[Diagnosis and current therapy of vestibular syndromes].

Abstract

Vertigo and dizziness are with an annual incidence of more than 10% and a lifetime prevalence of more than 30% among the most frequent symptoms. The keys to the diagnosis are the patient history and the bedside examination: a) for the patient history the time course, type and triggers of symptoms and accompanying symptoms, b) for the clinical examination of the vestibular system the head-impulse test (HIT), the examination for a spontaneous nystagmus, a displacement of subjective visual vertical, a positional nystagmus and the Romberg test, and c) for the differentiation between an acute peripheral and central vestibular lesion the skew deviation, central fixation nystagmus, gaze-evoked nystagmus, saccadic smooth pursuit and a normal HIT. The various forms of vertigo are treated with pharmacological therapy, physical therapy, psychotherapeutic measures and, rarely, surgery. For pharmacotherapy there are basically eight groups of drugs that can be used: anti-emetics, -inflammatory, -menières, -migraineous medications, anti-depressants, -convulsants, aminopyridines and acetyl-DL-leucine, however, with a currently often low level of evidence.

• Authors: Michael Strupp, Thomas Brandt
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 141 Issue 23 Pg. 1698-1710 (Nov 2016) ISSN: 1439-4413 [Electronic] Germany
• Vernacular Title: Diagnose und aktuelle Therapie von Schwindelsyndromen.
• PMID: 27855460 (Publication Type: Journal Article, Review)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Neuroprotective Agents

Topics

• Diagnosis, Differential
• Dizziness (diagnosis, therapy)
• Evidence-Based Medicine
• Humans
• Neuroprotective Agents (therapeutic use)
• Physical Examination (methods)
• Physical Therapy Modalities
• Psychotherapy (methods)
• Treatment Outcome
• Vestibular Diseases (diagnosis, therapy)
• Vestibular Function Tests (methods)