Discharge Instructions - Peripheral Vertigo

As discussed in the Emergency Department prior to discharge, you have been diagnosed with vertigo.  Vertigo or “the spins” is usually caused by a problem with your inner ear.  When people have vertigo, the room appears to spin or move, which can make you feel very ill, and you may vomit.  One reason for vertigo is if there is inflammation in your inner ear, which can happen when you are fighting off an infection like a cold.  The inner ear works together with your eyes to detect where you are in space.  If it is inflamed, it cannot do its job, which is why your surroundings feel as though they are spinning or moving.

Unfortunately, there is no treatment for this kind of vertigo, but it usually goes away on its own in 1-2 weeks.

If you have been diagnosed with vertigo, make sure to get a lot of sleep.  Most importantly, move very slowly.  Do not turn your head quickly or get up from bed suddenly.  Instead, sit up very slowly, and turn your whole body, instead of just your head, when you need to look to the side (and do it slowly).

You may have been given a medication for vertigo called Meclizine (also known as Antivert).  While it helps with vertigo, this medication may cause drowsiness, so you should avoid driving or operating machinery within 8 hours of taking it.

You may also attempt to perform an Epley Maneuver to improve your symptoms, as demonstrated in the Emergency Department.  First, you will determine which inner ear is the source of symptoms.  The Epley Maneuver is performed by:

1. Sit on the edge of your bed.  Turn your head 45-degrees to the affected ear side (not as far as your shoulder).  Place a pillow under you so when you lie down, it rests between your shoulders rather than under your head.
2. Quickly lie down on your back, with your head on the bed (still at the 45-degree angle).  The pillow should be under your shoulders.  Wait 30 seconds (for any vertigo to stop).
3. Turn your head halfway (90-degrees) to the opposite side without raising it.  Wait 30 seconds.
4. Turn your head and body on its side to the opposite side, so you're looking at the floor.  Wait 30 seconds.
5. Slowly sit up, but remain on the bed a few minutes.
6. Do these movements three times before going to bed each night, until you've gone 24 hours without dizziness.

Return to the Emergency Department for a new headache or confusion, if you are feeling very sleepy or drowsy, weakness in one arm, one leg or one side of your body or face, any changes in your vision, if you develop a mild spinning sensation that is present every day (this may be more concerning than severe vertigo which causes vomiting), or for any new or concerning symptoms.

https://www.mountsinai.on.ca/care/fammed/patient-resources/neurology/epley-maneuver.pdf