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1.

VERTIN 24MG------- Vertin contains Betahistine1----0---1

Betahistine hydrochloride is the generic name for the


anti vertigo drug SERC. It was first registered in Europe in
1970 for the treatment of Mnire's disease. It is commonly
prescribed for people who have balance disorders or to
alleviate the vertigo symptoms associated with Mnire's
disease.Betahistine is available in 8mg, 16mg, or 24mg
tablets. It is contraindicated for people with peptic ulcers or
tumours of the adrenal gland. People with bronchial asthma
should be closely monitored.
2.Diligan-25 25mg----Diligan-25 contains Meclozine-----1---0-----1

Meclizine is an antihistamine considered to be an


antiemetic. It is sold under the brand names of Bonine,
Bonamine, Antivert, Postafen, and Dramamine (Less Drowsy
Formulation), and is most commonly used to inhibit nausea
and vomiting. Emesafene is a combination of meclizine (1/3)
and pyridoxine (2/3). An alternative to dimenhydrinate
(Dramamine, Gravol, Gravamin, and Vertirosan), meclizine is
considered to be equally effective, but with reduced side
effects. Note that in Canada, Antivert (no longer available)
was a combination of meclizine and nicotinic acid.
3.Sompraz-L ------- Sompraz-L (Esomeprazole (EC) 40
mg,Levosulpiride (SR) 75 mg.)

A substituted benzamide anti-psychotic, reported to be


a selective antagonist of central dopamine (D-2, D-3 and D4) receptors, Levosulpiride is also calimed to have mood
elevating properties. Levosulpiride is used in the treatment
of psychoses, particularly negative symptoms of
schizophrenia, anxiety disorders, dysthymia, vertigo,
dyspepsia, irritable bowel syndrome and premature
ejaculation.

4.Librax----- Librax Chlordiazepoxide 5mg,Clidinium Br.


2.5mg0---0--1

Librax is used, in combination with other therapy, for


the treatment of peptic ulcer, irritable bowel syndrome
(spastic colon), and acute enterocolitis (inflammation of the
colon and small intestine). Librax is a combination of a
benzodiazepine (chlordiazepoxide) and an antispasmodic
medication (clidinium).
5.Stugeron ---- Stugeron 25mg(contains Cinnarizine)---1/2

Cinnarizine is an anti-histaminic drug which is mainly


used for the control of vomiting due to motion sickness. It is
marketed under the brand Stugeron or Stunarone.
It acts by interfering with the signal transmission between
vestibular apparatus of the inner ear and the vomiting centre
of the hypothalamus. The disparity of signal processing
between inner ear motion receptors and the visual senses is
abolished, so that the confusion of brain whether the
individual is moving or standing is reduced. Vomiting in
motion sickness is actually a physiological compensatory
mechanism of the brain to keep the individual from moving
so that it can adjust to the signal perception.
6.COGNIX PLUS--- Ginkgo Biloba(60 mg),Piracetam(800
mg),Vinpocetine(5 mg)
Ginkgo Biloba--- Uses Cerebrovascular and peripheral
activator, dementia.
How it works---The compounds found in ginkgo may have a
protective role in different stages of the decline of intellectual function
via several mechanisms of action: vasoregulating activity of arteries,
capillaries, and veins (increased blood flow), platelet activating factor
(PAF) antagonism, homeostasis of inflammation and oxidative stress,
and prevention of cell membrane damage causedby free radicals, and
neurotransmission modulation.

VinpocetineUses --Vinpocetine is used to reduce the severity


of ischemic strokes (heart attacks). It is also used in the treatment of
other heart-related, mental, and neurological diseases/disorders like
Alzheimers disease (disorder that causes mental confusion and
forgetfulness), as well as for enhancing memory and preventing,
memory problems, and tinnitus (ringing in the ear).
How it works--Vinpocetine is a semisynthetic derivative of the
vinca alkaloids. It increases blood flow to the brain and heart and
protects it from injury.
PiracetamUses--Piracetam is used in combination with other
medicines to treat myoclonus (uncontrolled muscle jerk).
How it works--Piracetam belongs to class of medications called
GABA (gamma amino butyric acid) analogues. It acts by protecting
brain and nervous system against shortness of oxygen and it also
affects various ion channels on nerve cell membrane.

