Neuro clinics 39 vertigo-2

Supported by Nirmal Clinics

Science comes first.

Dr Pratyush Chaudhuri

Supported by Nirmal Clinics

Science comes first.

68 yrs old female patient presented with c/o vertigo since 3-4 yrs – moderate to severe in distress causing great inconvienence in independent living.

She had been on cinnerazine and stemetil for more than 1 ½ years.

Well controlled hypertensive Depression +

Examination – routine – inconclusive except for obesity

Started her on full dose betahistine and low dose anti-depressant

Poor results after 3 weeks

Casual review of history – patient commented about difficulty in eating due to pain.

Left TM joint tenderness elicited

Vertigo significantly relieved after TM jt steroid injection.

Very unusual presentation Trial of systemic steroids had failed.

Reactive labrinthytis due to TM joint non-infective inflammation.

35yrs old rt handed male , teacher from Gogate Collage, presented with vertigo and feeling of imbalance.

He was relieved with exercise , but was scared to do much due to fear of fall.

Patient diagnosed as HT and started on Losartan and anxiolytic

In recent month, he was absent from college for more than 3 weeks.

Severeal anti-depresant therapy were stared and stopped.

Clinical finding – NIL (cardio, neuro & ENT)

I started him on Des-venelaflaxin, - part relief – BP control improved

On tapering Losartan – patient had remarkable relief of vertigo and depression

Presently on no medications Regular sports

Drug induced depression presenting as imbalance and lack of confidence.