Vestibular Disorders

Deutsches Ärzteblatt international, vol. 117, pp. 300–310

Abstract

BACKGROUND: Recent research findings have improved the understanding of the diagnosis, pathophysiology, genetics, etiology, and treatment of peripheral, central, and functional vestibular vertigo syndromes. METHOD: A literature search, with special attention to the current classification, treatment trials, Cochrane analyses, and other meta-analyses. RESULTS: There are internationally accepted diagnostic criteria for benign positional paroxysmal vertigo, Menière's disease, bilateral vestibulopathy, vestibular paroxysmia, and functional dizziness. Whether an acute vestibular syndrome is central or peripheral can usually be determined rapidly on the basis of the history and the clinical examination. "Cere - bellar vertigo" is a clinically important entity. For bilateral vestibulopathy, balance training is an effective treatment. For Menière's disease, preventive treatment with betahistine (48 mg and 144 mg per day) is not superior to placebo. For vestibular paroxysmia, oxcarbazepine has been shown to be effective. Treatments that are probably effective for functional dizziness include vestibular rehabilitation, cognitive behavioral therapy, and serotonin reuptake inhibitors. CONCLUSION: The diagnostic assessment of vestibular syndromes is much easier for clinicians now that it has been internationally standardized. There is still a lack of randomized, controlled trials on the treatment of, for example, Menière's disease, vestibular migraine, and "cerebellar vertigo."

Authors 6

1. Michael Leo Strupp Aachen Department of Otorhinolaryngology and Plastic Head and Neck Surgery

   University of Toronto · University of Zurich · Munich Cluster for Systems Neurology · Universitätsklinikum Aachen · Martin Luther University Halle-Wittenberg · Ludwig-Maximilians-Universität München · RWTH Aachen University

   Affiliation as printed

   Department of Neurology, Ludwig Maximilians University, Munich (LMU); German Center for Dizziness and Balance Disorders, Ludwig Maximilians University, Munich (LMU); Medical Imaging, University of Toronto, Canada; University Clinic and Outpatient Department for Psychiatry, Psychotherapy and Psychosomatics, University of Halle-Wittenberg; Department of Otorhinolaryngology and Plastic Head and Neck Surgery, University Medical Center, RWTH Aachen; Munich Cluster for Systems Neurology (SyNergy), Munich

   Department of Neurology, Ludwig Maximilians Univer-sity, Munich (LMU):

   Prof. Dr. med

   Zurich Open Repository and Archive University of Zurich University Library Strickhofstrasse 39 CH-8057 Zurich

2. Julia Dlugaiczyk

   University of Zurich · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Neurology, Ludwig Maximilians Univer-sity, Munich (LMU):

   Zurich Open Repository and Archive University of Zurich University Library Strickhofstrasse 39 CH-8057 Zurich

3. Birgit Betina Ertl-Wagner

   University of Zurich · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Neurology, Ludwig Maximilians Univer-sity, Munich (LMU):

   Zurich Open Repository and Archive University of Zurich University Library Strickhofstrasse 39 CH-8057 Zurich

4. Dan Rujescu

   University of Zurich · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Neurology, Ludwig Maximilians Univer-sity, Munich (LMU):

   Zurich Open Repository and Archive University of Zurich University Library Strickhofstrasse 39 CH-8057 Zurich

5. Martin Westhofen

   University of Zurich · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Neurology, Ludwig Maximilians Univer-sity, Munich (LMU):

   Zurich Open Repository and Archive University of Zurich University Library Strickhofstrasse 39 CH-8057 Zurich

6. Marianne Dieterich

   University of Zurich · Ludwig-Maximilians-Universität München

   Affiliation as printed

   Department of Neurology, Ludwig Maximilians Univer-sity, Munich (LMU):

   Zurich Open Repository and Archive University of Zurich University Library Strickhofstrasse 39 CH-8057 Zurich