have led to ongoing clinical studies in acute unilateral vestibulopathy, with the hope that H4 antagonists will offer new effective therapeutic options to patients suffering from vertigo.

Pharmacotherapy of vestibular and cerebellar disorders and downbeat nystagmus: translational and back‐translational research

In acute unilateral vestibulopathy, corticosteroids improve the recovery of peripheral vestibular function, but there is not sufficient current evidence for a general recommendation, and higher dosages are currently recommended; in animal studies, it was shown that betahistine increases cochlear blood flow.

Vertigo and dizziness in children.

  • K. Jahn
  • Medicine
    Handbook of clinical neurology
  • 2016

Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms

This study provides further details concerning the therapeutic efficacy of the fixed combination of cinnarizine and dimenhydrinate, and focuses attention on the possibility that these drugs could act in a gender-specific manner, paving the way for further research.

Benign Paroxysmal Positional Vertigo

BPPV remains a challenging field that is constantly evolving in terms of pathophysiology, clinical manifestation, recovery, treatment, and recurrence, with the existence of several and to a large extent unknown contributing factors.

The assessment of balance and dizziness in the TBI patient.

This chapter outlines the clinical pathways to be followed in history-taking, physical examination, and assessment of patients with TBI, and provides a useful roadmap clinical pathway for assessment of these patients with appropriate and timely referral for treatment.

Medical treatment of acquired nystagmus

Medical treatment of nystagmus is difficult, with often limited and variable response to pharmacologic therapies, and this mandates a continued re-evaluation of patients and creation of an individualized approach to this common clinical problem.

Meniere’s Disease and Vestibular Migraine: Updates and Review of the Literature

A systematic review of English-language publications dating from 1948 to March 2016 found no difference between the three groups of Meniere’s disease and vestibular migraine, and strongly encourages authors to focus on comparing MD and VM from MDVM in future studies to help adequately distinguish the diagnosis of both diseases.



Review: Current treatment of vestibular, ocular motor disorders and nystagmus

  • M. StruppT. Brandt
  • Medicine, Psychology
    Therapeutic advances in neurological disorders
  • 2009
Although progress has been made in the treatment of vestibular neuritis, downbeat and upbeat nystagmus, as well as EA 2, state-of-the-art trials must still be performed on many vestebular and ocular motor disorders, namely Menie`re's disease, bilateral vestibULAR failure, vestibul paroxysmia, vestIBular migraine, and many forms of central eye movement disorders.

Migraine and Vertigo: Classification, Clinical Features, and Special Treatment Considerations

Vestibular migraine is a recognized medical entity in most dizziness units. It accounts for approximately 10% of these ‘dizzy’ patients and is the most common cause of spontaneous episodic vestibular

Psychiatric dizziness

The development of this view was prompted by recent findings that indicate that certain types of anxiety symptoms, rather than ruling out a vestibular abnormality, implicate the Vestibular system and appear to challenge current diagnostic practices.

Pharmacology of vertigo/nystagmus/oscillopsia

  • A. Straube
  • Medicine, Biology
    Current opinion in neurology
  • 2005
Early cortisone treatment to improve recovery of the labyrinth function in vestibular neuritis, and intratympanic gentamicin treatment for Ménière's disease are described.

Vertigo and Dizziness Related to Migraine: A Diagnostic Challenge

Migrainous vertigo (MV) is a vestibular syndrome caused by migraine and presents with attacks of spontaneous or positional vertigo lasting seconds to days and migrainous symptoms during the attack.

Acquired nystagmus

Patients with acquired forms of nystagmus, particularly those with multiple sclerosis, often benefit from gabapentin, a drug with few side effects, and scopolamine, clonazepam, and valproate are also useful in some patients.

Episodic vertigo related to migraine (90 cases): vestibular migraine?

Migraine is a relevant differential diagnosis for episodic vertigo and the use of the more appropriate term “vestibular migraine” is proposed to ensure that at least those presenting with monosymptomatic episodic Vertigo receive effective treatment.

A Chameleon Among the Episodic Vertigo Syndromes: ‘Migrainous Vertigo’ or ‘Vestibular Migraine’

  • T. Brandt
  • Medicine, Psychology
    Cephalalgia : an international journal of headache
  • 2004
A thorough and very valuable survey of what is known about the association of migraine with (i) vestibular vertigo, (ii) motion sickness, (iii) cerebellar symptoms, and (iv) non-vestibular dizziness is given.

The interrelations of migraine, vertigo, and migrainous vertigo

The results substantiate the epidemiologic association between migraine and vertigo and indicate that migrainous vertigo affects a significant proportion of patients both in dizziness and headache clinics.

The effects of gabapentin and memantine in acquired and congenital nystagmus: A retrospective study

  • P. Box
  • Medicine, Psychology
  • 2006
Gabapentin and memantine may be effective in acquired nystagmus secondary to MS and this is the first series of patients showing that gabapentin is effective in improving nyStagmus in congenital ny stagmus/nystag Mus associated with ocular pathology.