Michael Strupp1, Thomas Brandt. 1. Neurologische Klinik der Universität München, Klinikum Grosshadern, Marchioninistrasse 15,Munich, Germany. Michael.Strupp@med.uni-muenchen.de
Abstract
INTRODUCTION: Vertigo is not a separate disease process, but a multisensory and sensorimotor syndrome with various etiologies and pathogeneses. It is among the commonest symptoms presented to doctors, with a lifetime prevalence of around 20% to 30%. Patients have often consulted multiple physicians before a diagnosis is made and therapy initiated. METHODS: Selective literature research and review of the guidelines of the German Neurological Society. RESULTS: A careful history remains the cornerstone of diagnosis. Once the correct diagnosis is made, specific and effective treatments are available for most peripheral, central, and psychogenic forms of dizziness. Treatment may include medication, physiotherapy, and psychotherapy; a few limited cases may require surgical treatment. The treatment of choice for acute vestibular neuritis is the administration of corticosteroids. Menière's disease is treated with high-dose, long-term betahistine. A new approach to the management of downbeat and upbeat nystagmus, and of episodic ataxia type 2, involves the use of aminopyridines as potassium-channel blockers. Close multidisciplinary cooperation is essential in dizziness, and further multicenter studies are needed.
INTRODUCTION:Vertigo is not a separate disease process, but a multisensory and sensorimotor syndrome with various etiologies and pathogeneses. It is among the commonest symptoms presented to doctors, with a lifetime prevalence of around 20% to 30%. Patients have often consulted multiple physicians before a diagnosis is made and therapy initiated. METHODS: Selective literature research and review of the guidelines of the German Neurological Society. RESULTS: A careful history remains the cornerstone of diagnosis. Once the correct diagnosis is made, specific and effective treatments are available for most peripheral, central, and psychogenic forms of dizziness. Treatment may include medication, physiotherapy, and psychotherapy; a few limited cases may require surgical treatment. The treatment of choice for acute vestibular neuritis is the administration of corticosteroids. Menière's disease is treated with high-dose, long-term betahistine. A new approach to the management of downbeat and upbeat nystagmus, and of episodic ataxia type 2, involves the use of aminopyridines as potassium-channel blockers. Close multidisciplinary cooperation is essential in dizziness, and further multicenter studies are needed.
Authors: R Kalla; A Deutschlander; K Hufner; T Stephan; K Jahn; S Glasauer; T Brandt; M Strupp Journal: Neurology Date: 2006-01-24 Impact factor: 9.910
Authors: Michael Strupp; Katharina Hüfner; Ruth Sandmann; Andreas Zwergal; Marianne Dieterich; Klaus Jahn; Thomas Brandt Journal: Dtsch Arztebl Int Date: 2011-03-25 Impact factor: 5.594