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Vertigo (Positional Vertigo)

An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1)

Also Known As:

Positional Vertigo; Paroxysmal Vertigo; Peripheral Vertigo; Central Nervous System Origin Vertigo; Spinning Sensation; Vertigo, Brain Stem; Vertigo, Brainstem; Vertigo, Central Nervous System Origin; Vertigo, Central Origin; Vertigo, Constant; Vertigo, Essential; Vertigo, Intermittant; Vertigo, Paroxysmal; Vertigo, Peripheral; Vertigo, Subjective; Brain Stem Vertigo; Brainstem Vertigo; Brainstem Vertigos; Central Origin Vertigo; Constant Vertigo; Essential Vertigo; Intermittant Vertigo; Sensation, Spinning; Sensations, Spinning; Spinning Sensations; Subjective Vertigo; Vertigo, Positional; Vertigos, Brainstem

Networked: 1787 relevant articles (196 outcomes, 191 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Tinnitus
2.	Meniere Disease (Menieres Disease)
3.	Migraine Disorders (Migraine)
4.	Headache (Headaches)
5.	Dizziness (Lightheadedness)

Experts

1.	Strupp, Michael: 10 articles (04/2015 - 05/2008)
2.	Brandt, Thomas: 10 articles (04/2015 - 08/2006)
3.	Kitahara, Tadashi: 9 articles (07/2015 - 05/2002)
4.	Carey, John P: 8 articles (04/2015 - 02/2004)
5.	Krause, Eike: 8 articles (03/2015 - 09/2004)
6.	Minor, Lloyd B: 8 articles (08/2009 - 05/2003)
7.	Jahn, Klaus: 7 articles (04/2015 - 05/2008)
8.	Horii, Arata: 7 articles (12/2014 - 05/2002)
9.	Cohen, Helen S: 7 articles (01/2011 - 01/2003)
10.	Baloh, Robert W: 7 articles (06/2009 - 02/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Vertigo:

