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VERTIGO

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.

Treatment

Surgical Intervention

Meniere’s Disease

Surgery is recommended if conservative and medical treatments have failed and the disease is severe

Endolymphatic duct/sac procedures and sacculotomy

The procedure exposes the endolymphatic sac and duct with the aim of improving endolymph drainage
Commonly done in Meniere’s disease patients with intact hearing
Control of vertigo has been reported in 75-80% in an uncontrolled case series
Low risk of sensorineural hearing loss

Vestibular nerve section or Vestibular neurectomy

Vestibular nerve bundle is surgically lysed as it enters the internal auditory canal
Relieves vertigo in 90-95% of patients
Low risk of sensorineural hearing loss

Labyrinthectomy

Neuroepithelium of the bony and membranous labyrinth is surgically removed, thus eliminating both balance and hearing function from the affected ear
Due to the irreversible hearing loss, this procedure is reserved for patients with intractable symptoms despite pharmacotherapy, and with poor hearing or complete hearing loss on the affected side

Product Highlight - Pontevia

16 Mar 2022

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Shifting paradigms in MS management: Early, optimized interventions improve patient outcomes

04 May 2018

Multiple sclerosis (MS) is one of the most common neurological disorders – affecting over 2.3 million people globally – and it is the leading cause of nontraumatic disability in young adults. However,the availability of supportive resources and services for people with MS is scarce in many regions of the world. In Malaysia, the prevalence of MS is estimated at 2-3/100,000; the current Malaysian clinical practice guidelines on the management of MS recommend disease modifying agents, such as interferon-β and teriflunomide, as first-line therapeutic agents. In this article, Dr Singer - in partnership with Sanofi and the Malaysian Society of Neurosciences - shares his insights into managing MS dynamically, highlighting the importance of early intervention in improving patient outcomes.