Conventional Treatment of Vertigo
Although BPPV and some other common causes of vertigo are relatively harmless and disappear over time, there are other forms whose appearance might signify the beginning of a more serious condition. Because of this, it is always recommended that any case of vertigo be evaluated by an experienced physician.
The conventional treatment of vertigo depends on its underlying cause. In the case of BPPV, the most common therapy is repositioning exercises that redistribute the calcium carbonate back throughout the inner ear. There are various forms of repositioning exercises, including the Epley maneuver. In the Epley maneuver, the person lies down and the head is moved from side to side, with each position being held about 20 seconds. This has been shown to redistribute the calcium deposits in the inner ear, thus reestablishing normal function (Epley 1994). Nonsurgical, nonpharmaceutical exercises such as the Epley maneuver have an excellent record of reversing vertigo caused by BPPV.
Treatment of Ménière’s is aimed at controlling the vertigo, usually through salt restriction or diuretics to relieve the elevated pressure in the endolymphatic sac. Similarly, glucocorticoids may be prescribed. For severe cases, surgery is sometimes recommended to decompress the endolymphatic sac. Unfortunately, no effective therapy for tinnitus or hearing loss has been identified.
Other pharmaceuticals used to suppress vestibular abnormalities include anticholinergics, benzodiazepines, and antihistamines. Some patients with nausea use antiemetics.