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Diagnosed with Acute Vestibular Decomposition, vertigo, dizziness, depression. Prescribed Vertin. Any advice?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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My Brother XXXXXXX XXXXXXX is diagnosed with Acute Vestibular Decomposition. He has consulted several doctors, neorologist and CMC Vellore Experts. He is suffering from Vertigo, Dizziness and psychiatric problem(depression, anxiety). Now Experts from Vellore has given him dosage on Vertin 48 mg once daily for 3 weeks. He has also been advised to take help of Neurologist for Posterior Third Ventricular Calcification but CMC has not given any medicine on that. He has also consulted Pshychitist and they have advised medicines for 6 months. He also have high colestoral. Please advise diet chart

Please advise on this.
Posted Wed, 24 Apr 2013 in Mental Health
 
 
Answered by Dr. Sudhir Kumar 20 minutes later
Hi XXXXXXX Ji,

Thank you for posting your query.

I have gone through the details regarding your brother.

First of all, I would like to reassure you that he does not have any serious problem.

Acute vestibular decompensation improves over 6-8 weeks period. Vertin is a good drug for that. In addition, vestibular adaptation exercises would also be useful (this can be done under the guidance of a physiotherapist).

Posterior third ventricular calcification is often an incidental finding, and no treatment is often necessary for that. In rare cases, a tumor of pineal galnd may cause that. So, a repeat MRI brain may be required after six months to see whether it has remained same or worsened.

For high cholesterol, he should avoid fried and oily food, and also sweets. Daily walks for 30 minutes is also advised. Dietician consultation may be taken for detailed food plan.

I was in CMC vellore from 1989-2004, both as a student and a faculty in Neurology dept.

I hope it helps.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: YYYY@YYYY
My Website: WWW.WWWW.WW My blog: http://bestneurodoctor.blogspot.com/
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with Acute Vestibular Decomposition, vertigo, dizziness, depression. Prescribed Vertin. Any advice? 18 hours later
Dear Sir,

Your suggestions are really encouraging and helpful. Post Dr Achamma Balraj (ENT HOD CMC) told to do a HRCT and consult a neurologist/neurosurgeon, My brother met Dr Ari Chacko Neorusurgery Unit 1 but doctor said nothing. Kindly let me know if this vertigo is curable as he was having Vertigon 25, then Zevert MD 24 before CMC has prescribed on Vertin. Are there any side effects having this dosages. If Vertin is okay then I am surprised why Vertigon and Zeovert was prescribed earlier by Kolkata Neuroscience Doctors. He has also anxiety, tension and depression and he had consulted Pshychitist in Vellore. They have given 6 months medicine and asked for a review after that. Kindly let me know if Vertigo is the cause for that. Most of the cases it is seen that even after taking Vertin, this Vertigo does not cures. Kindly let me know if this drug responds differently to different patients according to severity.

Also let me know what is the cost of HRCT Scan and in Kolkata which clinic is best to do it and whether there is any hurry to do it now or do it after 6 months.

As he is a Tea Professional, this is mainly field job. Should he continue with that or look for another option for Desk Job. Kindly opine.

Thank You.

With Warm Regards XXXXXXX XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Thank you for getting back with more details.

HRCT is for which part of body? It can be done in any good diagnostic center. The cost would depend on the part of body scanned and ranges from Rs 3000-5000/ usually.

Dr Ari Chacko is a good neurosurgeon and if surgery was required, he would have discussed that possibility. So, I think surgery was not required in his case.

Vertin is the original brand and has the best efficacy. It is safe and is free of any significant side effects.

He can continue with the current job.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with Acute Vestibular Decomposition, vertigo, dizziness, depression. Prescribed Vertin. Any advice? 40 minutes later
Dear Sir,

Thanks for your reply and expert opnion.

His HRCT scan is for temporal bone which we can't understand and need to understand why this has been recommended. Also need to understand why vomiting tendency is still there. He has starter this medicine from 22nd March onward. Please suggest going ahead these symptoms would gradually diminish and he would lead a healthy life.

Thank You

With Warm Regards XXXXXXX XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Thank you for getting back.

HRCT of temporal bones is useful for ENT doctors to see if the patient has sinus infections and infections in the related areas. So, the report should be shown to and discussed with the ENT doctor. They may prescribe a course of antibiotics if there is evidence of infection on HRCT.

Vomiting tendency is part of his illness with dizziness, and he would gradually improve and be able to lead a normal life with treatment.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Diagnosed with Acute Vestibular Decomposition, vertigo, dizziness, depression. Prescribed Vertin. Any advice? 19 hours later
Dear Sir,

Thank you on your response. Your insights are really helpful.

Kindly suggest if HRCT is important now as this stage or it can be done afterwards on revisit to CMC. If yes, we can do it or else will do it at later stage.

Also kindly let me know if any cardiovascular surgeon consultation is required at this stage on any sign of peripheral vascular disease.

Regards XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 5 minutes later
Thank you for getting back.

HRCT may be postponed, and done later when the patient visits CMC Vellore.

Cardiovascular surgeon consultation is not necessary at this stage.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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