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Vertigo Information
is a sensation of irregular or whirling motion, either of oneself or of external
objects.
The word is sometimes incorrectly used as a general term to describe dizziness. The most
common form of vertigo is benign positional paroxysmal vertigo (BPPV), in which brief attacks
are brought on by certain changes in head position.1 BPPV may be due to a previous
head injury, viral infection, and certain drug
therapies, although in about half the cases the cause is unknown.2 3
BPPV tends to resolve without treatment within weeks to months, but may persist for years in
some cases.4 5
People experiencing vertigo should have a complete medical evaluation to determine the
cause. Common causes of non-BPPV vertigo include conditions in which there is decreased blood
flow to certain areas of the brain,
Ménière’s disease, and infection of the inner ear.6
7 may also be a symptom of numerous other conditions,8 9
10 including sinusitis, panic attacks, migraine headaches, and problems with
metabolism,11 12 such as
hypothyroidism, high blood triglycerides,
diabetes, and hypoglycemia.
What are the symptoms of vertigo?
People with vertigo may have sudden sensations of spinning or whirling motion that may be
accompanied by lightheadedness and loss of balance, and less often by sweating, fatigue,
nausea, and vomiting.13 14
Medical treatments for vertigo
Over the counter medication such as
dimenhydrinate (Dramamine®),
meclizine (Bonine®), and cyclizine (Marezine®) may be helpful.
Prescription medications include anticholinergic drugs, such as scopolamine (Transderm
Scop®), prochlorperazine
(Compazine®), and meclizine
(Antivert®), as well as sedatives,
including diazepam (Valium®), lorazepam (Ativan®), and alprazolam (Xanax®).
Healthcare practitioners recommend getting fresh air, lying down, closing the eyes, and
alcohol avoidance. People frequently affected by severe, disabling vertigo may require a
surgical treatment, such as vestibular neurectomy or labyrinthectomy. These procedures involve
surgical removal of either the nerves or labyrinthine structures that control balance and
position senses.
Dietary changes that may be helpful for vertigo
In preliminary studies, vertigo associated with high triglycerides, diabetes mellitus, and hypoglycemia responded to dietary management of the
underlying disorder.15 16 In a preliminary study of people with migraine headaches, most of whom (83%) also
experienced vertigo, a multifaceted approach including dietary changes was investigated.
Dietary changes involved the elimination of
foods and food additives suspected of causing migraine attacks. This approach resulted in
complete or substantial improvement of symptoms in a significant number of
participants.17 No other research has investigated the effects of diet on
vertigo.
Lifestyle changes that may be helpful for vertigo
Head positions that bring on sudden, acute attacks of vertigo, particularly bending the
neck back while looking up, should be avoided. In one report, for example, the head position
used in salons for shampooing hair was associated with the onset of vertigo.18
According to one authority,19 certain chronic or repetitive body positions may
produce painful nodules, called trigger points, in the muscles of the head and neck, which can
lead to dizziness and possibly vertigo. These positions include forward bending of the neck as
when sleeping on two pillows, backward neck bending as when painting a ceiling, and turning
the neck to one side as in some reading positions.20 A healthcare practitioner
knowledgeable in postural education can give advice on avoiding such positions. Trigger point
therapy is discussed below in “Other integrative approaches that may be
helpful.”
Nutritional supplements that may be helpful for vertigo
A preliminary trial showed that 15 mg per day of vinpocetine had a moderate or greater effect on
reducing the signs and symptoms of vertigo in 77% of patients with this
condition.21 Other preliminary reports exist describing benefits of vinpocetine for
vertigo and other symptoms of inner ear disorders,22 but controlled research is
needed to evaluate these claims.
Two preliminary human studies reported that
vitamin B6 supplementation reduced symptoms of vertigo produced with drugs in a laboratory
setting.23 Vitamin B6 supplementation has not been studied in BPPV or other forms
of vertigo and may not share the same causative mechanism as experimentally induced
vertigo.
Are there any side effects or interactions with Vertigo?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful for vertigo
Herbs that may be helpful: In a preliminary clinical trial, a standardized extract
of Ginkgo biloba (GBE) significantly
reduced symptoms of vertigo in a group of elderly people with mild cognitive
impairment.24 Participants were given 40 mg three times per day for one year. GBE
has also been reported to significantly reduce vertigo of unknown cause in
preliminary25 and double-blind26 trials. The amounts given were 120 mg
and 160 mg per day, respectively, for three months.
One gram of powdered ginger
(Zingiber officinale) root in a single application has been reported to significantly
reduce symptoms of artificially induced vertigo in one double-blind trial.27 In a
double-blind trial, 1 gram of powdered ginger root was found to have very little effect in
reducing vertigo related to
seasickness.28
Are there any side effects or interactions with Vertigo?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful for vertigo
Other integrative approaches that may be helpful: Numerous preliminary reports
suggest certain “vestibular rehabilitation” exercises may help some cases of
vertigo.29 30 31 32 33 34
These exercises were also found to be effective in relieving vertigo in two controlled
studies,35 including one on BPPV.36 While vestibular rehabilitation
exercises may be done at home, initial guidance by a qualified practitioner is necessary.
BPPV appears to be caused by an accumulation of free-floating cell fragments in the fluid
of the inner ear.37 38 Certain manipulation therapy maneuvers, referred
to as particle repositioning maneuvers (PRMs), are intended to relocate this debris to a
harmless location,39 40 41 in order to improve symptoms. Both
preliminary42 43 44 45 46 and
controlled47 48 49 trials achieved significant improvement
in, or elimination of, BPPV using these maneuvers. Most studies report that over 90% of people
with BPPV treated one or two times with PRM respond to this treatment, although up to 45% may
develop BPPV again within a few years, requiring further treatments.50
51 52
Research indicates some cases of vertigo are related to spinal disorders affecting the head
and neck.53 54 55 56 57 58
59 Preliminary studies report that certain treatments, such as spinal manipulation,60 61
62 63 physical therapy,64 and combined approaches including
manipulation and specific exercise programs,65 66 result in significant
improvement of vertigo symptoms.
Trigger points are thought by most,67 68 69 though not
all,70 authorities to potentially cause pain and abnormal function in other parts
of the body. Trigger points appear to develop as the result of injury, poor posture,
structural abnormalities of the leg or pelvis, emotional tension, and other body
stressors.71 72 Also known as myofascial pain dysfunction (MPD), this
condition, when it affects certain muscles of the head and neck, has been associated with
vertigo in preliminary research.73 74 75 Musculoskeletal
healthcare specialists and other practitioners can often treat MPD with a variety of natural
therapies, including deep pressure
massage,76 77 78 79 80
transcutaneous electrical nerve stimulation (TENS),81 82 and other
approaches,83 but no controlled studies have investigated the effectiveness of
these treatments specifically for vertigo.
In a preliminary study of people with migraine headaches, most of whom (83%) also
experienced vertigo, a combined and individualized approach using dietary changes, medication,
physical therapy, lifestyle changes, and
acupuncture resulted in complete or substantial improvement of symptoms in a significant
number of participants.84 In addition, a large number of case studies presented in
two preliminary reports suggest acupuncture may help to reduce symptoms of
vertigo.85 86 These preliminary studies have yet to be confirmed by
controlled clinical trials.
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in
vitro), clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of
the conditions discussed, treatment with prescription or over the counter
medication is also available. Consult your doctor, practitioner, and/or
pharmacist for any health problem and before using any supplements or before
making any changes in prescribed medications.
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