1.	Gentamicins (Gentamicin)FDA LinkGeneric 11/01/2001 - "Results of this study on this group of patients indicate that vertigo can be controlled in the long term using microdose gentamicin without a significant reduction in cochlear or vestibular function in most of the patients in our series. " 06/01/2010 - "The shunt group showed a significantly higher percentage of the best outcome (62%) than the gentamicin group (56%, p <or= 0.003), as well as a higher rate of complete vertigo control (86% versus 71%; p <or= 0.001). " 12/01/2008 - "Although low dose intratympanal gentamicin has empirically been very effective in treating Menière's disease, the mechanisms of elimination or amelioration of vertigo are still insufficiently understood. " 10/01/2003 - "Intratympanic gentamicin titration therapy provides excellent vertigo control, with a similarly significant improvement in both personal and occupational functioning." 01/01/2011 - "Both of these trials found a significant reduction in vertigo complaints in the gentamicin group when compared to the placebo group. "
2.	Betahistine (Serc)IBA 01/01/2008 - "Treatment with the fixed combination led to significantly greater improvements in mean vertigo scores than the reference therapy betahistine after 4 weeks of therapy (p = 0.013). " 01/01/2005 - "Treatment with the fixed combination led to significantly greater improvements in mean vertigo scores compared with the reference therapy betahistine. " 09/01/2005 - "To evaluate the therapeutic efficacy of Yinxing Damo (YXDM) combined with Betahistine Hydrochloride Injection (BHI) on vertebra basilar artery ischemic vertigo (VBIV). " 01/01/2004 - "Therapeutic efficacy of 2-month betaserc course in peripheral vertigo has been proved." 12/01/2015 - "According to clinical studies, betahistine 48 mg daily during 3 months is an effective and safe option for the treatment of peripheral vertigo."
3.	Benign paroxysmal positional vertigoIBA 01/01/2015 - "The Epley particle repositioning maneuver (PRM) is an effective treatment for benign paroxysmal positional vertigo (BPPV), the most common cause of peripheral vertigo in primary care settings. " 12/05/1998 - "The most common cause of vertigo, benign paroxysmal positional vertigo, can be cured with a simple positional manoeuvre. " 12/01/2003 - "If Semont's liberating manoeuvre does not lead to relief of symptoms in benign paroxysmal positional vertigo of posterior semicircular canal after the first session, it can be repeated once again, in refractory cases, whilst symptomatic patients after second manoeuvre require rehabilitation therapy Repeating Semont's manoeuvre several times has proven to progressively increase the percentage of cured patients or it may convert posterior semicircular canal forms to typical incomplete or lateral semicircular canal forms, hence requiring other manoeuvres to achieve vertigo resolution. " 02/01/2014 - "Two of the participants reported intermittent vertigo for up to 2 wk, were diagnosed with benign paroxysmal positional vertigo (BPPV), and were treated successfully with the Epley Maneuver. " 06/01/2012 - "Effects of sleep position on time course in remission of positional vertigo in patients with benign paroxysmal positional vertigo."
4.	Cinnarizine (Cinna)IBA 05/01/2002 - "Cinnarizine treatment decreased the incidence of moderate vertigo episodes by 65.8% and decreased severe vertigo episodes by 89.8%. " 01/01/1989 - "The anti-vertigo effect of Cinnarizine (Stugeron R) has been tested in a controlled double blinded study on 40 patients suffering from various, well defined peripheral or central vestibular disorders. " 06/01/2005 - "On the other hand, cinnarizine is a blocker of voltage-gated Ca2+ currents in hair cells and is used as a drug in conditions with vestibular vertigo. " 06/01/2004 - "We conclude that these direct actions of cinnarizine on hair cells should be considered as molecular mechanisms contributing to therapeutic effects of cinnarizine in vertigo." 01/01/1989 - "12 patients out of 20 treated with 75 mg Cinnarizine twice a day during seven days demonstrated satisfactory vertigo suppression versus only 5 out of 20 treated with placebo. "
5.	Dimenhydrinate (DMH)FDA LinkGeneric 10/01/2000 - "Dimenhydrinate appears to be the preferred medicine for patients who present to the ED with vertigo likely to be of peripheral origin." 10/01/2000 - "All other measures of vertigo also decreased more in the dimenhydrinate group, although the differences were not statistically significant. " 10/01/2000 - "The patients' symptom of "vertigo with ambulation" decreased 1.5 units more (95% confidence interval [CI] 0 to 3.0) on average on a 10-point scale 2 hours after treatment in the dimenhydrinate group. " 01/01/2005 - "The fixed combination of cinnarizine and dimenhydrinate was shown to be an effective and very well tolerated treatment option for patients with otogenic vertigo. " 10/01/2000 - "Our results suggest that dimenhydrinate was more effective in relieving vertigo and less sedating than lorazepam at the intravenous doses administered in this study. "
