Tags

Type your tag names separated by a space and hit enter

[Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders].
Laryngorhinootologie. 2018 01; 97(1):14-23.L

Abstract

There are currently different groups of drugs for the pharmacotherapy of vertigo, nystagmus and cerebellar disorders: antiemetics; anti-inflammatories, antimenieres, and antimigraineous medications and antidepressants, anticonvulsants, aminopyridines as well as acetyl-DL-leucine. In acute unilateral vestibulopathy, corticosteroids improve the recovery of peripheral vestibular function, but currently there is not sufficient evidence for a general recommendation. There is insufficient evidence to support the view that 16 mg t. i. d. or 48 mg t. i. d. betahistine has an effect in Menière's disease. Therefore, higher dosages are recommended. In animal studies, it was shown that betahistine increases cochlear blood flow. In vestibular paroxysmia, oxcarbazepine was effective (one randomized controlled trial (RCT)). Aminopyridines are recommended for the treatment of downbeat nystagmus (two RCTs) and episodic ataxia type 2 (EA2, one RCT). There has been no RCT on the efficacy of beta-blockers or topiramate but one RCT on flunarizine in vestibular migraine. Based on clinical experience, a treatment analogous to that for migraine without aura can be recommended. Acetyl-DL-leucine improved cerebellar ataxia (two observational studies); it also accelerated central compensation in an animal model of acute unilateral lesion, but RCTs were negative. There are ongoing RCTs on treatment of vestibular paroxysmia with carbamazepine (VESPA), acute unilateral vestibulopathy with betahistine (BETAVEST), vestibular migraine with metoprolol (PROVEMIG), benign paroxysmal positional vertigo with vitamin D (VitD@BPPV), EA2 with 4-aminopyridine versus acetazolamide (EAT-2-TREAT), and cerebellar ataxias with acetyl-DL-leucine (ALCAT).

Authors+Show Affiliations

Neurologische Klinik und Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Neurologische Klinik und Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Neurologische Klinik und Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Neurologische Klinik und Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Neurologische Klinik und Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.Neurologische Klinik und Deutsches Zentrum für Schwindel- und Gleichgewichtsstörungen, Klinikum der Universität München.

Pub Type(s)

Journal Article
Review

Language

ger

PubMed ID

29301160

Citation

Feil, K, et al. "[Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders]." Laryngo- Rhino- Otologie, vol. 97, no. 1, 2018, pp. 14-23.
Feil K, Böttcher N, Kremmyda O, et al. [Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders]. Laryngorhinootologie. 2018;97(1):14-23.
Feil, K., Böttcher, N., Kremmyda, O., Muth, C., Teufel, J., Zwergal, A., Brandt, T., & Strupp, M. (2018). [Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders]. Laryngo- Rhino- Otologie, 97(1), 14-23. https://doi.org/10.1055/s-0043-123487
Feil K, et al. [Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders]. Laryngorhinootologie. 2018;97(1):14-23. PubMed PMID: 29301160.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders]. AU - Feil,K, AU - Böttcher,N, AU - Kremmyda,O, AU - Muth,C, AU - Teufel,J, AU - Zwergal,A, AU - Brandt,T, AU - Strupp,M, Y1 - 2018/01/04/ PY - 2018/1/5/entrez PY - 2018/1/5/pubmed PY - 2019/8/29/medline SP - 14 EP - 23 JF - Laryngo- rhino- otologie JO - Laryngorhinootologie VL - 97 IS - 1 N2 - There are currently different groups of drugs for the pharmacotherapy of vertigo, nystagmus and cerebellar disorders: antiemetics; anti-inflammatories, antimenieres, and antimigraineous medications and antidepressants, anticonvulsants, aminopyridines as well as acetyl-DL-leucine. In acute unilateral vestibulopathy, corticosteroids improve the recovery of peripheral vestibular function, but currently there is not sufficient evidence for a general recommendation. There is insufficient evidence to support the view that 16 mg t. i. d. or 48 mg t. i. d. betahistine has an effect in Menière's disease. Therefore, higher dosages are recommended. In animal studies, it was shown that betahistine increases cochlear blood flow. In vestibular paroxysmia, oxcarbazepine was effective (one randomized controlled trial (RCT)). Aminopyridines are recommended for the treatment of downbeat nystagmus (two RCTs) and episodic ataxia type 2 (EA2, one RCT). There has been no RCT on the efficacy of beta-blockers or topiramate but one RCT on flunarizine in vestibular migraine. Based on clinical experience, a treatment analogous to that for migraine without aura can be recommended. Acetyl-DL-leucine improved cerebellar ataxia (two observational studies); it also accelerated central compensation in an animal model of acute unilateral lesion, but RCTs were negative. There are ongoing RCTs on treatment of vestibular paroxysmia with carbamazepine (VESPA), acute unilateral vestibulopathy with betahistine (BETAVEST), vestibular migraine with metoprolol (PROVEMIG), benign paroxysmal positional vertigo with vitamin D (VitD@BPPV), EA2 with 4-aminopyridine versus acetazolamide (EAT-2-TREAT), and cerebellar ataxias with acetyl-DL-leucine (ALCAT). SN - 1438-8685 UR - https://www.unboundmedicine.com/medline/citation/29301160/[Pharmacotherapy_of_Vestibular_Disorders_Nystagmus_and_Cerebellar_Disorders]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0043-123487 DB - PRIME DP - Unbound Medicine ER -