[Special forms of vertigo. Which therapy for which type of vertigo?].

Paroxysmal vertigo, permanent vertigo, positional and postural vertigo, and transient vertigo are special forms, which are differentiated by their temporal course. Paroxysmal vertigo, together with hearing impairment and noises in the ear, is typical of Menière's disease. Persistent vertigo often occurs after the loss of a peripheral vestibular end organ (e.g. after trauma of infection). In the case of positional and postural vertigo, a differentiation must be made between benign paroxysmal positional vertigo due to "wandering" otoliths, and orthostatic vertigo, which occurs on changing rapidly from a lying to a sitting position. The diagnosis is verified by Epley or Semont positional maneuvers. Confirmation of a cervical vertigo is provided by the de Kleijn and Nieuwenhuyse test. Brief episodes of vertigo (transient vertigo) occur after transient ischemia, for example when craning to look at a high building. In the acute stage, treatment of vestibular vertigo consists in the damping of the threshold for vestibular stimuli with antiemetics. For long-term treatment, antihistaminics and histamine-like substances have proven of value.