Acupuncture Therapy for Peripheral Vestibular Vertigo (with Suspected Ménière's Disease)

Background: Vertigo occurs in the balance system, both peripherally and centrally. Vertigo that occurs due to abnormalities in the peripheral balance system is called peripheral vestibular vertigo. Pharmacologic therapies, such as vestibular suppressants, antiemetics, and benzodiazepines, are often used for complaints of spinning dizziness, but these drugs are not indicated for long-term daily use. Acupuncture can be a therapeutic choice for treating vertigo. Case: Mrs. T.R., age 66, had episodic spinning dizziness for 18 months. Her dizziness recurred 3-4 times per month, and lasted ∼30 minutes to 2 hours. The dizziness was accompanied by cold sweating, but no nausea and vomiting. She also felt fullness in her right ear. A Rinne test was positive in both ears and a Weber test showed lateralization to the left. On a balance examination, the Fukuda stepping test showed 90° to the left. Her Vertigo Symptom Scale-Short Form (VSS-SF) score was 22. She was diagnosed with vestibular peripheral vertigo (Meniere's disease). Manual acupuncture therapy was performed 1-2 times per week at GV 20 (Baihui), TE 17 (Yifeng), GB 20 (Fengchi), LI 4 (Hegu), and LR 3 (Taichong). Results: After 6 sessions of acupuncture therapy, this patient no longer experienced spinning dizziness and her score on the VSS-SF questionnaire was reduced to 4. Conclusions: This case report shows that acupuncture therapy was very helpful for a patient with peripheral vestibular vertigo. Acupuncture can be used to treat patients who have vertigo and contraindications to pharmacologic therapies, and can to reduce side-effects of pharmacologic therapies. Further investigation of acupuncture therapy for peripheral vertigo is warranted.