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Strupp M, Brandt T. Current treatment of vestibular, ocular motor disorders and nystagmus. Ther Adv Neurol Disord. 2009;2(4):223-39doi: 10.1177/1756285609103120.
Strupp, M., & Brandt, T. (2009). Current treatment of vestibular, ocular motor disorders and nystagmus. Therapeutic advances in neurological disorders, 2(4), 223-39. https://doi.org/10.1177/1756285609103120
Strupp, Michael, and Brandt, Thomas. "Current treatment of vestibular, ocular motor disorders and nystagmus." Therapeutic advances in neurological disorders vol. 2,4 (2009): 223-39. doi: https://doi.org/10.1177/1756285609103120
Strupp M, Brandt T. Current treatment of vestibular, ocular motor disorders and nystagmus. Ther Adv Neurol Disord. 2009 Jul;2(4):223-39. doi: 10.1177/1756285609103120. PMID: 21179531; PMCID: PMC3002631.
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Ther Adv Neurol Disord. 2009 Jul;2(4):223-39. doi: 10.1177/1756285609103120.

Current treatment of vestibular, ocular motor disorders and nystagmus.

Therapeutic advances in neurological disorders

Michael Strupp, Thomas Brandt

Affiliations

  1. Professor of Neurology and Clinical Neurophysiology, University of Munich, Klinikum Grosshadern, Munich, Germany [email protected].

PMID: 21179531 PMCID: PMC3002631 DOI: 10.1177/1756285609103120

Abstract

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.

Keywords: Menière's disease; benign paroxysmal positioning vertigo; dizziness; downbeat nystagmus; episodic ataxia type 2; upbeat nystagmus; vertigo; vestibular migraine; vestibular neuritis; vestibular paroxysmia

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