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Pharmacological advances in the treatment of neuro-otological and eye movement disorders.
Curr Opin Neurol. 2006 Feb; 19(1):33-40.CO

Abstract

PURPOSE OF REVIEW

First, to describe the current pharmacological treatment options for peripheral and central vestibular, cerebellar, and ocular motor disorders. Second, to identify vestibular and ocular motor disorders in which treatment trials are warranted.

RECENT FINDINGS

Peripheral vestibular disorders: In vestibular neuritis recovery of the peripheral vestibular function can be improved by treatment with oral corticosteroids. In Ménière's disease treatment strategies range from low-salt diet, diuretics, and betahistine, to intratympanic injection of corticosteroids or gentamicin. Unfortunately most of the trials on Ménière's disease do not have an up-to-date design. In bilateral vestibulopathy steroids do not seem to improve vestibular function.Central vestibular, cerebellar, and ocular motor disorders: The use of aminopyridines introduced a new therapeutic principle in the treatment of downbeat and upbeat nystagmus and episodic ataxia type 2 (EA2). 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. Many other eye movement disorders, however, such as ocular flutter, opsoclonus, central positioning, or see-saw nystagmus are still difficult to treat.

SUMMARY

Although progress has been made in the treatment of vestibular neuritis, downbeat and upbeat nystagmus, as well as EA2, state-of-the-art trials must still be performed on many vestibular and ocular motor disorders, namely Ménière's disease, bilateral vestibulopathy, vestibular paroxysmia, vestibular migraine, and many forms of central eye movement disorders.

Authors+Show Affiliations

Department of Neurology, University of Munich, Germany. Michael.Strupp@med.uni-muenchen.deNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16415675

Citation

Strupp, Michael, and Thomas Brandt. "Pharmacological Advances in the Treatment of Neuro-otological and Eye Movement Disorders." Current Opinion in Neurology, vol. 19, no. 1, 2006, pp. 33-40.
Strupp M, Brandt T. Pharmacological advances in the treatment of neuro-otological and eye movement disorders. Curr Opin Neurol. 2006;19(1):33-40.
Strupp, M., & Brandt, T. (2006). Pharmacological advances in the treatment of neuro-otological and eye movement disorders. Current Opinion in Neurology, 19(1), 33-40.
Strupp M, Brandt T. Pharmacological Advances in the Treatment of Neuro-otological and Eye Movement Disorders. Curr Opin Neurol. 2006;19(1):33-40. PubMed PMID: 16415675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacological advances in the treatment of neuro-otological and eye movement disorders. AU - Strupp,Michael, AU - Brandt,Thomas, PY - 2006/1/18/pubmed PY - 2006/4/29/medline PY - 2006/1/18/entrez SP - 33 EP - 40 JF - Current opinion in neurology JO - Curr Opin Neurol VL - 19 IS - 1 N2 - PURPOSE OF REVIEW: First, to describe the current pharmacological treatment options for peripheral and central vestibular, cerebellar, and ocular motor disorders. Second, to identify vestibular and ocular motor disorders in which treatment trials are warranted. RECENT FINDINGS: Peripheral vestibular disorders: In vestibular neuritis recovery of the peripheral vestibular function can be improved by treatment with oral corticosteroids. In Ménière's disease treatment strategies range from low-salt diet, diuretics, and betahistine, to intratympanic injection of corticosteroids or gentamicin. Unfortunately most of the trials on Ménière's disease do not have an up-to-date design. In bilateral vestibulopathy steroids do not seem to improve vestibular function.Central vestibular, cerebellar, and ocular motor disorders: The use of aminopyridines introduced a new therapeutic principle in the treatment of downbeat and upbeat nystagmus and episodic ataxia type 2 (EA2). 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. Many other eye movement disorders, however, such as ocular flutter, opsoclonus, central positioning, or see-saw nystagmus are still difficult to treat. SUMMARY: Although progress has been made in the treatment of vestibular neuritis, downbeat and upbeat nystagmus, as well as EA2, state-of-the-art trials must still be performed on many vestibular and ocular motor disorders, namely Ménière's disease, bilateral vestibulopathy, vestibular paroxysmia, vestibular migraine, and many forms of central eye movement disorders. SN - 1350-7540 UR - https://www.unboundmedicine.com/medline/citation/16415675/Pharmacological_advances_in_the_treatment_of_neuro_otological_and_eye_movement_disorders_ L2 - https://doi.org/10.1097/01.wco.0000196156.00481.e1 DB - PRIME DP - Unbound Medicine ER -