Upon admission to inpatient rehabilitation eight days after injury, he had symptoms of vertigo that did not interfere with his function. Here we report the successful treatment of two cases of central vertigo with a low dose of olanzapine.Ĭases one and two were presented at the 20 American Academy of Physical Medicine and Rehabilitation Annual Assembly, respectively. Olanzapine was for central vertigo based on its effectiveness as an anti-emetic. Olanzapine is an atypical antipsychotic approved for the treatment of schizophrenia and bipolar depression. Vertigo secondary to a stroke or brain injury can be symptomatically and functionally disabling and has no consensus treatment.
Central vertigo is clinically characterized by purely vertical spontaneous nystagmus, purely torsional with direction change on lateral gaze, or downbeating. It can last for weeks to months and usually has little effect with head position changes, but this can occur. Ĭentral vertigo can occur when there is a lesion or dysfunction of the brainstem vestibular apparatus - vestibular nuclei and their projections, especially to the cerebellum.
Central vertigo is a condition in which an individual experiences hallucinations of motion of their surroundings, or a sensation of spinning, while remaining still, as a result of dysfunction of the vestibular structures in the central nervous system (CNS). The most important differentiating facts are peripheral vertigo presents with predominant vestibulocochlear signs and symptoms of vertigo, tinnitus, and/or hearing impairment, whereas central vertigo is often associated with other brainstem signs and symptoms. Vertigo can have peripheral and central causes.
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