Vestibular vertigo treatment in a polymorbid patient
Abstract
Many physicians have difficulty managing patients with vertigo. Incorrect routine diagnoses are frequently made in patients with peripheral vestibulopathy, which makes therapy fail. Most cases of vestibular vertigo are caused by peripheral vestibular disorders (otolithiasis, hydrops, neuronitis). Rehabilitation maneuvers are effective in the treatment of benign paroxysmal positional dizziness; salt-free diet, diuretics, and betahistine dihydrochloride are for MОniПre’s disease (syndrome); vestibular rehabilitation is for vestibular neuronitis. Betahistine dihydrochloride is most effective among all the medicines used in different causes of vestibular vertigo, including that of unclear origin. The paper gives the positive experience with betahistine made in Russia for vestibular vertigo.
About the Authors
O. V. Kosivtsova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery,
11, Rossolimo St., Moscow 119021
S. A. Yavorskaya
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery,
11, Rossolimo St., Moscow 119021
T. G. Fateeva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery,
11, Rossolimo St., Moscow 119021
References
1. Парфенов ВА, Абдулина ОВ, Замерград МВ. Дифференциальный диагноз, прогноз и лечение острого вестибулярного головокружения. Неврологический журнал 2007;(6):21-5. [Parfenov VA, Abdulina OV, Zamergrad MV. Differential diagnosis, prognosis and treatment of acute vestibular dizziness. Nevrologicheskii zhurnal 2007;(6):21-5. (In Russ.)].
2. Парфенов ВА, Абдулина ОВ, Замерград МВ. Периферическая вестибулопатия под маской инсульта. Неврологический журнал. 2005;(6):28-32. [Parfenov VA, Abdulina OV, Zamergrad MV. Peripheral vestibulopathy under the mask of stroke. Nevrologicheskii zhurnal. 2005;(6):28-32. (In Russ.)].
3. Самородская ИВ, Андреев ЕМ, Заратьянц ОВ и др. Показатели смертности населения старше 50 лет от цереброваскулярных болезней за 15-летний период в России и США. Неврология, нейропсихиатрия, психосоматика. 2017;9(2):15-24. [Samorodskaya IV, Andreev EM, Zarat'yants OV, et al. Cerebrovascular disease mortality rates in the population over 50 years of age in Russia and the USA over a 15-year period. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(2):15-24. (In Russ.)]. doi: 10.14412/2074-2711-2017-2-15-24
4. Barnett K, Mercer SW, Norbury M, et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012 Jul 7;380(9836):37-43. doi: 10.1016/S0140-6736(12)60240-2. Epub 2012 May 10.
5. Leatham AM. Safety and efficacy of antiemetics used to treat nausea and vomiting in pregnancy. