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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Medication Is Suggested For Vertigo?

Dear Dr., 12 days ago got intense vertigo while waking up, out of nowhere. Tried to stand up, got worse, fell on the bed. After a couple of tens of seconds - vertigo stopped. During that day, nothing happened, normal. Until tried in the evening to put the head in horizontal position - vertigo again... Decided to visit Emergency that night. The problem reproduced in front of the doctor. Given Allerfin injection and made appointment for the evening next day. Well, next day, doctor did an Epley. No vertigo while slowly moving down and turning right and left. However, a very intense (falling) sensation while tilting back the head in vertical position, almost fell out of the bed, could not stand it, doctor put me back in horizontal. After a while, tried it again but much slower, somehow managed it and came back on the feet. Once again, given Allerfin injection. Since then, already 11 days, very foggy feeling, all the time... Moving the head or even just eyes causes a strong imbalance feeling. A minute of focus in front of the laptop is almost impossible, get a feeling as if will fall down. Pretty much not really able to walk or do any activities. As if someone pushes me to the left, to the right. Generally feeling very bad, constant dizziness. Not even trying horizontal position anymore. Some nausea, brought me to the edge of vomiting, however, not vomited. Taking as advised, 3 times daily a 24mg Betaserc. What is happening? Why do I feel so bad after Epley? How long can that last? The doctor in Emergency mentioned two or three days, later another ENT specialist I had visited mentioned around a week; I am already in the second week and it looks like not improving at all... Can you please comment on this and give some advise. Thanks!
Mon, 8 Jun 2015
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Neurologist,  's  Response
I'm sorry you are feeling this way. Vertigo is the sensation of motion where there shouldn't be, often described as the room spinning. It's important to understand that vertigo is a symptom and not a diagnosis. There are many types of vertigo that can often be diagnosed based on the duration of symptoms.

If it lasts seconds and can be triggered by a motion to one side, such as laying down to the left in bed, this is Benign Paroxysmal Positional Vertigo (BPPV), defined by crystals dislodged in the fluid in the semicircular canals. When you turn your head in the direction of the problem, this causes a brief upset in the vestibular system, which is then perceived as vertigo. It is diagnosed by the Dix-Hallpike maneuver and then treated with the Epley maneuver.

Often the Epley maneuver should correct the problem immediately. Sometimes it needs to be repeated. There is less common version of BPPV, where the crystals are lodged in the other canal and a complete "log roll" needs to be performed. If your ENT can't help, consider a neuro-otologist.

There really aren't any effective medicines for BPPV, just antihistamines that can make people drowsy.

The subsequent symptoms do not sound like vertigo but more of a visual motion sensitivity. This could be from the Allerfin injection. In the US we have a different version of the medicine involved in cold medicine and these symptoms sound very similar to side effects from this.

Another possibility is that this is migraine-related symptoms.
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General & Family Physician,  Dr. Maria Monica Villanueva's  Response
Hi have they referred you to a neurologist. At the most vertigo after an Epleys maneuver should last a week. Try not to tilt your hesd back for now because it seems to make your symptoms worse. Hows is your blood pressure by the way?No hearing loss or any ringing sound in your ears? Monitor please. I would suggest a neuro visit ASAP. A head scan like an MRI might be needed if ENT tests are negative
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What Medication Is Suggested For Vertigo?

I m sorry you are feeling this way. Vertigo is the sensation of motion where there shouldn t be, often described as the room spinning. It s important to understand that vertigo is a symptom and not a diagnosis. There are many types of vertigo that can often be diagnosed based on the duration of symptoms. If it lasts seconds and can be triggered by a motion to one side, such as laying down to the left in bed, this is Benign Paroxysmal Positional Vertigo (BPPV), defined by crystals dislodged in the fluid in the semicircular canals. When you turn your head in the direction of the problem, this causes a brief upset in the vestibular system, which is then perceived as vertigo. It is diagnosed by the Dix-Hallpike maneuver and then treated with the Epley maneuver. Often the Epley maneuver should correct the problem immediately. Sometimes it needs to be repeated. There is less common version of BPPV, where the crystals are lodged in the other canal and a complete log roll needs to be performed. If your ENT can t help, consider a neuro-otologist. There really aren t any effective medicines for BPPV, just antihistamines that can make people drowsy. The subsequent symptoms do not sound like vertigo but more of a visual motion sensitivity. This could be from the Allerfin injection. In the US we have a different version of the medicine involved in cold medicine and these symptoms sound very similar to side effects from this. Another possibility is that this is migraine-related symptoms.