Differential diagnosis of dizziness and symptomatic therapy

Dizziness is one of the most common reasons for seeking medical attention from specialists in various fields. However, despite its apparent clarity, patients describe a wide range of sensations under this term: from loss of balance and uncertainty when moving to swaying, lightheadedness, pre-syncope, “heaviness in the head”, and coordination problems. Patients often struggle to clearly articulate their complaints and offer several different definitions of their condition. Specifying complaints can be difficult, which complicates diagnosis and determining the cause of dizziness. Therefore, modern practice uses a diagnostic algorithm that includes assessing the nature of vestibular syndrome (acute, intermittent, or persistent), identifying triggering factors, analyzing associated symptoms, performing a physical examination, and, if necessary, additional diagnostic methods. A clinical case study of a patient with multiple sclerosis who initially presented with complaints of dizziness illustrates the complexity of diagnosing this condition. In the treatment of dizziness, the primary goal is rapid and effective symptom relief. Given the frequent presence of comorbidities requiring the simultaneous use of multiple medications, combination medications are preferred. One such drug is the fixed-dose combination of dimenhydrinate 40 mg and cinnarizine 20 mg (Arlevert). Low doses of dimenhydrinate and cinnarizine enhance each other’s effects when used together, with minimal adverse effects. Due to the different mechanisms and locations of action of the components (peripheral action of cinnarizine and central action of dimenhydrinate), Arlevert is the only anti-dizzy medication with synergistic action in both peripheral and central areas.

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