DIZZINESS AND VERTIGO
Dizziness is an imprecise symptom used to describe a variety of sensations that include vertigo, light-headedness, faintness, and imbalance. When used to describe a sense of spinning or other motion, dizziness is designated as vertigo.
CAUSES
It may be due to peripheral or central causes:-
(1). PERIPHERAL CAUSES
Benign paroxysmal positional vertigo
Vestibular neuritis
Herpes zoster oticus (Ramsay Hunt syndrome)
Meniere disease
Labyrinthine concussion
Perilymphatic fistula
Semicircular canal dehiscence syndrome
Cogan's syndrome
Recurrent vestibulopathy
Acoustic neuroma
Aminoglycoside toxicity
Otitis media
(2).CENTRAL CAUSES
Vestibular migraine
Brainstem ischemia
Cerebellar infarction and hemorrhage
Chiari malformation
Multiple sclerosis
Episodic ataxia type 2
TREATMENT
A)...ORAL
(1).Antihistamines, first-generation
Dimenhydrinate 50 to 100 mg every 4 to 6 hours
Diphenhydramine 25 to 50 mg every 4 to 6 hours
Meclizine 25 to 50 mg every 6 to 12 hours
(2).Benzodiazepines
Alprazolam 0.5 mg immediate release every 8 hours
Clonazepam 0.25 to 0.5 mg every 8 to 12 hours
Diazepam 1 mg every 12 hours
Lorazepam 1 to 2 mg every 8 hours
(3).Antiemetics
Domperidone 10 mg every 8 hours
Metoclopramide 5 to 10 mg every 6 hours
Ondansetron 4 mg every 8 to 12 hours
Prochlorperazine 5 to 10 mg every 6 hours
Promethazine 12.5 to 25 mg every 8 hours
B....PARENTERAL DRUG
Antihistamines, first-generation
Diphenhydramine 10 to 50 mg IV
Dimenhydrinate 50 mg IV
Antiemetics
Metoclopramide 10 mg IV
Ondansetron 4 to 8 mg IV
Prochlorperazine 2.5 to 10 mg IV
Promethazine 12.5 to 50 mg IM or IV .
Dr. Atul Chowdhury
General Medicine
Dizziness is an imprecise symptom used to describe a variety of sensations that include vertigo, light-headedness, faintness, and imbalance. When used to describe a sense of spinning or other motion, dizziness is designated as vertigo.
CAUSES
It may be due to peripheral or central causes:-
(1). PERIPHERAL CAUSES
Benign paroxysmal positional vertigo
Vestibular neuritis
Herpes zoster oticus (Ramsay Hunt syndrome)
Meniere disease
Labyrinthine concussion
Perilymphatic fistula
Semicircular canal dehiscence syndrome
Cogan's syndrome
Recurrent vestibulopathy
Acoustic neuroma
Aminoglycoside toxicity
Otitis media
(2).CENTRAL CAUSES
Vestibular migraine
Brainstem ischemia
Cerebellar infarction and hemorrhage
Chiari malformation
Multiple sclerosis
Episodic ataxia type 2
TREATMENT
A)...ORAL
(1).Antihistamines, first-generation
Dimenhydrinate 50 to 100 mg every 4 to 6 hours
Diphenhydramine 25 to 50 mg every 4 to 6 hours
Meclizine 25 to 50 mg every 6 to 12 hours
(2).Benzodiazepines
Alprazolam 0.5 mg immediate release every 8 hours
Clonazepam 0.25 to 0.5 mg every 8 to 12 hours
Diazepam 1 mg every 12 hours
Lorazepam 1 to 2 mg every 8 hours
(3).Antiemetics
Domperidone 10 mg every 8 hours
Metoclopramide 5 to 10 mg every 6 hours
Ondansetron 4 mg every 8 to 12 hours
Prochlorperazine 5 to 10 mg every 6 hours
Promethazine 12.5 to 25 mg every 8 hours
B....PARENTERAL DRUG
Antihistamines, first-generation
Diphenhydramine 10 to 50 mg IV
Dimenhydrinate 50 mg IV
Antiemetics
Metoclopramide 10 mg IV
Ondansetron 4 to 8 mg IV
Prochlorperazine 2.5 to 10 mg IV
Promethazine 12.5 to 50 mg IM or IV .
Dr. Atul Chowdhury
General Medicine
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