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Long-term course and relapses of vestibular and balance disorders.
Restor Neurol Neurosci. 2010; 28(1):69-82.RN

Abstract

The long-term course and the frequency of relapses for various peripheral vestibular disorders and somatoform phobic postural vertigo are discussed with respect to the clinically most important questions for thus afflicted patients. This review is mainly based on our own long-term follow-up studies and takes into consideration the most relevant literature. The following syndromes are discussed in detail. Vestibular neuritis: the recovery rate of peripheral vestibular function lies between 40-63% depending on early-onset treatment with corticosteroids; the recurrence rate within 10 years is 2%. Menière's disease} loss of auditory and vestibular function occurs mainly in the first 5 to 10 years; frequency of vertigo attacks may decline after 5 to 10 years; bilateral involvement increases with increasing duration of the condition in up to 30-50%; vestibular drop attacks may occur early or late within the course, mostly with spontaneous remission; high-dose and long-term treatment with betahistine significantly reduces attack frequency in Menière's disease, Benign paroxysmal positioning vertigo: the recurrence rate is 50% within 10 years (in females 58%, in males 39%), most recurrences (80%) being observed within the first year after initial relief; recurrence rate in the seventh decade is half of that in the sixth decade. Vestibular paroxysmia: medical treatment with carbamazepine or oxcarbazepine leads to a continuous significant reduction in attack frequency, intensity, and duration of 10-15% of baseline. Bilateral vestibulopathy: recovery of vestibular function is limited to single cases depending on their etiology. Phobic postural vertigo: within 5 to 16 years 27% of the patients are symptom-free, 48% improve, 22% remain unchanged, and 3% worsen; a detailed explanation of the mechanisms that cause and the factors that provoke attacks is imperative, as well as instructions for self-controlled desensitization within the context of behavioral therapy.

Authors+Show Affiliations

Institute of Clinical Neurosciences, Germany Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders, Ludwig-Maximilian University, Klinikum Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20086284

Citation

Brandt, Thomas, et al. "Long-term Course and Relapses of Vestibular and Balance Disorders." Restorative Neurology and Neuroscience, vol. 28, no. 1, 2010, pp. 69-82.
Brandt T, Huppert T, Hüfner K, et al. Long-term course and relapses of vestibular and balance disorders. Restor Neurol Neurosci. 2010;28(1):69-82.
Brandt, T., Huppert, T., Hüfner, K., Zingler, V. C., Dieterich, M., & Strupp, M. (2010). Long-term course and relapses of vestibular and balance disorders. Restorative Neurology and Neuroscience, 28(1), 69-82. https://doi.org/10.3233/RNN-2010-0504
Brandt T, et al. Long-term Course and Relapses of Vestibular and Balance Disorders. Restor Neurol Neurosci. 2010;28(1):69-82. PubMed PMID: 20086284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term course and relapses of vestibular and balance disorders. AU - Brandt,Thomas, AU - Huppert,Tdoreen, AU - Hüfner,Katharina, AU - Zingler,Vera C, AU - Dieterich,Marianne, AU - Strupp,Michael, PY - 2010/1/21/entrez PY - 2010/1/21/pubmed PY - 2010/4/7/medline SP - 69 EP - 82 JF - Restorative neurology and neuroscience JO - Restor Neurol Neurosci VL - 28 IS - 1 N2 - The long-term course and the frequency of relapses for various peripheral vestibular disorders and somatoform phobic postural vertigo are discussed with respect to the clinically most important questions for thus afflicted patients. This review is mainly based on our own long-term follow-up studies and takes into consideration the most relevant literature. The following syndromes are discussed in detail. Vestibular neuritis: the recovery rate of peripheral vestibular function lies between 40-63% depending on early-onset treatment with corticosteroids; the recurrence rate within 10 years is 2%. Menière's disease} loss of auditory and vestibular function occurs mainly in the first 5 to 10 years; frequency of vertigo attacks may decline after 5 to 10 years; bilateral involvement increases with increasing duration of the condition in up to 30-50%; vestibular drop attacks may occur early or late within the course, mostly with spontaneous remission; high-dose and long-term treatment with betahistine significantly reduces attack frequency in Menière's disease, Benign paroxysmal positioning vertigo: the recurrence rate is 50% within 10 years (in females 58%, in males 39%), most recurrences (80%) being observed within the first year after initial relief; recurrence rate in the seventh decade is half of that in the sixth decade. Vestibular paroxysmia: medical treatment with carbamazepine or oxcarbazepine leads to a continuous significant reduction in attack frequency, intensity, and duration of 10-15% of baseline. Bilateral vestibulopathy: recovery of vestibular function is limited to single cases depending on their etiology. Phobic postural vertigo: within 5 to 16 years 27% of the patients are symptom-free, 48% improve, 22% remain unchanged, and 3% worsen; a detailed explanation of the mechanisms that cause and the factors that provoke attacks is imperative, as well as instructions for self-controlled desensitization within the context of behavioral therapy. SN - 1878-3627 UR - https://www.unboundmedicine.com/medline/citation/20086284/Long_term_course_and_relapses_of_vestibular_and_balance_disorders_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/RNN-2010-0504 DB - PRIME DP - Unbound Medicine ER -