MRI of brain with GADO


1.What is gadolinium contrast medium?

Gadolinium contrast media (sometimes called a MRI contrast media, agents or


dyes) are chemical substances used in magnetic resonance imaging (MRI) scans.
When injected into the body, gadolinium contrast medium enhances and improves
the quality of the MRI images (or pictures). This allows the radiologist (a specialist
doctor trained to examine the images and provide a written report to your doctor or
specialist) to more accurately report on how your body is working and whether
there is any disease or abnormality present.
Gadolinium contrast media consist of complex molecules, arrangements of atoms
held together by chemical bonds. The chemical bonds are made between a
gadolinium ion and a carrier molecule (a chelating agent). A chelating agent
prevents the toxicity of gadolinium while maintaining its contrast properties.
Different brands of gadolinium contrast medium use different chelating molecules.
The contrast medium is injected intravenously (into a vein) as part of an MRI scan,
and eliminated from the body through the kidneys.
2. Why do I need to have gadolinium contrast medium?

Gadolinium contrast medium is used in about 1 in 3 of MRI scans to improve the


clarity of the images or pictures of your bodys internal structures. This improves
the diagnostic accuracy of the MRI scan. For example, it improves the visibility of
inflammation, tumours, blood vessels and, for some organs, blood supply.
MR SPECTROSCOPY
MR spectroscopy provides a measure of brain chemistry. The most common nuclei
that are used are 1H (proton), 23Na (sodium), 31P (phosphorus). Proton spectroscopy
is easier to perform and provides much higher signal-to-noise than either sodium or
phosphorus. Proton MRS can be performed within 10-15 minutes and can be added
on to conventional MR imaging protocols. It can be used to serially monitor
biochemical changes in tumors, stroke, epilepsy, metabolic disorders, infections,
and neurodegenerative diseases. The MR spectra do not come labeled with
diagnoses. They require interpretation and should always be correlated with the
MR images before making a final diagnosis.

High resolution computed tomography(HRCT) of the temporal bone


The advent of high-resolution computed tomography (CT)
scanning in the 1980s has revolutionized diagnostic imaging of
the temporal bone. CT scanning offers the greatest structural
definition of any currently available imaging modality. [1, 2] The
purpose of this article is to familiarize the reader with the normal
anatomy of the temporal bone depicted by CT scanning. The
article reviews the anatomy of the middle ear space and
surrounding bone and presents radiographic imaging in both axial
and coronal views, with labeled salient features and relevant text.

Vertigo is a sensation of spinning. If you have these dizzy spells, you might feel like you are
spinning or that the world around you is spinning.

Causes of Vertigo
Vertigo is often caused by an inner ear problem. Some of the most common causes include:
BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny
calcium particles (canaliths) clump up in canals of the inner ear. The inner ear sends signals to
the brain about head and body movements relative to gravity. It helps you keep your balance.
BPPV can occur for no known reason and may be associated with age.
Meniere's disease. This is an inner ear disorder thought to be caused by a buildup of fluid and
changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears
(tinnitus) and hearing loss.
Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection
(usually viral). The infection causes inflammation in the inner ear around nerves that are
important for helping the body sense balance
Less often vertigo may be associated with:

Head or neck injury

Brain problems such as stroke or tumor

Certain medications that cause ear damage

Migraine headaches

Symptoms of Vertigo
Vertigo is often triggered by a change in the position of your head.
People with vertigo typically describe it as feeling like they are:

Spinning

Tilting

Swaying

Unbalanced

Pulled to one direction

Other symptoms that may accompany vertigo include:

Feeling nauseated

Abnormal or jerking eye movements (nystagmus)

Headache

Sweating

Ringing in the ears or hearing loss

Symptoms can last a few minutes to a few hours or more and may come and go.

