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	Central
Definition	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.	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	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	Lesions caused by Infarctions / Hemorrhage /Tumors Epilepsy Cervical spine disorders such as Cervical spondylosis, Degenerative ataxia disorders Migrainous vertigo Lateral medullary syndrome Chiari malformation Multiple sclerosis Parkinsonism 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	Labyrinthitis Vestibular neuritis Vertigo Hearing impaired	Dysarthria Nystagmus / Diplopia Ataxia Vertigo
Viral miasms	MMP VZV	STLE
Remedies	MMP+ VZV: MERC MMP only: Con, Puls, Sill, Bell, Phyt, Aur, Bar-m, Iod VZV only: Sul, Ars, Sep, Canth, Iris, Nat-m , Ran-b, Rhus-t, Thuj, Agar, Arg-n, Cocc, Mez, Nat-c, Zinc	PHOS, APIS Gels, Op, Cupr, Lach, Merc, Sul, Bell Nux-m, Cocc, Alum, Hell, Plb, Agar

Rubrics

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

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.

Remedies

Peripheral		Central		Common
Con	Vertigo accompanied by a feeling of weakness or trembling. Vertigo triggered by sudden movements or changes in position. Nausea and vomiting. Vertigo due to age-related changes in the inner ear.	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	Merc
Puls	Vertigo accompanied by a sensation of fullness in the head. Dizziness, lightheaded, and disoriented. Ringing in the ears and a sensation of pressure in the head. Vertigo due to sinus congestion or ear infections.	Gels	Vertigo that is triggered by emotional stress or anxiety. Dizziness, Lightheaded, Staggering / Weakness / Faint-like Trembling, sweating, and a pounding heart. Vertigo due to stage fright or anxiety. Pregnancy, Senile problems (Phos), With Cerebral / Nervous origin High places (Phos) Tinnitus, Diplopia	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
Sil	Vertigo that is accompanied by pressure in the head. Dizziness, lightheaded, and disoriented. Ringing in the ears Vertigo due to pressure in the inner ear	Lach	Faint like, Sinking Agg: Closing eyes, sleep after, Eruption suppression (Phos) Accompanied by Heart symptoms (Phos)	Agar	Cerebellar vertigo (Nystagmus, Ataxia, staggering) Accompanies by agitation + True vertigo (turning in a cycle) Agg : Rolling head / Moving /Walking
Ars	Acute Vertigo + Ear noise Pregnancy during			Sul	High place, Ascending, Senile people (Phos, Gels, Cocc)
Nat-m	Periodic, Sinking Causation (Smoke, Eye exertion, High, Coffee)			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) Senile people (Phos, Gels, Sul) Neurological Dizziness (Phos, Ther, Con)
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			Alum	Agg: Closing eyes, Bending forward, Breakfast after, rubbing eyes, Smoke Sinking
Rhus-t	Suppressed eruption
Zinc	Vertigo tinnitus, esp in high places

Acute vertigo remedies

• Banerji protocols same as Meniere's disease

• Chinin-s
• Con
• Tab
• Chel

Bry

• Vertigo that is worsened by sudden movements or changes in position.
• Spinning or dizziness when moving the head or standing up.
• Nausea and vomiting.
• Vertigo due to dehydration or overheating.

Cocc

• Vertigo that is accompanied by nausea or motion sickness
• Dizziness, weak, and lightheaded.
• Motion sickness or jet lag: Nausea and vomiting, particularly when traveling by car or boat.

Tissue Salt Remedies

• FP: Dizziness is caused by rush of blood to the head
• KP: Vertigo with nervous / Neurological origin
• SIL: Vertigo in the elderly
• NM: Dizziness on getting up (Orthostatic hypotention)
• NS: Vertigo due to bilious status
• NP: Dizziness with vomiting. In sea-sickness alternate KP with NP