6.	Piracetam (Nootropil)IBA 03/01/1999 - "Piracetam has been shown to be effective in vertigo of both central and peripheral origin. " 01/01/2009 - "[Efficacy of piracetam in vertigo]." 01/01/1980 - "The efficacy of piracetam in vertigo. " 03/01/1999 - "The usual dosage of piracetam in vertigo is 2.4-4.8 g daily. " 03/01/1999 - "Piracetam decreases the frequency but probably not the severity of exacerbations in patients with chronic or recurrent vertigo. "
7.	Dexamethasone (Maxidex)FDA LinkGeneric 11/01/2004 - "To examine whether intratympanic injection of dexamethasone is effective in long-term control of vertigo for patients with Ménière disease whose dietary and diuretic therapy has proved unsuccessful. " 08/01/2006 - "Promising results of intratympanic dexamethasone medication were found in cases with shorter duration or/and without vertigo. " 05/01/2015 - "This study aimed to evaluate the changes in electrocochleography (EcohG) measurements after intratympanic (IT) dexamethasone therapy and to correlate them with the long-term effects on the control of vertigo. " 12/01/2015 - "The effect of intra-tympanic dexamethasone on the vestibular function in patients with recurrent vertigo." 01/01/2008 - "IT dexamethasone injection therapy on an as-needed outpatient basis can provide vertigo control that is satisfactory in patients with Ménière's disease. "
8.	FlunarizineIBA 11/01/2014 - "Flunarizine (10 mg) is effective in patients with migrainous vertigo who suffer from considerable vestibular symptoms." 01/01/1982 - "The anti-vertigo activity of flunarizine has been evaluated in a 16-week double-blind placebo-controlled cross-over trial involving 41 patients. " 01/01/1979 - "Improvement of vertigo was significant both objectively and subjectively in studies I and II. In study III, objective tests were always clearly in favour of flunarizine, but subjectively, flunarizine was superior only by month two. " 01/01/1979 - "The antivertiginous properties of flunarizine were evaluated in three consecutive studies --- two open and one double-blind --- in an total of 99 patients showing definite vertigo. " 01/01/1978 - "Improvement of vertigo was significant both objectively and subjectively in Studies I and II. In Study III, objective tests were always clearly in favour of flunarizine, but subjectively, flunarizine was superior only by month two. "
9.	Nimodipine (Modus)FDA LinkGeneric 05/01/2002 - "Nimodipine treatment decreased the incidence of moderate vertigo episodes by 78.8% and decreased severe vertigo episodes by 85.0%. " 06/01/2013 - "In the conventional nimodipine group (NC), rate of vertigo severity was decreased by 50%: 17% of patients in 14 days, 41% of patients in 4 weeks and 90% of patients in 8 weeks. " 06/01/2013 - "In the AP nimodipine group (NAP), vertigo severity index was decreased by 50%: 24% of patients in 14 days, 41% in 4 weeks and 89% in 8 weeks. " 07/01/1996 - "The four (33%) patients whose vertigo symptoms persisted despite treatment with nimodipine (AAOO class D) were surgically treated with successful vertigo control. " 07/01/1996 - "Our preliminary clinical experience using nimodipine in 12 patients with Menière's disease from December 1992 until March 1995 resulted in successful control of vertigo and hearing improvement or stabilization in seven (58%) of 12 patients. "
10.	Pentoxifylline (Trental)FDA LinkGeneric 05/01/1988 - "In addition, symptoms like sleep disturbances, vertigo, and tinnitus improved significantly during the pentoxifylline observation period." 01/01/2002 - "The efficacy of pentoxifylline (PXF) in vascular inner ear disease (VIED) was studied comparing PXF and placebo in a 4-week study; 60 patients with unilateral loss of hearing, vertigo, dizziness, tinnitus (analyzed with an analogue scale line), and cochlear flow reduction were included. " 01/01/2002 - "The efficacy of Pentoxifylline in vascular inner ear disease (VIED) was studied comparing PXF and placebo in a 4-week study; 40 patients with vascular disease and monolateral loss of hearing, vertigo, dizziness, tinnitus (analyzed with an analogue scale line), and cochlear flow reduction were included. " 01/01/1989 - "Global symptoms, sensorimotor disorders and vertigo were improved in all treatment groups, although improvement tended to be more pronounced with ticlopidine-pentoxifylline. " 10/01/1989 - "In the treatment of vertigo, flunarizine appears at least as effective as cinnarizine and more effective than nicergoline, betahistine dichlorhydrate, pentoxifylline (oxpentifylline) and vincamine. "

