Patient management with complaints of vertigo at the first visit
Authors:   I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russian Federation, Amelin A.V. , Lilenko S.V. ,   St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russian Federation,   I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation, Zamergrad M.V. ,   Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation,   I.V. Davydovskiy City Clinical Hospital, Moscow, Russian Federation, Guseva A.L. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Zaitseva O.V. ,   National Medical Research Center of Otorhinolaryngology, Federal Research and Clinical Center of the Federal Medical Biological Agency, Moscow, Russian Federation, Voronov V.A. ,   I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation, Demidenko D.Yu. ,   I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation, Koreshkina M.I. ,   Adelmed Medical Board LLC, St. Petersburg, Russian Federation, Ovchinnikov D.A. ,   V.A. Almazov National Medical Research Center, St. Petersburg, Russian Federation
Published: November 2023

Vertigo and balance disorders are one of the most common causes of patients seeking medical help. Vertigo and balance disorders study primarily consists of the following: complaint report, anamnestic data and neurovestibular study. Currently, an algorithm is used based on the identification of three vestibular syndromes: acute, recurrent and chronic, as well as on the analysis of vertigo triggers and concomitant symptoms. Primarily, it is important to determine which vestibular syndrome is acute, recurrent or chronic at the first patient visit with vertigo and balance disorders. Besides, using the otoneurological examination methods is essential for determining the presence or absence of signs concerning the central nervous system disorder or the labyrinth. At the same time, it should be understood that the nervous system disorders accompanied by vertigo can pose a particular danger to the patient and should be excluded first of all. For the treatment and rehabilitation of patients with vertigo, individual selection of therapy and vestibular rehabilitation programs is most effective, taking into account the origin of vestibular disorder, the progression severity, as well as the age, physical and emotional condition. Vestibular rehabilitation can significantly reduce the vertigo severity and improve resistance indicators in patients with vestibular disorders. To improve vestibular compensation, it is advisable to use drug therapy with betahistine dihydrochloride, 48 mg per day, in a modified-release dosage form for better adherence. KEYWORDS: dizziness, balance disorder, acute vestibular syndrome, chronic vestibular syndrome, recurrent vestibular syndrome, betahistine, neurovestibular study FOR CITATION: Amelin A.V., Lilenko S.V., Zamergrad M.V., Guseva A.L., Zaitseva O.V., Voronov V.A., Demidenko D.Yu., Koreshkina M.I., Ovchinnikov D.A. Patient management with complaints of vertigo at the first visit. Russian Medical Inquiry. 2023;7(10):658–665 (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-8.