All listed drugs are . Food and Drug Administration approved, but most are not approved for the treatment of vertigo. b Usual oral (unless otherwise stated) starting dose in adults; maintenance dose can be reached by a gradual increase. c For acute vertigo only. d For motion sickness only. e For benign paroxysmal positional vertigo. f For vertigo other than Ménière's and positional. g For Ménière's disease. h For migraine-associated vertigo (see Chap. 15 for a listing of prophylactic antimigrainous drugs). i For perilymphatic fistula and refractory cases of Ménière's semicircular canal BPPV, the most common type, is often selflimited but, when persistent, may respond dramatically to specific repositioning exercise programs designed to empty particulate debris from the canal. . | Chapter 022. Dizziness and Vertigo Part 6 All listed drugs are . Food and Drug Administration approved but most are not approved for the treatment of vertigo. Usual oral unless otherwise stated starting dose in adults maintenance dose can be reached by a gradual increase. cFor acute vertigo only. rfFor motion sickness only. eFor benign paroxysmal positional vertigo. For vertigo other than Ménière s and positional. gFor Ménière s disease. For migraine-associated vertigo see Chap. 15 for a listing of prophylactic antimigrainous drugs . For perilymphatic fistula and refractory cases of Meniere s semicircular canal BPPV the most common type is often selflimited but when persistent may respond dramatically to specific repositioning exercise programs designed to empty particulate debris from the canal. One of these exercises the Epley procedure is graphically demonstrated in four languages on a website for use in both physicians offices and self-treatment www. charite. de ch neuro verti go. html . Prophylactic measures to prevent recurrent vertigo are variably effective. Antihistamines are commonly utilized but are of limited value. Meniere s disease may respond to a diuretic or more effectively to a very low salt diet 1 g d . Recurrent episodes of migraine-associated vertigo should be treated with antimigrainous therapy Chap. 15 . There are a variety of inner ear surgical procedures for refractory Meniere s disease but these are only rarely necessary. Psychogenic phobic postural vertigo is best treated with cognitive-behavioral therapy. Helpful websites for both physicians and vertigo patients are and . Global Considerations There are no epidemiologic studies indicating an increased frequency of specific types of vertigo in different geographical areas. However whereas BPPV of the posterior semicircular canal is overwhelmingly the most common form of positional vertigo in most countries there seems to be an unusually .
