Vertigo

Clinic

• Vertigo is a condition in which a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement.
• This may be associated with nausea, vomiting, sweating, or difficulties walking.
• It is typically worse when the head is moved.
• Vertigo is the most common type of dizziness.
• Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo. About 5% have vertigo in a given year. It becomes more common with age and affects women two to three times more often than men. Vertigo accounts for about 2–3% of emergency department visits in the developed world.

Classification

Vertigo is classified into either peripheral or central, depending on the location of the dysfunction of the vestibular pathway, although it can also be caused by psychological factors.

Peripheral

Vertigo that is caused by problems with the inner ear or vestibular system, which is composed of the semicircular canals, the vestibule (utricle and saccule), and the vestibular nerve is called "peripheral", "otologic", or "vestibular" vertigo.

• Benign paroxysmal positional vertigo (BPPV)(32%)
• Ménière's disease (12%)
• Superior canal dehiscence syndrome
• Vestibular neuritis
• Common cold, influenza, and bacterial infections
• Chemical insults (e.g., aminoglycosides)
• Physical trauma (e.g., skull fractures).
• Motion sickness is sometimes classified as a cause of peripheral vertigo
• Viral  Labyrinthitis

Central

• Vertigo that arises from injury to the balance centers of CNS, often from a lesion in brainstem or cerebellum
• It may have accompanying neurologic deficits such as slurred speech, double vision, pathologic nystagmus (which is pure vertical/torsional).
• Central pathology can cause Disequilibrium/ Unbalance, which is so severe that paitients are unable to stand or walk.
• Causation
  • Lesions caused by Infarctions / Hemorrhage /Tumors (Cerebellopontine/ Vestibular schwannoma/ Cerebellar tumors)
  • Epilepsy
  • Cervical spine disorders such as Cervical spondylosis, Degenerative ataxia disorders
  • Migrainous vertigo
    • Migraine-related dizziness, vestibular migraine or migraine with prominent vertigo) is a type of migraine where people experience a combination of.
  • Lateral medullary syndrome
  • Chiari malformation
  • Multiple sclerosis
  • Parkinsonism, as well as cerebral dysfunction.

• Central vertigo may not improve or may do so more slowly than vertigo caused by disturbance to peripheral structures. Alcohol can result in positional alcohol nystagmus (PAN).

	Entities/ Miasms	Acute remedies
	Orthostatic hypotention: SAHF Ataxia: STLE Hypertention / Flashed face: HFRS	Vertigo - MOTION, from : BRY. COCC. TAB. Vertigo - TURNING, on - moving the head, or turning – quickly : CALC. CON. Vertigo - SHAKING, the head: acon.mp1 calc.mp1 Con.mp1 corn.mp1 genist.mp1 glon.mp1 hep.mp1 kali-c.mp1 Morph.mp1 nat-act.mp1 sep.mp1 spig.mp1
Viral vestibular neuritis	Neuritis, vestibular Ataxia Vertigo / Dizziness Concentration difficult Miasm: VZV, STLE Remedies: Agar, Rhus-t
Viral  Labyrinthitis	Vertigo Ataxia Hearing impaired Miasm: VZV Remedies: Ars, Arg-n, Cocc, Zinc, Nat-m	Hearing - NOISES, in ears - buzzing - vertigo, with: Arg-n, Ars, Bell, CHININ-S, Cic, Glon, Laur. Nat-s, Zinc. Vertigo - MENIERE'S disease, noises in ear with vertigo: CHININ-S, PHOS Vertigo - MENIERE'S disease, noises in ear with vertigo alum. arg-met. Arg-n. arn. ars. bar-m. bell. benz-ac. bry. calc. Camph. carb-v. carbn-s. Caust. chen-a. chin. CHININ-S. Chinin-val. Cic. Cocc. colch. com. con. crot-h. crot-t. Dig. eucal. ferr-p. gels. Glon. gran. hell. kali-c. kali-i. kali-m. kali-p. kalm. laur. mag-c. myric. nat-act. nat-c. nat-m. nat-p. nat-s. nat-sal. nux-v. onos. op. petr. ph-ac. PHOS. pic-ac. pilo. psor. puls. rad-br. Sal-ac. Sang. seneg. sep. Sil. stann. tab. Ther. zinc. Vertigo - MENIERE'S disease, noises in ear with vertigo - seasick, as if tab.

True Vertigo miasmatic remedies

Ars

• Acute Vertigo + Ear noise
• Pregnancy during

Nat-m

• Periodic, Sinking
• Causation (Smoke, Eye exertion, High, Coffee)

Rhus-t

• Suppressed eruption

Agar

• Cerebellar vertigo (Nystagmus, Ataxia, staggering)
• Accompanies by agitation + True vertigo (turning in a cycle)
• Agg : Rolling head / Moving /Walking

Arg-n

• Tinitus, Nervous, Sleep on going, Ataxia, weakness, Chilliness, true vertigo (turning in a cycle)
• Agg: High, looking upward, Mental exertion, bending forward, Closing eyes, Dark room, Crossing bridge, walking

Cocc

• Everything turning around him)
• Staggering, Falling sides
• Neurologic / Psychologic vertigo
• Agg: opening eyes (opp to Arg-n), Motion, rising, Insomnia/ Supportive anxiety
• Accompanied by: Nausea, Vomiting, Occiput pain, Chilliness/ Coldness (Warm amel) (Being alone amel)

Zinc

• Vertigo tinnitus, esp in high places

Dizziness miasmatic remedies

Phos

• Dizziness with most of his problems such as heart problems (Lach) , Epistaxis, Senile problems (Gels, Sul) etc
• Neurologic Dizziness (Cocc, Ther, Con)
• Staggering
• Agg with eye exertion, Flower odors, Coffee, Eruption suppression (Lach), High places (Gels), Looking up or looking down, Fluid loss, Fasting

Gels

• Dizziness with Staggering / Weakness / Faint-like
• Pregnancy, Senile problems (Phos), With Cerebral / Nervous origin
• High places (Phos)
• Tinitus, Diplopia

Lach

• Faint like, Sinking
• Agg: Closing eyes, sleep after, Eruption suppression (Phos)
• Accompanied by Heart symptoms (Phos)

Sul

• High place, Ascending,
• Senile people (Phos, Gels, Cocc)

Bell

• Noise agg, Eruption suppression, senile people, Motion esp turning head , bending double, Lying
• Sinking
• Accompanied by tinnitus, Red face, Epistaxis, Heart problems, Head congestion, Stroke, Hypertension, Dilated pupil
• Pregnancy

Cocc

• Senile people (Phos, Gels, Sul)
• Neurological Dizziness (Phos, Ther, Con)

Alum

• Agg: Closing eyes, Bending forward, Breakfast after, rubbing eyes, Smoke
• Sinking

Agar

• Cerebellar vertigo (Nystagmus, Ataxia, staggering)
• Accompanies by agitation + True vertigo (turning in a cycle)
• Agg : Rolling head / Moving /Walking

Acute vertigo remedies

• Chinin-s
• Con
• Tab

Others

Chel