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	Gels	Cocc
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	Alum Agg: Closing eyes, Bending forward, Breakfast after, rubbing eyes, Smoke Sinking	Sul High place Ascending Senile people (Phos, Gels, Cocc)
Rhus-t Suppressed eruption	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	Agar Cerebellar vertigo (Nystagmus, Ataxia, staggering) Accompanies by Agitation True vertigo (turning in a cycle) Agg: Rolling head / Moving /Walking
Puls Sensation of Fullness / Pressure in the head. Dizziness, lightheaded, and disoriented. Ringing in the ears Vertigo due to sinus congestion or ear infections.		Bell
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)
Ars Acute Vertigo + Ear noise Pregnancy during
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

Both Peripheral and Central Vertigo			Etiology/ Modalities
Loss Of Balance / Dizziness	Gels	Both Peripheral and Central Vertigo Difficulty in walking which causes staggering gait Accompanied by Dim vision, Double vision Heaviness of eyelids Dizziness/ Lightheaded/ Faint Staggering / Weakness Trembling/ Sweating/ Pounding heart. Tinnitus	Walking agg (mostly) Triggered by Emotional stress / Anxiety / stage fright Pregnancy Senile problems (Phos) High places (Phos)
Nausea, Vomiting	Cocc	Both Peripheral and Central Vertigo (Phos, Ther, Con) Psychologic vertigo Everything turning around him Accompanied Nausea / Vomiting during travelling. Motion sickness / Jet lag, particularly traveling by car or boat. Dizziness, weak, and lightheaded /Faint sensation Occiput pain Staggering, Falling sides / Sudden loss of balance Frequent nausea and vomiting. Difficulty in hearing or feeling of ear blockage Dread of sudden noise	Agg: Opening eyes (opp to Arg-n), Motion, rising, sitting up or standing Insomnia Supportive anxiety Chill/ Coldness agg /Warm amel Being alone amel Senile people (Phos, Gels, Sul)
Vertigo During Headache	Bell	Both Peripheral and Central Vertigo Accompanied by Headache due to Cervical Spondylosis. Sinking sensation Tendency to fall to the left side or backward Tinnitus Red face Epistaxis Heart problems/ Hypertension Head congestion/ Stroke Dilated pupil	Movement, when turning in bed, turning head, Bending double Stooping or from rising from stooped position Headache amel by applying pressure or binding the head. Agg Noise Eruption suppression Senile people Lying Pregnancy

Only Peripheral			Modalities / Etiology
Ringing Noises	Chinin-s	Periodical episodes of tinnitus Sudden attack of vertigo followed by tinnitus He may lose balance and fall. The noises can be buzzing, ringing or roaring Difficulty in standing and frequently falls down. Headache	Most common homeopathic remedy of Meniere’s disease (Hearing loss+ Tinnitus and vertigo occur.) Vertigo mainly agg on stooping.
Top remedy	Con	Peripheral Vertigo As if moving around in a circle. Tendency to fall sideways. Accompanied by Weakness or trembling. Nausea and vomiting.	Agg from head movement (Key indication) Agg from turning in bed / Sudden Movements / Changes in position/ While rising from a seat or bed. Walking agg Best remedy of BPPV Age-related changes in the inner ear.
Buzzing Noises	Chen-a	Hears a buzzing noise in the ear. Sudden episodes of vertigo that may follow the buzzing noise in the ear and tinnitus attacks that are synchronous with heartbeats
Tinnitus + Nausea	Sal-ac	Troublesome nausea. Noises in the ear can be roaring, ringing, or buzzing (similar to flies or a swarm of bees) He may hears musical noises	Meniere’s disease (Vertigo+ Diminished hearing+ Intense nausea)
Upon Closing Eyes	Ther	Flare-up of vertigo increases with the closure of eyelids, He comes up with complaints of Nausea / Vomiting along with vertigo Sensitive to noises and may not be able to bear loud noises at most times.
Fullness in Ears	KM	It is also useful for noises in the ears. There is a crackling noise in the ears on swallowing. Vertigo is present, along with head congestion. Sensation of having a plug inside ears (Maybe)	Deafness due to swelling of internal ear and eustachian tube. It causes a reduction of the fluid secretion and gradually reduces the swelling. History of chronic catarrhal conditions of the middle ear
Tinnitus of Low Tone	Nat-sal	Excellent remedy for tinnitus accompanied by vertigo and deafness of the ears. He complain of a loss of hearing over a period indicating progressive deafness
Hissing Noises	Sil	Sounds may be loud and pistol-like. Feeling of blockage in the ears. Itching in the ears and vertigo spells upon closing the eyes are also present.	Meniere’s disease History of ear discharges of offensive, fetid nature.
Noises in Ear + Fainting	Phos	Echoing sounds in their ears. Gradual hearing impairment + Vertigo immediately after rising from the bed	Meniere’s Disease External stimuli, such as bright lights and sharp noises, trigger sudden attacks of vertigo
Sharp Pain in Ear	Arg-n	Primary symptoms include noises in the ear, vertigo, and hardness of hearing. The sounds may be buzzing, ringing, whizzing in nature. Fullness or obstructed sensation in the ear may be present.	Meniere’s Disease Head congestion/ Vertigo agg upon closing the eyes (Maybe)
In Case Of BPPV	Bry	Peripheral Vertigo Objects are moving in a circle during vertigo. Spinning or dizziness when moving the head or standing up. Nausea and vomiting.	Sudden motion of the head in any direction Amel in an absolute rest position of head without even the slightest motion Vertigo due to dehydration or overheating.
Worse On Movement /Walking	Chin	Unable to walk straight and staggers while walking. Fainting spells Tendency to fall backward is mainly present	Amel by lying down

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