Vertigo

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1. DDx:

    1. central: less severe, constant, bilateral nystagmus, diplopia, Focal neurological deficit

    2. Peripheral: more severe, lasting for minutes then resolves, N/V, positional

        1. Vestibular neuritis

        2. Meniere

        3. BPPV

        4. Labyrinthitis

2. Check in BP in all patients

3. Peripheral Treatment

    1. Amp promethazine 25mg IM

        1. if IV infused, control symptoms with diphenhydramine

    2. Discharge the pt with:

        1. Tab ondansetron 4 mg tds

        2. Tab baclofen tds #20

        3. or  Tab dimenhydrinate 50 mg tds #10

4.