Comorbid disorders and their possible prevention in patients with vestibular vertigo

Acute vestibular vertigo (AVV) is manifested by the illusion of movement of surrounding objects in front of the eyes or the sensation of movement of one's own body in space. The cause of AVV is in most cases a pathology of the peripheral vestibular analyser, in rarer cases – involvement of the brain stem. Headaches, neck pain, anxiety-depressive disorders, unsteadiness when walking, reduced cognitive abilities and general weakness often complicate AVV, significantly impair quality of life and slow down recovery. Treatment of patients with AVV should include rapid relief of an acute attack to prevent the development of these symptoms, increase patient compliance with vestibular rehabilitation and reduce the risk of developing anxiety-depressive syndrome. As a drug therapy for AVV, a fixed combination of dimenhydrinate and cinnarizine (Arlevert) is effective; it has a minimal sedative effect compared to other vestibular blockers and helps to rapidly reduce the intensity of dizziness and vegetative symptoms. Vestibular gymnastics promotes the processes of natural habituation, reduces the severity of instability and the risk of falling and increases motor activity. All patients with dizziness should have their mental state assessed and existing disorders corrected in collaboration with psychiatrists and cognitive behavioural therapists.