In many cases, vertigo can be successfully treated using medication, allowing patients to be largely or totally free from dizziness symptoms.
Special medications, referred to as antivertiginous, play a role in acute and severe attacks of dizziness in particular; they improve the symptom, not the disease. Treatment may also comprise cortisone, circulation-promoting medications as well as anti-histamines as acute medication during an attack as well as for motion sickness, partially as an infusion also. There are also effective formulations for concomitant nausea and vomiting. This medication is based on the respective clinical picture and of course the accompanying illnesses.
The injection of medications into the middle ear (intratympanic therapy) may be a very good therapy option for the treatment of certain forms of dizziness.
Also, the insertion of a drain in the eardrum alone eliminates the some patients’ balance disruptions permanently (especially in M.Meniere). These small measures may be carried out under local anaesthetic. This procedure has an additional advantage. It allows medications to be administered directly into the middle ear.
In Labyrinth anaesthesia, a small cut is made in the eardrum and then an anaesthetic is dropped into the middle ear. The narcotic spreads from there into the balance organ and calms or deactivates the sense of balance. However, the data situation of this form of therapy is weak and the duration of efficacy of the local anaesthetic is max. 8 hours.
In treating vestibular dizziness, we distinguish between the following two general therapy types:
Vestibular rehabilitation therapy
“Release manoeuvres” as developed by Epley or Sémont are applied in the treatment of benign positional vertigo. In all other clinical pictures, the manoeuvres make less sense because they were developed in such a way that they cause the “stones” which trigger the positional vertigo to go from the semicircular canals of the balance organ back to their point of origin.
The manoeuvres are carried out by either/both the doctor/therapist or/and the patient him/herself. The treatment consists in a sequence of positions which are carried out with the patient lying down or in a seated position or on his/her side, depending on the manoeuvre.
A guide to the manoeuvres is provided on the website of the German Dizziness Centre. We currently do not recommend the videos on YouTube. Many of them contain errors which could make the manoeuvre ineffective.
Vestibular rehabilitation therapy comprises the following measures: Voluntary eye movements, active head movements with and without focusing the gaze, balance and walking exercises.
Biofeedback as dizziness therapy
Neurofeedback training, as developed by Prof. Ernst, is a new non-medical therapy for the treatment of dizziness. It is a special type of balance training, where stimuli are given repeatedly, which lead to the habituation of the balance system.
In this vibrotactile neurofeedback training, targeted vibration stimuli are delivered to the body via a small machine attached to the hips by a belt. Specific, tailor-made exercises and frequent repetition enables stimulation of the entire balance system and the information is transmitted to the brain and stored, which significantly reduces dizziness and feelings of insecurity. To achieve an optimal training outcome, the training is carried out in our practice over the course of 2-4 weeks or several times during one week for approx. 30 minutes.
This very intuitive type of feedback shows noticeable results after just the first one or two training sessions. Rather than muscle training, these consist of a correction of the balance processing in the brain. The additional stimulus signals the brain that the body stability does not correspond to that of a healthy person. The brain in turn rapidly converts this into a corresponding compensation of the body stability.
In an international placebo-controlled multi-centre study, the effectiveness of biofeedback dizziness training was tested for various risks of falling causes and it was found that the effectiveness of the training could be demonstrated in over 95% of the patients.
Surgical dizziness therapies
We also use body and ear acupuncture to treat dizziness symptoms. By directing needle stimuli into the skin at specific points, dizziness symptoms can be positively influenced. As a treatment method, acupuncture is practically free from risks and side effects.
In our practice, bioresonance therapy offers a good alternative or supplement to conventional medicine in the treatment of dizziness symptoms.
Operative dizzyness therapy
However, it must be stated that, in principle, surgery is used only very rarely or not at all in the treatment of dizziness.
There are only a few illnesses, such as inflammations or therapy-resistant M. Menière in which the surgery promises recovery.
Potentially laborious procedures such as saccotomy or sacculotomy may be used in these cases.