Treatment for Vertigo


Treatment for vertigo depends on what's causing it. In many cases, vertigo goes away without
any treatment. This is because your brain is able to adapt, at least in part, to the inner ear
changes, relying on other mechanisms to maintain balance.
For some, treatment is needed and may include:

Vestibular rehabilitation. This is a type of physical therapy aimed at helping strengthen the
vestibular system. The function of the vestibular system is to send signals to the brain about head
and body movements relative to gravity.
Vestibular rehab may be recommended if you have recurrent bouts of vertigo. It helps train your
other senses to compensate for vertigo.
Canalith repositioning maneuvers. Guidelines from the American Academy of Neurology
recommend a series of specific head and body movements for BPPV. The movements are done to
move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by
the body. You will likely have vertigo symptoms during the procedure as the canaliths move.
A doctor or physical therapist can guide you through the movements. The movements are safe
and often effective.
Medicine. In some cases, medication may be given to relieve symptoms such as nausea or
motion sickness associated with vertigo.
If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling
and cure infection.
For Meniere's disease, diuretics (water pills) may be prescribed to reduce pressure from fluid
buildup.
Surgery. In a few cases, surgery may be needed for vertigo.
If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain
or neck, treatment for those problems may help to alleviate the vertigo.

Cholesteatoma

Patient Health Information

An abnormal skin growth in the middle ear behind the eardrum is called cholesteatoma.
Repeated infections and/or a tear or pulling inward of the eardrum can allow skin into the middle
ear. Cholesteatomas often develop as cysts or pouches that shed layers of old skin, which build
up inside the middle ear. Over time, the cholesteatoma can increase in size and destroy the
surrounding delicate bones of the middle ear leading to hearing loss that surgery can often

improve. Permanent hearing loss, dizziness, and facial muscle paralysis are rare, but can result
from continued cholesteatoma growth.
What causes a cholesteatoma?

A cholesteatoma usually occurs because of poor eustachian tube function as well as infection in
the middle ear. The eustachian tube conveys air from the back of the nose into the middle ear to
equalize ear pressure (clear the ears). When the eustachian tubes work poorly, perhaps due to
allergy, a cold, or sinusitis, the air in the middle ear is absorbed by the body, creating a partial
vacuum in the ear. The vacuum pressure sucks in a pouch or sac by stretching the eardrum,
especially areas weakened by previous infections. This can develop into a sac and become a
cholesteatoma. A rare congenital form of cholesteatoma (one present at birth) can occur in the
middle ear and elsewhere, such as in the nearby skull bones. However, the type of cholesteatoma
associated with ear infections is most common.
How is cholesteatoma treated?

An examination by an otolaryngologisthead and neck surgeon can confirm the presence of a


cholesteatoma. Initial treatment may consist of a careful cleaning of the ear, antibiotics, and ear
drops. Therapy aims to stop drainage in the ear by controlling the infection. The growth traits of
a cholesteatoma must also be evaluated.
A large or complicated cholesteatoma usually requires surgical treatment to protect the patient
from serious complications. Hearing and balance tests, and CT scans (3-D x-rays) of the mastoid
may be necessary. These tests are performed to determine the hearing level in the ear and the
extent of destruction the cholesteatoma has caused.
Surgery is performed under general anesthesia in most cases. The primary purpose of surgery is
to remove the cholesteotoma to eliminate the infection and create a dry ear. A second surgery is
sometimes necessary both to ensure that the cholesteatoma is gone as well as to attempt
reconstruction of the damaged middle ear bones in an effort to improve hearing. In cases of
severe ear destruction, reconstruction may not be possible. Facial nerve repair or procedures to
control dizziness are rarely required. Reconstruction of the middle ear is not always possible in
one operation; therefore, another operation may be performed six to 12 months later. This
operation will attempt to restore hearing and, at the same time, allow the surgeon to inspect the
middle ear space and mastoid for residual cholesteatoma.
Surgery is commonly performed in an out-patient setting. For some patients, an overnight stay is
necessary. In rare cases of serious infection, prolonged hospitalization for antibiotic treatment
may be necessary. Time off from work is typically one to two weeks. After surgery, follow-up
office visits are necessary to evaluate results and to check for recurrence. In cases requiring the
creation of an open mastoidectomy cavity, office visits every few months are needed to clean out
the mastoid cavity and prevent new infections. Some patients will need lifelong periodic ear
examinations.
Symptoms and dangers

