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Vestibular neuronitis - Management
How should I treat the symptom of vertigo?
- If symptoms are severe, offer short-term symptomatic drug treatment.
- To rapidly relieve severe nausea or vomiting associated with vertigo, consider giving buccal prochlorperazine, or a deep intramuscular injection of prochlorperazine.
- To alleviate less severe nausea, vomiting, and vertigo, consider prescribing a short course of:
- Prochlorperazine (the buccal preparation has a faster onset of action than standard-release oral tablets), or antihistamines (cinnarizine, cyclizine, or promethazine teoclate). Prochlorperazine is less sedating than the recommended antihistamines but may cause a dystonic reaction (particularly in young women).
- Advise the person to take medication regularly for 3 days then, if possible, on an as-required basis. Explain that medication should be taken for the minimum time possible (ideally no longer than 1 week), as it may delay recovery by affecting the body's compensatory mechanisms.
- For more information, see Prescribing information.
- Treatment with antiviral drugs, corticosteroids, or benzodiazepines is not recommended.
- Advise the person to return if their symptoms deteriorate or have not fully resolved after 1 week of treatment.
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