Common treatments for vertigo

  Vertigo is not an untreatable disease, but can be controlled and prevented from recurring as long as regular treatment, good living habits and a relaxed state of mind are maintained. Commonly used treatment methods are as follows: 1. General treatment: In acute attacks, you should be absolutely bedridden, the room should be quiet and dark, and avoid head movement. After the vertigo is reduced, head and body activities should be increased to facilitate recovery. After the vertigo is controlled, you should make a regular work and rest schedule, avoid staying up late, relieve mental tension and stress, and keep your body and mind happy.  2.Psychological treatment: Vertigo is a symptom that makes people extremely afraid. It is necessary to provide support to patients to make them feel relieved, and if patients’ worries can be alleviated, then the pain they feel will be less. After history and examination, if serious diseases can be ruled out, patients can be told that their vertigo will not affect their lives and can be controlled quickly to enhance their confidence in treating the disease.  3.Diet therapy: For patients with Meniere’s disease, a low-salt diet is required, and the intake of water, ethanol, nicotine and coffee should be restricted.  4.Medication: sedation, dehydration, vestibular depressants (such as the antihistamine teicoplanin or the antiparasympathomimetic scopolamine). Drugs that have a sedative effect on the vestibular system should be applied only during the first 24h. 24-72 hours use should be greatly reduced, or preferably discontinued altogether, and the patient should be encouraged to get out of bed, otherwise it is not conducive to recovery.  5. Ear canal pressure therapy: Ear canal pressure therapy can significantly inhibit the development and extent of endolymphatic effusion and improve cochlear function and is indicated for patients with Meniere’s disease. Low-frequency, low-amplitude pressure pulses are applied to the middle ear, causing lymphatic fluid in the inner ear to drain from the cochlea, achieving the therapeutic effect of reducing the patient’s symptoms associated with Ménière’s disease. It can relieve vertigo, improve hearing, and suppress tinnitus.  6.Manual repositioning: It is suitable for patients with benign paroxysmal positional vertigo (BPPV). The otoliths that trigger vertigo are discharged into the vestibular cavity through manual repositioning to reduce the irritation to the ridge of the semicircular canal potbelly.  7. Vagus chemical resection: Gentamicin intra-dural injection, advocating small dose interval injection, has high vertigo control rate (80-90%) and less deafness aggravation. Gentamicin can temporarily inhibit calcium channels of inner ear cells and destroy vestibular hair cells, thus removing vestibular function; it can also destroy dark cells to reduce endolymphatic fluid production and alleviate local fluid accumulation.  8.Surgical treatment: The purpose of surgical treatment is to restore the normal physiological function of the vestibular organs by eliminating the lesion; or to reduce or eliminate the symptoms of vertigo by blocking a certain link in the pathological process. Different types of patients and different stages of lesions will choose different surgical methods. The common types of surgery are endolymphatic sac decompression, vestibular resection and vestibular neurotomy.  9.Chinese herbal medicine: After the acute phase, symptoms such as vertigo and instability can be further controlled by Chinese herbal medicine conditioning to maintain the stability of the treatment effect.  10.Vestibular rehabilitation: vestibular rehabilitation can promote the central vestibular compensation process (central compensation), suppress the vestibular signal on the normal side and enhance the vestibular signal on the lesion side (increase excitability, increase synaptic connections), improve static and dynamic balance function, and improve gait. Vestibular rehabilitation is currently considered to be an appropriate and valuable method for the treatment of vestibular hypofunction.