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.

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 due to injury of CNS balance centers (Brainstem/ Cerebellum) Concomitant neurologic deficits Slurred speech, Double vision, Pathologic nystagmus (which is pure vertical/torsional). Disequilibrium/ Unbalance/ 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) Trauma (e.g., skull fractures). Motion sickness is sometimes classified as a cause of peripheral vertigo Viral  Labyrinthitis	Infarctions / Hemorrhage /Tumors Epilepsy 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

Remedies

Peripheral Vertigo	Central Vertigo	Common
Con Vertigo accompanied by weakness or trembling. Vertigo triggered by sudden Movements / Changes in position. Nausea and vomiting. Vertigo due to age-related changes in the inner ear. Arg-n Tinnitus, Nervous, Sleep on going, Ataxia, weakness, Chilliness, true vertigo Agg: High, looking upward, Mental exertion, bending forward, Closing eyes, Dark room, Crossing bridge, walking	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, Agg withFlower odors, Coffee Agg with Eruption suppression (Lach) Agg in High places (Gels) Agg with Looking up or down Agg with Fluid loss, Fasting	Cocc Everything turning around him Staggering, Falling sides Psychologic vertigo Agg: opening eyes (opp to Arg-n), Motion, rising, Insomnia/ Supportive anxiety Accompanied by Occiput pain Chill/ Coldness agg /Warm amel Being alone amel Senile people (Phos, Gels, Sul) Neurological (Phos, Ther, Con) Vertigo accompanied by Nausea /Vomiting / Motion sickness / jet lag, particularly traveling by car or boat. Dizziness, weak, and lightheaded.
Puls Sensation of Fullness / Pressure in the head. Dizziness, lightheaded, and disoriented. Ringing in the ears Vertigo due to sinus congestion or ear infections. Rhus-t Suppressed eruption	Gels Triggered by Emotional stress / Anxiety / stage fright Dizziness/ Lightheaded/ Faint Staggering / Weakness Trembling/ Sweating/ Pounding heart. 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 Closing eyes Agg Sleep after Agg 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	Alum Agg: Closing eyes, Bending forward, Breakfast after, rubbing eyes, Smoke Sinking	Sul High place Ascending Senile people (Phos, Gels, Cocc)
Zinc Vertigo tinnitus, esp in high places
Nat-m Periodic, Sinking Causation (Smoke, Eye exertion, High, Coffee)

Acute vertigo remedies

• Banerji protocols same as Meniere's disease

• Chinin-s
• Con
• Tab
• Chel

Remedies

Top remedy	Con	He feels as if he/she is moving around in a circle. Worsening of vertigo from head movement is the key indication to use this medicine. Best remedy of BPPV (condition in which vertigo occurs from head movement). Agg from turning in bed. Agg while rising from a seat or bed. Walking agg Tendency to fall sideways. Elderly people vertigo
Vertigo With Loss Of Balance	Gels	Difficulty in walking which causes staggering gait (unsteady walk as if drunk). Vertigo is attended with dim vision, double vision and heaviness of eyelids. Vertigo agg from walking mostly.
Vertigo With Nausea, Vomiting	Cocc	Agg while sitting up or standing Vertigo with nausea and vomiting during travelling. Vertigo agg from loss of sleep. Faint sensation
In Cases Of Meniere’s Disease	Chin-s	Meniere’s Disease: Hearing loss+ Tinnitus and vertigo occur. The noises can be buzzing, ringing or roaring Difficulty in standing and frequently falls down. Vertigo mainly agg on stooping. Maybe vertigo is accompanied by headache
Vertigo During Headache	Bell	Vertigo that occurs with headache due to Cervical Spondylosis. Vertigo agg from movement, when turning in bed Stooping or from rising from stooped position agg. Tendency to fall to the left side or backward Headache amel by applying pressure or binding the head.
In Case Of BPPV	Bry	Vertigo appears from sudden motion of the head in any direction. Objects are moving in a circle during vertigo. Vertigo improves when the head is in an absolute rest position without even the slightest motion. 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.
Worse On Movement /Walking	Chin	He is unable to walk straight and staggers while walking. Vertigo is relieved by lying down. Fainting spells Tendency to fall backward is mainly present

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 hypotension)
NS	Vertigo due to bilious status
NP	Dizziness + vomiting. In sea-sickness alternate KP with NP