Initially, the ear may drain fluid with a foul odor. As the cholesteatoma pouch or sac enlarges, it
can cause a feeling of fullness or pressure in the ear, along with hearing loss. An ache behind or
in the ear, especially at night, may cause significant discomfort.
Dizziness, or muscle weakness on one side of the face (the side of the infected ear) can also
occur. Any or all of these symptoms are good reasons to seek medical evaluation.
Cholesteatoma is a serious but treatable ear condition, which can be diagnosed only by medical
examination. Bone erosion can cause the infection to spread into the surrounding areas, including
the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and, rarely, death can
occur.

Benign Positional Vertigo


Written by Bree Normandin and Marijane Leonard
Medically Reviewed by Debra Sullivan, PhD, RN, CNE, COI on November 3, 2015

What Is Benign Positional Vertigo?


Benign positional vertigo (BPV) is the most common cause of vertigo. It causes a sudden
sensation of spinning. It can also make you feel like your head is spinning from the inside.
If you have BPV, you can have brief periods of mild or intense dizziness. An episode is generally
triggered by changing the position of your head. In particular, the following actions can trigger
an episode of BPV:

tilting your head up or down

lying down

turning over

getting up

BPV can be annoying, but its rarely serious except when a person falls due to dizziness.

What Causes Benign Positional Vertigo?


BPV is the result of a disturbance inside your inner ear. Fluid inside tubes in your ear, called
semicircular canals, moves when your position changes. The semicircular canals are extremely
sensitive.
BPV develops when small crystals of calcium carbonate that are normally in another area of the
ear break free and find their way to the semicircular canal in your inner ear. This causes your
brain to receive confusing messages about your bodys position.

Who Is at Risk for Benign Positional Vertigo?


There are no major risk factors for BPV, but theres some indication that it could be an inherited
condition. Many diagnosed individuals have indicated that multiple relatives also have had the
condition.
Prior head injuries, osteoporosis, diabetes, or an inner ear condition can also make some people
more prone in developing BPV.

What Are the Symptoms of Benign Positional Vertigo?


The symptoms of BPV can include:

vomiting

vertigo, which is a sensation of spinning or swaying

blurred vision

nausea

dizziness

lightheadedness

loss of balance

unsteadiness

Symptoms of BPV can come and go. They commonly last less than one minute.

A variety of activities can bring on BPV. However, most symptoms occur when theres a change
in your heads positioning. Abnormal eye movements, also called nystagmus, usually accompany
BPV symptoms. Although its extremely rare, you can have BPV in both ears.
In some extreme cases of BPV, people can develop dehydration due to vomiting.

How Is Benign Positional Vertigo Diagnosed?


Your doctor can diagnose BPV by performing a test called the Dix-Hallpike maneuver. Your
doctor will hold your head in a certain position while asking you to rapidly lie down with your
back over a table. Theyll look for abnormal eye movements during this test, and they may ask
you if youre experiencing a spinning sensation.
Your doctor will also give you a general physical exam. Theyll get a complete medical history
and perform a neurological exam to rule out any other disorders or diseases.
Additional tests might include:

caloric stimulation, which is a warming and cooling the inner ear with water or air to
observe eye movements

magnetic resonance angiography of the head

hearing evaluation

MRI of the head

CT scan of the head

electronystagmography (ENG) to record eye movement

electroencephalogram (EEG) to measure brain activity

What Are the Treatments for Benign Positional Vertigo?


