3 research outputs found
Current Treatment of Vestibular, Ocular Motor Disorders and Nystagmus
Vertigo and dizziness are among the most common complaints with a lifetime
prevalence of about 30%. The various forms of vestibular disorders can be
treated with pharmacological therapy, physical therapy, psychotherapeutic
measures or, rarely, surgery. In this review, the current pharmacological
treatment options for peripheral and central vestibular, cerebellar and ocular
motor disorders will be described. They are as follows for peripheral vestibular
disorders. In vestibular neuritis recovery of the peripheral vestibular function
can be improved by treatment with oral corticosteroids. In
Menière's disease a recent study showed long-term
high-dose treatment with betahistine has a significant effect on the frequency
of the attacks. The use of aminopyridines introduced a new therapeutic principle
in the treatment of downbeat and upbeat nystagmus and episodic ataxia type 2 (EA
2). These potassium channel blockers presumably increase the activity and
excitability of cerebellar Purkinje cells, thereby augmenting the inhibitory
influence of these cells on vestibular and cerebellar nuclei. A few studies
showed that baclofen improves periodic alternating nystagmus, and gabapentin and
memantine, pendular nystagmus. However, many other eye movement disorders such
as ocular flutter opsoclonus, central positioning, or see-saw nystagmus are
still difficult to treat. Although progress has been made in the treatment of
vestibular neuritis, downbeat and upbeat nystagmus, as well as EA 2,
state-of-the-art trials must still be performed on many vestibular and ocular
motor disorders, namely Menière's disease, bilateral
vestibular failure, vestibular paroxysmia, vestibular migraine, and many forms
of central eye movement disorders