Therapies and Procedures

1.	Decompression 01/01/1991 - "In patients suffering from a unilateral Ménière's disease with disabling vertigo and poor residual hearing, footplate decompression appears to be one of the most simple safe and effective surgical procedures." 02/01/1987 - "After successful decompression of the eighth nerve from offending vessels, the attacks of vertigo disappeared in 11 patients, improved markedly in 3 patients, and improved mildly in 4 patients. " 10/01/1977 - "Furthermore, these reports indicate that endolymphatic sac decompression and drainage surgery alone offers a considerable chance for conservation or improvement in hearing, as well as relief of vertigo in early cases of reversible, fluctuating hearing deficits. " 09/01/1991 - "This disorder, named disabling positional vertigo (DPV), was found to be caused by a blood vessel or vessels compressing the eighth cranial nerve in its intracranial portion, and it can be relieved by microvascular decompression (MVD) of the nerve. " 05/01/1980 - "We describe our method of sac decompression and drainage and suggest that this procedure might be considered for patients with uncontrollable luetic vertigo who have not benefited from adequate medical therapy."
2.	Injections 10/01/2007 - "Both single and multiple injections of ITGM were effective in vertigo control and functional improvement. " 10/01/2007 - "We compared the clinical efficacy of ITGM with regard to the vertigo control rate and the incidence of SNHL between two different protocols: the use of single and multiple injections. " 04/01/2009 - "To date, studies have not provided detailed descriptions of the time course of recurrent vertigo and repeated injections. " 06/01/2014 - "A subgroup of 22 patients (12.6%) reporting a late recurrence of vertigo attacks after an initial vertigo-free interval lasting more than 2 years (short-term responders) were successfully treated with a further cycle of injections. " 06/01/2014 - "Effective vertigo control was obtained with a single injection in 40.2% of the patients (excellent responders) and with repeated injections (2-9) in 43.7% of the patients (moderate responders). "
3.	Aftercare (After-Treatment) 05/01/2000 - "All patients had complete remission of the positional vertigo after treatment. " 05/01/2002 - "We obtained good results over vertigo control (types A and B of the objective criteria based in the improvement index after treatment) in 16 out of the 24 patients (66.6%), (13 were type A with total absence of crisis and 3 were type B) and an acceptable result (type C) in three of them (12.5.%). " 03/01/2015 - "Resolution of vertigo and nystagmus on the Dix-Hallpike test at 1-week follow-up after treatment was the main outcome measure to assess the efficacy of treatment. " 06/01/2013 - "After 8 weeks of treatment, symptoms such as vertigo, heavy sensation of head, palpitation, chest distress, dry mouth and thirsty were obviously improved after treatment. " 01/01/2012 - "There were 90% of patients who indicated improvement in quality of life after treatment and 88% who indicated improvement in their "vertigo subscore," a domain within the survey that focuses on vertigo control. "
4.	Stapes Surgery (Stapedectomy) 06/01/2001 - "If CT is not contributive as to the origin of SNHL and vertigo occurring after stapes surgery, then MR imaging may be helpful in these patients." 01/01/2000 - "Report of an unusual complication of stapes surgery, called "perilymph gush", resolved with improved hearing and no vertigo." 01/01/1978 - "Vertigo improved or completely disappeared in 23 patients, indicating that stapedectomy is probably helpful. " 05/01/2004 - "The aim of this study is to report experience gained in revision stapes surgery in cases of delayed vertigo. " 01/01/2015 - "However, stapedotomies were more effective and atraumatic than stapedectomies because of the better postoperative hearing results at middle and high frequencies and the shorter postoperative vertigo."
5.	Activities of Daily Living (ADL) 01/01/2003 - "Vertigo decreased and independence in activities of daily living improved significantly. " 04/01/1999 - "The groups did not differ significantly, but subjects decreased significantly on vertigo intensity and frequency and improved significantly on independence in activities of daily living. " 03/01/2004 - "Results were related to improved independence in activities of daily living and to decreased vertigo. " 06/01/2012 - "The fixed combination led to significant improvements in vertigo and ADL within the first week, and to a nearly complete recovery after 4 weeks. " 06/01/2012 - "Vertigo and concomitant symptoms, activities of daily living (ADL), posturography and a battery of vestibulo-ocular tests, registered by electronystagmography including spontaneous nystagmus, bithermal caloric and rotatory test, among others, were assessed at baseline (t(0)), after 1 week (t(1w)) and after 4 weeks (t(4w)). "