Epleys Maneuver
Some doctors consider Epleys maneuver to be the most effective BPV treatment. It involves
moving the piece of calcium carbonate to a different part of your inner ear where it will no
longer cause problems.

Medication
Your doctor may prescribe medications to relieve spinning sensations. These drugs may include:

sedative-hypnotics

anticholinergics

antihistamines

However, medications are often not effective in treating vertigo.

Home Treatment
There are steps you can take to manage the dizziness associated with BPV.
Losing your balance is always a possibility. Be aware of your surroundings and avoid placing
yourself at risk. Falls can cause serious injuries.
Whenever you feel dizzy, take a seat. Sitting down during a dizzy spell can help you avoid
falling. You should also take precautions such as using good lighting around the home and using
a cane for stability.
Also, learn what triggers your episodes. Preventing symptoms of vertigo from becoming worse
during episodes of BPV can be as simple as avoiding the positions that trigger it.

What Are the Complications of Benign Positional Vertigo?


It may be necessary to call your doctor if the treatment for vertigo isnt working or if you
develop weakness, slurred speech, or vision problems.
Keep in mind that symptoms of BPV can sometimes be related to other, more serious conditions.

What Is the Long-Term Outlook?


Living with the condition can be challenging. It can affect relationships with friends and family,
productivity at work, and quality of life. BPV is uncomfortable but manageable, and it usually
improves with time. Unfortunately, BPV can occur again after successful treatment, and it may
return without warning. Theres no cure for BPV.
References:

Benign positional vertigo. (n.d.). Retrieved from


http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002393/

Mayo Clinic Staff. (2015, May 28). Benign paroxysmal positional vertigo (BPPV).
Retrieved from http://www.mayoclinic.org/diseasesconditions/vertigo/basics/definition/con-20028216

Woodhouse, S. (n.d.). Benign paroxysmal positional vertigo (BPPV). Retrieved from


http://vestibular.org/understanding-vestibular-disorders/types-vestibulardisorders/benign-paroxysmal-positional-vertigo

Copyright 2005 - 2018 Healthline Networks, Inc. All rights reserved. Healthline is for
informational purposes and should not be considered medical advice, diagnosis or treatment
recommendations.

Benign paroxysmal positional vertigo (BPPV)

Vertigo: Walking Exercises - Topic Overview


Vertigo: Walking Exercises Guide

Topic Overview

Health Tools

Related Information

Credits

Walking is a simple but powerful exercise for vertigo that can help your balance. Walking with
greater balance will allow you to function better on your own, which in turn may lead to
improved self-confidence. As you walk, you will also be working your muscles, which helps you
keep muscle tone and may increase your strength.
Because you are moving, there is an increased risk of falling. If possible, do your walking next to
a wall with a handrail or in a hall, or be sure to have someone with you.
If you are concerned about falling, always have someone with you.

Walking exercise 1
Walk 5 steps and stop abruptly. Wait 10 seconds or until any dizziness goes away. Repeat this
until you have walked about 50 ft (15 m).
Do this exercise twice. To chart your progress, gradually work up to walking 100 ft (30 m).

Walking exercise 2

Walk 5 steps, and then turn around and walk back. Wait 10 seconds or until any dizziness goes
away. Repeat 5 times.
Do this exercise twice. To chart your progress, gradually work up to repeating the exercise 10
times.

Walking exercise 3
1. Walk and turn your head to the left and then to the right, every other step. Try to walk
about 50 ft (15 m).
2. Walk about 50 ft (15 m) while moving your head up and down.
3. Walk about 50 ft (15 m) while tipping your head side to side (tip your ear toward your
shoulder).
When first starting this exercise, you will probably weave considerably. Weaving less while
doing the exercise is a sign of progress. This is a more difficult walking exercise, so consider
having someone with you.
Do this exercise twice each day. To chart your progress, gradually work up to walking 100 ft (30
m).

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