Treatment Guideline Chart

Vertigo is having a sensation of spinning of either the surrounding or within oneself but physical movement does not exist.

It may be secondary to different causes that may be determined by numerous factors eg timing and duration, aggravating conditions or associated symptoms.
Central vertigo originates from the central nervous system (brainstem or cerebellum). It is uncommon but more serious and should be ruled out immediately.
Peripheral vertigo originates from the labyrinth or vestibular nerve.

Vertigo References

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  3. Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the quality standards subcommittee of the American Academy of Neurology. Neurology. 2008 May;70(22):2067-2074. doi: 10.1212/ PMID: 18505980
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  6. Kuo CH, Pang L, Chang R. Vertigo - part 1 - assessment in general practice. Aust Fam Physician. 2008 May;37(5):341-347. PMID: 18464964
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  8. Wuyts F. Principle of the head impulse (thrust) test or Halmagyi head thrust test (HHTT). B-ENT. 2008;4(Suppl 8):23-25
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  10. Olshaker JS. Dizziness and vertigo. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine. 7th ed. Philadelphia: Mosby, Elsevier; 2009
  11. Budoin KS. The testing and treatment of benign paroxysmal positional vertigo. In: Weber PC. Vertigo and Disequilibrium, a Practical Guide to Diagnosis and Management. New York: Thieme Medical Publishers Inc; 2008.
  12. Weber PC. Vertigo and disequilibrium. a practical guide to diagnosis and management. New York: Thieme Medical Publishers Inc; 2008.
  13. MedWorm
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  15. Bowdler D, Faulconbridge RL. Dizziness and vertigo. ENT UK- The British Association of Otolaryngologists - Head and Neck Surgeons. 2011. Accessed 28 Feb 2012.
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  19. Mayo Clinic. Meniere's disease. Mayo Clinic. Accessed 15 Mar 2012.
  20. National Institute on Deafness and Other Communication Disorders. NIDCD fact sheet: Meniere’s disease. Jul 2010.
  21. Furman JM, Barton J. Vestibular neuritis. UpToDate. 06 Jul 2010. Accessed 06 Mar 2012.
  22. Furman JM, Barton J. Treatment of vertigo. UpToDate. 09 Jun 2011. Accessed 06 Mar 2012.
  23. Knott L. Vestibular neuritis. Patient UK. 16 Jul 2010. Accessed 06 Mar 2012.
  24. Dispenza F, De Stefano A. Textbook of Vertigo: Diagnosis and Management. 1st ed. India: Jaypee Brothers Medical Publishers (P) Ltd; 2014:223.
  25. Taghdiri F, Togha M, Razeghi Jahromi S, et al. Cinnarizine for the prophylaxis of migraine associated vertigo: a retrospective study. Springerplus. 2014 May 7;3:231. doi: 10.1186/2193-1801-3-231. PMID: 24834377
  26. Teggi R, Gatti O, Sykopetrites V, et al. Association of cinnarizine and betahistine in prophylactic therapy for Ménière’s disease with and without migraine. Acta Otorhinolaryngol Ital. 2014 Oct;34(5):349-353. Accessed 15 Oct 2015. PMID: 25709150
  27. Alyono JC. Vertigo and dizziness. The Otolaryngologic Clinics of North America. 2018;51(4):725-740.
  28. Furman JM. Pathophysiology, etiology and differential diagnosis of vertigo. UpToDate. Aug 2018. Accessed 14 Sep 2018.
  29. Moscowitz HS, Dinces EA. Meniere's disease. UpToDate. Aug 2018. Accessed 14 Sep 2018.
  30. Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017 Mar;156(Suppl 3):1-47. doi: 10.1177/0194599816689667. PMID: 28248609
  31. Christopher LH, Wilkinson EP. Meniere's disease: medical management, rationale for vestibular preservation and suggested protocol in medical failure. Am J Otolaryngol. 2021 Jan;42(1):102817. doi: 10.1016/j.amjoto.2020.102817. Accessed 17 Feb 2021. PMID: 33202330
  32. Muncie HL, Sirmans SM, James E. Dizziness: Approach to evaluation and management. Am Fam Physician. 2017 Feb;95(3):154-162. Accessed 11 Feb 2021. PMID: 28145669
  33. National Institute for Health and Care Excellence. Suspected neurological conditions: recognition and referral. NICE. 1 May 2019.
  34. De Luca P, Cassandro C, Ralli M, et al. Dietary restriction for the treatment of Meniere's disease. Transl Med UniSa. 2020 May;22:5-9. PMID: 32523900
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