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Suggest Treatment For Severe Vertigo

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Posted on Tue, 26 Apr 2016
Question: i am asking this question on behalf of my father , 72 yrs , he is having severe vertigo problem from past 2 months and it very very bad and he starts crying , he feels as if something is coming out of head and his heart becomes heavy after vertigo , 2 months before , he had pain in a tooth and the dentist removed the tooth - since after then he is having this problem , this may be a co incidence but it happened just after that , all testings have being done and there is nothing in reports , i am attaching 3 prescriptions , he took medicines of dr manjit XXXXXXX for 15 days but no relief , then switched to dr prasads medication from past 20 days but no relief and now have moved to another doctor , we are highly confused and worried as what to do , what is the problem and whom to consult , we have shown neorologist also , kindly suggest and help
doctor
Answered by Dr. Neel Kudchadkar (4 hours later)
Brief Answer:
Please perform "Epley's method" to stop vertigo attacks.

Detailed Answer:
Hi!

I have carefully examined all the three prescriptions that you have sent. I have read your case in detail. There is a simple solution for this problem that does not need medicines and can be done anytime an attack of vertigo comes.

1. First, you must know from which side, left or right the vertigo is coming from.
2. If it is on the left side, every time you (meaning the patient) get an attack, you must be near a bed. Keep a neck pillow close by. Position the head slightly towards the vertigo attack, keep an angle of 45 degrees.
3. Lying on the bed, with the pillow underneath, Now maintain the head at a perfect 90 degrees.
4. Keep this slow movement from left to right till you can face the floor.

This is very easy to write down and read. You need to take your father to a physiotherapist or an ENT doctor to show him practically how this is done.
It requires some practice, but an attack of vertigo and dizziness can be stopped in a few minutes.

I agree that the three doctors have given him the best medicines. But as you say, they have not worked well. You also never mentioned any doctor teaching or asking you to do this method called Epley's maneuvre, that stops any vertigo attack without medicines.

So, follow these instructions. Keep taking the medicines from the last prescription. There is no need for further medications.

Thanks and regards,
Dr. Neel Kudchadkar
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Neel Kudchadkar (55 minutes later)
we have shown to ent specialist now and attaching the prescription of mr dhanuka , he has asked to stop previous medications and start his , also perfromed ct scan but found no problem , then whats the reason behind this severe vertigo problem , can the tooth taken out before 2 month be the cause behind it , the attack is so severe that the said epleys method is almost impossible as during that time he is unable to bear and speak, the vertigo attack is direct from the middle of the head.
kindly suggest as to which specialist we should consult now as its almost a month that he has gone out of the house due to this problem, also plz go through the latest prescription as we are to start that now , really feeling helpless and lost , plz show way
doctor
Answered by Dr. Neel Kudchadkar (44 hours later)
Brief Answer:
Referring your case to a good healthcaremagic neurologist. Details given.

Detailed Answer:
Hi!

Thanks for your thoughts on this.

1. You mentioned that the Epley method was not possible in this case. This is understandable.
2. I have examined the prescriptions and medicines given by all three doctors and I assure you that the latest medications have been given. This is obvious because Venlafaxine has even been given, and it is indeed used to correct the neurotransmitter issues associated with vertigo.
3. There is a possibility that the dental work might have caused this vertigo. However, this is very remote. For example, in the extraction of the 3rd molar, the dental surgeon sometimes causes injury to the facial nerve. This is seen later as a neurological deficit. This does not help the patient of iatrogenic facial nerve paresis anyway. My thoughts are that, there is indeed very less practical probability of the dental work causing injury to the structures in the inner ear, the incus, malleus and the stapes, and the eighth cranial nerve causing this vertigo. Most commonly, there can be infection of a dry socket after extraction of the tooth, that can possibility spread to the spaces (sacs) of the mastoid and the inner ear or the vestibulo cochlear nerve.

In any case, even if it is true that the dental work, indirectly caused this problem, there is little that we can do to reverse it.

So, practically, for now, I am recommending that instead of seeing an ENT doctor, you must take your father to a doctor called as a neuro physician. This Doctor has got a DM degree. Please note this fact. I am not asking you to take him to a neurologist with an MD degree. This is because the first prescription that you have scanned and uploaded is indeed from a doctor with an MD degree, who is technically a neurologist or equivalent.

In health care magic website, kindly click on the doctors listing. Personally, I would give an example of Dr. XXXXXXX Panwar, DM. This doctor is on the health care magic forum and definitely can give you the exact guidance on what to do in this case, given the exact symptoms you mention.
You may mail customer support team ( YYYY@YYYY ) who can guide you to ask Dr. XXXXXXX Alternatively you also have the option of visiting a local super specialty center and finding a doctor of your choice face to face.

I feel that vertigo, that is not controlled by traditional drugs like cinnarizine, or venlafaxine and other latest medicines which have been given to your father can be effectively handled by such a neuro physician.

If you have any doubts, or need clarification, please feel free to ask me.

Most sincerely,
Dr. Neel Kudchadkar
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Neel Kudchadkar

General & Family Physician

Practicing since :2004

Answered : 532 Questions

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Suggest Treatment For Severe Vertigo

Brief Answer: Please perform "Epley's method" to stop vertigo attacks. Detailed Answer: Hi! I have carefully examined all the three prescriptions that you have sent. I have read your case in detail. There is a simple solution for this problem that does not need medicines and can be done anytime an attack of vertigo comes. 1. First, you must know from which side, left or right the vertigo is coming from. 2. If it is on the left side, every time you (meaning the patient) get an attack, you must be near a bed. Keep a neck pillow close by. Position the head slightly towards the vertigo attack, keep an angle of 45 degrees. 3. Lying on the bed, with the pillow underneath, Now maintain the head at a perfect 90 degrees. 4. Keep this slow movement from left to right till you can face the floor. This is very easy to write down and read. You need to take your father to a physiotherapist or an ENT doctor to show him practically how this is done. It requires some practice, but an attack of vertigo and dizziness can be stopped in a few minutes. I agree that the three doctors have given him the best medicines. But as you say, they have not worked well. You also never mentioned any doctor teaching or asking you to do this method called Epley's maneuvre, that stops any vertigo attack without medicines. So, follow these instructions. Keep taking the medicines from the last prescription. There is no need for further medications. Thanks and regards, Dr. Neel Kudchadkar