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Diagnosed with acute vestibular syndrome. Having vertigo, dizziness, depression and anxiety. Advice?

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ENT Specialist
Practicing since : 1992
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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. Please advise what is the prospect.
Posted Wed, 24 Apr 2013 in Ear, Nose and Throat Problems
Answered by Dr. Ravinder Sharma 9 hours later
I am Dr Ravinder Sharma ENT surgeon
I have gone through your query, the reports and the prescription attached and before answering your query I would like to explain to you the causes of vertigo

Vertigo is described in different ways by the patients and it requires multidisciplinary approach as it can be because of a variety of causes. It may be attributed to a disease of
1.     Ear / Labyrinth / Vestibular system
2.     Brain/Cerebellum
3.     Cervical spine and Joints
4.     Systemic diseases like thyroid disorders , anemia and diabetes mellitus
5.     Disease of cardiovascular system
6.     Psychiatric disorders
After careful review of the papers it appears that the patient has a problem with the vestibular system and he is in the phase of vestibular compensation which is a gradual process and may take months. A history of peripheral vascular disease and these symptoms may be explained due to decreased blood flow in one labyrinth / vestibular system and producing signs of hypoactive response.

Calcification in brain may also present with such symptoms and a neurologist is the best person to explain this further.

Psychiatric diseases may also present with symptoms of dizziness but with positive findings the possibility of an organic cause is more strong. We think of a psychiatric cause when the examination findings and investigation findings are normal. To me this appears to be a unlikely cause.

I would suggest you for a cardiologist or a cardiovascular surgeon consultation as there is a positive history of peripheral vascular disease.
I would suggest that
1.     Medications as advised will help in compensation
2.     Vestibular exercises will be of help
3.     Regular follow up are necessary
4.     You can plan for a thyroid function test and a cardiologist opinion

Besides this what is more important here that it appears it is not life threatening and it will improve gradually. In the mean time if he develops a new symptom like headache, vomiting or abnormal movements he will need a review. With the present information it appears this will settle gradually.

I hope this answers your concern.
With regards
Ravinder Sharma

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