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STEROID THERAPY FOR VERTIGO

There is new hope for patients who suffer from vertigo, the condition characterized by severe dizziness that causes rooms to seem like they’re spinning. A commonly used steroid medication has been shown to be helpful for the treatment of vertigo patients who have the problem because of a condition that suddenly causes nerve inflammation in the inner ear.

“I remember lying in bed and feeling like the whole bed was spinning. It was really unpleasant,” says Diane Umansky, a magazine editor. Diane is one of the millions of patients who, each year, suffer the incredibly uncomfortable sensation known as vertigo. It’s the form of dizziness which gives one the sense that the environment is spinning around the individual.
“Some people just have a sensation of swaying back and forth or side to side. Sometimes they feel as if the world is turning upside down,” says Dr. Richard Libman, a neurologist at Long Island Jewish Medical Center in New York.
There are several causes of vertigo. This study looked at the second most common type, vestibular neuronitis. When vertigo comes on suddenly, there is a good chance it is vestibular neuronitis.
Vestibular neuronitis is an inflammation of the vestibular or balance nerve, which is located in your inner ear. This nerve carries balance signals from the inner ear to the brain. When the nerve is inflamed, it causes vertigo.
Now new research found the steroid methylprednisolone, which decreases inflammation, can provide marked improvement, so that much fewer vertigo symptoms are seen a year later. Patients who were given placebos did not report a similar improvement. The steroid must be used within the first three days after the onset of the vestibular neuronitis.
Vestibular neuronitis usually develops in only one ear at a time. The inflamed nerve is thought to be caused by a respiratory virus infection or by the herpes simplex virus.
However, this study also showed anti-herpes virus medications do not work.
Diane got no treatment, which may prove to be beneficial in the long run. “Often the vertigo will resolve on its own whether it originates from the brain or whether it originates from the inner ear,” says Dr. Libman. Many patients will recover fully within a few weeks. But it is not uncommon for as many as half of them, like Diane, to have recurrent episodes of vertigo, especially after rapid head movements. These can linger literally years after onset.
“I had it for a sporadic and fairly brief period of time so I was certainly not disabled by it but there were certainly things I couldn’t do like carry my kids down the stairs, carry groceries, things like that. I couldn’t trust that I wouldn’t fall down,” states Diane.
But because some symptoms come back occasionally, Diane says she would certainly have taken the steroid if she were offered it at the time. “Certainly if I was really dizzy I would be pretty willing to take something to make it go away.”

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