Peripheral and neurologic vertigo (ear)- Dubai ENT Clinic
Vertigo can be either peripheral or related to neurological issue. we will try to explain the differences, and how to manage vertigo.
- Severe vertigo mostly accompanied by nausea, vomiting, and sweating.
- Sometimes with hearing loss and tinnitus.
- Increases when eyes are closed.
- No other symptoms between attacks.
- Mild, continuous, not fatigable dizziness with weakness.
- Numbness on fall attacks.
- Feels better when eyes are closed.
The most frequent cause of peripheral vertigo is benign paroxysmal positional vertigo (BPPV).
- Repositioning of the canalith using clinical manoeuvres: Epley, and Semont maneuvers.
- Use of vibration in the repositioning procedure.
- Premedication for nausea and vomiting is recommended.
- Postural restriction following canalith repositioning.
- Head should be positioned at 30 degrees for two nights.
- Don’t place the head on dependent position or sleep on the affected ear for one week.
- Success rate is 90%. Repetition of manoeuvre is needed.
- Recurrence rate is 30% to 50%. Repetition of manoeuvre is needed.
- 90% posterior, 10% to 13% horizontal, 2% anterior.
Contraindications for canalith repositioning manoeuvres:
- Acute fractures that prevent from lying down quickly or rolling over.
- Recent neck fracture, surgery, or instability.
- History of vertebral discectomy.
- Unstable carotid disease.
- Recent retinal detachment.
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