Check B.P., Check for pallur and Murmur. Ask for cochlear symptoms (Deafness and Tinnitus) and vestibular symptoms. General Advise:
1. Bed rest, avoid movements of head, if giddiness is severe. 2. Stop smoking and alcohol. 3. Check whether any drug that the patient is taking is causing sedation or postural hypotension. 4. If patient is on Inj. Streptomycin, Stop it immediately. 5. Use cervical collar, if cervical spondilitis.
Drug Treatment:
1. Tab. Strugeron 25mg. 1 tds till giddiness is controlled or Tab. STEMETIL 1tds. 2. Inj. STEMETIL 2 cc IM stat for severe giddiness. 3. Inj. Neurobion 2cc IM x A.T.D. x daily x 5-10 injections. 4. Cap. Becosules 1 bf x 15. 5. If there are cochlear symptoms add Tab. Vertin 8mg tds
Other drugs that may be tried in Meniere’s disease
Tab. COMPLAMINA 150mg 1-2 tds.Tab. TRENTAL 400mg tds If giddiness is not promptly controlled, Ask for Hb% X-raCervical- spine-AP & Lateral, ENT checkup and ophthalmic check up. If giddiness is severe, or associated with any neurological sign, Refer immediately to neurologist. In old age, cervical spondilitis is one of the commonest causes for giddiness. If a Hypertensive patient complains of giddiness, it may be excess dose or postural hypotensioin. Put the patient ot bedrest, stop the drug for a day, then adjust the dose or use a different drug.
Recurrent episodes of vertigo, with tinnitus or deafness with normal between the attacks + suspect Meniere’s Disease.
