LYCOS RETRIEVER 
Dizziness: Cases
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No significant double-blinded studies have been undertaken regarding cervicogenic dizziness. Experience at the Cleveland Clinic Foundation (CCF), and case series in the literature13, suggest that advanced-level physiotherapy directed toward the upper cervical spine may be beneficial. Therapy modalities should target normalization of biomechanics, range of movement, tone, mitigation of pain/tenderness, strengthening, and resetting of proprioception. Clinical trials at CCF are under way to assess the potential benefit of botulinum toxin combined with neck physiotherapy in the treatment of cervicogenic dizziness. The hypothesis is that botulinum toxin may be beneficial in relieving spasmodic torticollis (neurally-sustained spasm), allowing the physiotherapy to progress.
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Some cases of dizziness cannot be prevented. Acoustic neuromas, for example, were not as of 2004 predictable or preventable. When the underlying cause of dizziness cannot be discovered, it may be difficult to recommend preventive measures. Alternative approaches designed to rebalance the body's energy flow, such as acupuncture and constitutional homeopathy, may be helpful in cases where the cause of dizziness cannot be pinpointed.
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Consult a physician when dizziness or vertigo becomes bothersome or lasts a long time. Usually, the symptoms respond to an anti motion-sickness drug such as meclizine (Antivert®, Bonine®, or Dramamine®), the newer skin patches that deliver scopolamine, or the anti-nausea drug ondansetron (Zofran®). In very severe cases of dizziness or vertigo, a short course of corticosteroids may be needed.
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A large percentage of the adult population reports episodes of dizziness or vertigo to a physician during their lifetime. Many of these cases involve vestibular (inner ear) disorders. Other cases of dizzinessare due toproblems unrelated to the inner ear, such as cardiovascular,neurological, or psychologicaldisorders.
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The prognosis for most cases of dizziness is good, often with no treatment. In up to 50% of cases, dizziness goes away on its own or improves substantially within about 2 weeks. For example, many common causes of vertigo (eg, inner ear inflammation or BPV) typically resolve within days or weeks.
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