Thomas Brandt1, Andreas Zwergal, Michael Strupp. 1. Ludwig-Maximilians-University, Institute of Clinical Neuroscience, Marchioninistr. 15, 81377 Munich, Germany. thomas.brandt@med.uni-muenchen.de
Abstract
BACKGROUND: The lifelong prevalence of rotatory vertigo is 30%. Despite this high figure, patients with vertigo generally receive either inappropriate or inadequate treatment. However, the majority of vestibular disorders have a benign cause, take a favorable natural course, and respond positively to therapy. OBJECTIVE: This review puts special emphasis on the medical rather than the physical, operative, or psychotherapeutic treatments available. METHODS: A selected review of recent reports and studies on the medical treatment of peripheral and central vestibular disorders. RESULTS/ CONCLUSIONS: In vestibular neuritis, recovery of the peripheral vestibular function can be improved by oral corticosteroids; in Menière's disease, there is first evidence that high-dose, long-term administration of betahistine reduces attack frequency; carbamazepine or oxcarbamazepine is the treatment of first choice in vestibular paroxysmia, a disorder mainly caused by neurovascular cross-compression; the potassium channel blocker aminopyridine provides a new therapeutic principle for treatment of downbeat nystagmus, upbeat nystagmus, and episodic ataxia type 2.
BACKGROUND: The lifelong prevalence of rotatory vertigo is 30%. Despite this high figure, patients with vertigo generally receive either inappropriate or inadequate treatment. However, the majority of vestibular disorders have a benign cause, take a favorable natural course, and respond positively to therapy. OBJECTIVE: This review puts special emphasis on the medical rather than the physical, operative, or psychotherapeutic treatments available. METHODS: A selected review of recent reports and studies on the medical treatment of peripheral and central vestibular disorders. RESULTS/ CONCLUSIONS: In vestibular neuritis, recovery of the peripheral vestibular function can be improved by oral corticosteroids; in Menière's disease, there is first evidence that high-dose, long-term administration of betahistine reduces attack frequency; carbamazepine or oxcarbamazepine is the treatment of first choice in vestibular paroxysmia, a disorder mainly caused by neurovascular cross-compression; the potassium channel blocker aminopyridine provides a new therapeutic principle for treatment of downbeat nystagmus, upbeat nystagmus, and episodic ataxia type 2.
Authors: Alexander A Tarnutzer; Aaron L Berkowitz; Karen A Robinson; Yu-Hsiang Hsieh; David E Newman-Toker Journal: CMAJ Date: 2011-05-16 Impact factor: 8.262
Authors: Michael Strupp; Matthew J Thurtell; Aasef G Shaikh; Thomas Brandt; David S Zee; R John Leigh Journal: J Neurol Date: 2011-04-02 Impact factor: 4.849