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CDHB

Management of Vertigo

Benign Positional Vertigo

Repositioning treatment. Absence of vertigo on positional test, non-response to treatment or non-typical nystagmus should alert to a possible central cause.

Symptomatic Relief of an Acute Episode

• Prochlorperazine IM or PO under top lip (3 mg buccal tab). Suppositories if continues for days. An alternative drug is cyclizine.
• Migraine: sumatriptan or non-steroidal anti-inflammatory.

Vertigo Prophylaxis

• For Meniere's disease: salt restriction, betahistine
• For Migraine: beta-blocker, pizotifen, sodium valproate

Investigation

This is guided by the clinical findings, but the three most relevant investigations are MRI (8^th nerve pathology, infarction/ischaemia, demyelination, tumour), pure tone audiogram, and electrocochleography for Meniere's disease.

Topic Code: 3783