Treating Central Vertigo After Lateral Medullary Stroke with Low-Dose Olanzapine in Acute Inpatient Rehabilitation

Vertigo is a common neurologic symptom and can be a distressing and disabling condition. Vertigo has peripheral and central etiologies. While there are useful treatments for many peripheral cases, there is a notable absence of effective treatments for central vertigo. We describe the case of a 74-year-old male presenting with severe vertigo after a lateral medullary stroke persisting through eight days of acute inpatient rehabilitation. Low-dose olanzapine (2.5 mg nightly) was then initiated with complete resolution of his debilitating dizziness two days later, followed by a successful rehabilitation course and eventual return home.