From the Guidelines
Steroids are not typically used for benign paroxysmal positional vertigo (BPPV) or vertigo from migraine, but may be considered for other vestibular disorders such as vestibular neuritis, Meniere's disease, or sudden sensorineural hearing loss with vertigo, as they can help reduce inflammation and alleviate symptoms. The use of steroids for vertigo is guided by the underlying cause of the condition, with vestibular neuritis, Meniere's disease, and sudden sensorineural hearing loss being potential indications for steroid treatment 1. A typical regimen involves a short course of oral prednisone starting at 60mg daily and tapering over 10-14 days, or methylprednisolone starting at 24-32mg with a similar taper. For severe, acute vertigo, intravenous steroids might be administered in hospital settings.
Some key points to consider when using steroids for vertigo include:
- Reducing inflammation in the inner ear and vestibular nerve to decrease vertigo symptoms and potentially prevent permanent damage to balance structures
- Potential side effects, including increased blood sugar, mood changes, sleep disturbances, and fluid retention
- Importance of proper diagnosis and monitoring, especially in patients with diabetes, hypertension, or other conditions that may be affected by steroid use
- Alternative treatments, such as vestibular suppressant medications, may be considered for BPPV or vertigo from migraine, as these conditions respond better to other treatments 1.
It is essential to consult a healthcare provider before starting steroids, as they require proper diagnosis and monitoring to ensure safe and effective use. The most recent and highest quality study, published in 2017, provides guidance on the diagnosis and treatment of vestibular disorders, including the use of steroids for vertigo 1.
From the Research
Use of Steroids for Vertigo
- The use of steroids for vertigo is mentioned in a study published in 2022 2, which discusses the current diagnosis and treatment of vestibular neuritis, a condition that can cause vertigo.
- According to this study, steroid therapy is one of the specific drug therapies used to treat vestibular neuritis, in addition to antiviral therapy and vasodilator therapy.
- However, the study does not provide detailed information on the effectiveness of steroid therapy for vertigo or its potential side effects.
- Other studies on vertigo, such as those published in 2003 3, 2017 4, 2020 5, and 2012 6, do not mention the use of steroids as a treatment option for vertigo.
- These studies discuss various other treatments for vertigo, including vestibular suppressants, antihistamines, benzodiazepines, and physical therapy, but do not provide information on the use of steroids.
Conditions that may be Treated with Steroids
- Vestibular neuritis is a condition that may be treated with steroids, according to the study published in 2022 2.
- This condition is characterized by abrupt true-whirling vertigo lasting for more than 24 hours, and is often caused by a viral infection or ischemia of the anterior vestibular artery.
- Other conditions that may cause vertigo, such as benign paroxysmal positional vertigo, Meniere's disease, and vestibular migraine, are not typically treated with steroids, according to the available studies 3, 4, 5, 6.