What therapies are effective for relief of chronic vertigo symptoms?
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For unilateral peripheral vestibular dysfunction, vestibular rehabilitation (VR) improves subjective dizziness. In benign paroxysmal positional vertigo (BPPV), canalith repositioning maneuvers are associated with excellent short-term relief. (SOR A, based on a systematic review.) In patients with Ménière's disease, instruction in VR and symptom control are equally effective; the Meniett device can produce symptom relief in refractory cases. (SOR B, based on randomized controlled trials [RCTs].) Antihistamines, anticholinergics, benzodiazepines, diuretics, calcium channel blockers, and topiramate may also help relieve symptoms. (SOR C, based on expert opinion.)
Evidence Based Practice 12(7): 06-07.