Chronic vertigo: treat with exercise, not drugs

Abstract

#### What you need to know Chronic vertigo is a challenging problem. Currently patients are generally treated in general practice with betahistine (off-label use), while stronger evidence exists for the effectiveness of vestibular rehabilitation. Vertigo is the most common type of dizziness.1 Each year around 1 in 20 people in the general population experiences vertigo.2 Around 80% of these people affected by vertigo find that it severely impairs their daily functioning.2 Since the symptoms of vertigo prevent many people from working, as well as resulting in an increase in the risk of falling and a high use of healthcare services, vertigo also represents a substantial economic cost.2 Most cases of vertigo are caused by peripheral vestibular disorders such as vestibular neuronitis, benign paroxysmal positional vertigo, vestibular migraine, and Ménière’s disease.2 Initial treatment varies, depending on the most likely vestibular disorder. Box 1 provides an overview of specific treatments for the most common peripheral vestibular disorders. #### Box 1: Specific treatments for the most common peripheral vestibular disorders ##### Vestibular neuronitis ##### Benign paroxysmal positional vertigo (BPPV)