The most commonly used calcium channel blockers for the management of vestibular disorders are nimodipine, nitrendipine (a dihydropyridine with long lasting effect) and verapamil.
Diazepam (Valium®), clonazepam, lorazepam and alprazolam are benzodiazepines commonly prescribed for their effect as anxiolytics and antidepressants. These drugs also act as vestibular suppressants and can, in small dosages, be extremely useful for the management of acute vertigo3.
Vestibular Suppressants
Antihistamines can suppress the vestibular system and reduce dizziness. Some examples include meclizine (Antivert®), diphenhydramine (Benadryl®), and dimenhydrinate (Dramamine®; Rascol et al, 1995).
Vestibular rehabilitation therapy (VRT) is physical therapy that helps to reduce or eliminate balance issues. Studies show people with balance issues who have VRT have improved balance, less dizziness and reduce their risk of falling.
Regarding specific drug therapy, steroid therapy has been reported to relieve dizziness and promote vestibular compensation in vestibular neuritis; methylprednisolone is much more effective than placebo in reducing vertiginous symptoms in patients with acute vestibular vertigo [39], and early treatment of acute ...
Vestibular neuritis can be treated with corticosteroids (a type of anti-inflammatory medication) in the early stages, and, if necessary, with medication to reduce nausea and vertigo.
What causes vestibular disease? Causes of vestibular disease include middle or inner ear infections, drugs that are toxic to the ear, trauma or injury, tumors, and hypothyroidism. When no specific cause is found, the condition is called idiopathic vestibular syndrome.
Sit or lie down immediately when you feel dizzy. Lie still with your eyes closed in a darkened room if you're experiencing a severe episode of vertigo. Avoid driving a car or operating heavy machinery if you experience frequent dizziness without warning. Avoid using caffeine, alcohol, salt and tobacco.
Anti-vertigo or anti-nausea medications may relieve your symptoms, but they can also make you drowsy. Other medications, such as gentamicin (an antibiotic) or corticosteroids may be used. Although gentamicin may reduce dizziness better than corticosteroids, it occasionally causes permanent hearing loss.
Similarly, low doses of diazepam (Valium) (2 mg) can be quite effective for dizziness. Clonazepam (Klonopin), is as effective a vestibular suppressant as lorazepam (Ganaca et al, 2002).
Two of the most well-known vestibulotoxic medications are the antibiotics streptomycin and gentamicin. Additionally, platinum-based chemotherapy agents such as cisplatin and carboplatin, which are primarily cochleotoxic (damaging to the hearing mechanisms of the inner ear), may also produce vestibulotoxic effects.
The symptoms in vestibular neuritis are typically constant, in contrast to the episodic symptoms of other peripheral causes such as BPPV or Meniere's disease. Symptoms are worsened with head movement but not triggered.
Vestibular neuritis (or vestibular neuronitis) is a neurological condition resulting from an inflammation of the nerve(s) of the inner ear, and can produce dizziness, imbalance, motion sensitivity, nausea, and visual problems.
The six most common peripheral vestibular syndromes, in order of decreasing incidence: Benign paroxysmal positional vertigo, Menière's disease, acute unilateral vestibulopathy/vestibular neuritis, bilateral vestibulopathy, vestibular paroyxsmia, and the third mobile window syndromes.
Acute vestibular syndrome is characterized by a constellation of symptoms, including vertigo, nausea, vomiting, head motion intolerance, unsteady gait, and postural instability.
What triggers vestibular neuritis? Experts believe vestibular neuritis results from viral infections that start in your inner ear or begin somewhere else in your body, like chickenpox or viral hepatitis.
Stay hydrated, avoid foods high in salt or sugar, avoid stress-inducing beverages like caffeine to avoid migraines. Limit or eliminate alcohol consumption. Eliminate smoking due to the ability of nicotine to increase symptoms by decreasing blood supply to the inner ear, which is also a migraine trigger.
In this case study, we present a case of vestibular neuritis, 24 hours after the administration of the Pfizer booster vaccine with the resolution of major symptoms by seven days.
A vestibular physiotherapist is trained in very specific assessment and treatment techniques to diagnose dizziness, vertigo and balance problems, as well as provide appropriate treatments to resolve symptoms.
The symptoms often ease after a few days. You'll usually get your balance back over 2 to 6 weeks, although it can take longer.