geoffrey modest medical blogs

  A recent systematic review and meta-analysis found that antihistamines provided greater vertigo relief than benzodiazepines (see  vertigo antihistamine better than benzo jamaneurol2022  in  dropbox , or  doi:10.1001/jamaneurol.2022.1858)    Details : -- 17 RCTs were identified with a total of 1586 participants -- diazepam was the major benzodiazepine studied, though lorazepam was used in one study -- antihistamines used included: betahistidine (2 studies), cinnarizine (4 studies), dimenhydrinate (7 studies, this is OTC generic of dramamine), flunarizine (2 studies), meclizine (1 study), and promethazine (2 studies) -- antihistamines were compared with benzodiazepines in 3 studies, with placebo or no treatment in 7 studies, and with other active controls in 6 studies (including methylprednisolone, various repositioning maneuvers, and some others) -- primary outcome: change in 10- or 100-point vertigo or dizziness visual analog scale (VAS) at 2 hours a...

an intriguing article just came out from the Netherlands showing that Internet-based vestibular rehab works well for adults with chronic vestibular syndrome  (see vertigo online rehab bmj2019 in dropbox, or doi :  https://doi.org/10.1136/bmj.l5922 ) Details: -- 59 general practices recruited 322 adults >50yo with chronic vestibular syndrome that had been present for at least one month and was exacerbated or triggered by head movements -- mean age 67; 61% female; level of education 33% low/27% middle/40% high; 32% living alone; chronic diseases: 58% zero/31% one/10% more; time since vestibular diagnosis: 1 to 6 months in 16%/ 6 months to 2 years 29%/2 to 10 years 38%/>10 years 16%; associated psych conditions: 3% panic disorder/14% generalized anxiety disorder/6% major depressive disorder -- participants were divided into 3 groups:     -- stand-alone ventricular rehab (VR): internet-based intervention with weekly online sessions for ...