Brief Answer:
Vertigo management

Detailed Answer:
Hi XXXX, thanks for from HCM.


I can understand your concern. You mentioned that you are suffering from vertigo for last 3.5 years. Before treating vertigo, the doctor need to know few things about it

- What is the cause? Vertigo can be caused by few diseases like

Vestibular nerve (8th nerve) disease - vestibulitis, vestibular nerve compression syndrome, vestibular nerve tumor, Menier's disease, Benign Paroxysmal Positional Vertigo

cerebellar disease - cerebellar infarct, cerebellar tumor, cerebellar demyelination

systemic illness - anaemia, autonomic dysregulation

vascular disease - vertebra-basilar insufficiency, transient ischemic attack

spine - cervical spondylosis

These are the most common causes. Before treatment, you must be evaluated. The doctor will examine your

- vestibular system - dynamic visual acuity, Hallpike manouver
- cerebellar system - balancing, co-ordination, tremors
- rest nervous system - sensory-motor

It will help in narrowing down the diagnosis. After it few investigations are needed to confirm

- Hemoglobin level to rule out anaemia
- BP examination in both lying and standing position
- MRI brain to rule out cerebellar or vestibular nerve disease
- MRI cervical spine for cervical spondylosis
- Ultrasound doppler for vertebrobasilar insufficiency

Treatment will be best effective if given after confirming diagnosis. The cerebellar vertigo is most resistant type of vertigo. Rest vertigo can be managed with with medication or surgery (if needed).
Usual medications are

- Betahistine
- Cinnarizine
- Dimenhydrinate
- Meclizine
- Benzodiazepines like clonazepam

I need to know about your investigations and examination. After that I can guide what to do?
Hope above answer will give you some insight. If still having doubts, do let me know.
Thanks. Take care.

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