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Vertigo (BPPV, vestibular neuritis)

Vertigo · Závrať (BPPV, vestibulární neuritida)

What it is

The balance organ misreports movement; the room spins.

Symptoms & signs

  • Spinning for under a minute on turning the head or lying down (BPPV)
  • days of severe vertigo after a virus, without hearing loss (neuritis)
  • nausea
  • imbalance

🚩 Get help if…

  • call 112 / 911 now Vertigo with double vision, slurred speech, weakness or numbness
  • call 112 / 911 now Can't stand or walk at all, or a new severe headache or neck pain
  • see a doctor soon Vertigo with sudden hearing loss
  • see a doctor soon Vertigo that doesn't settle within a few days

Where it strikes

Medical treatment

  • Epley manoeuvre for BPPV (often curative in one visit)
  • vestibular rehabilitation
  • short-course prochlorperazine only (longer use slows recovery)
  • steroids early in neuritis — faster recovery of the nerve, not clearly of the symptoms

Natural & lifestyle

  • Epley exercises at home
  • vestibular rehab exercises
  • fall-proofing the home
  • sudden vertigo with weakness, double vision or slurred speech is a stroke until proved otherwise

Emerging & experimental

  • Vestibular implants
  • low-pressure pulse devices
  • gentamicin micro-dosing

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Ginkgo extract (EGb 761) — trials comparable to betahistine mixed evidence
  • Acupuncture — trials disagree mixed evidence
  • Ginger — small studies of less dizziness and nausea early / small studies

ICD codes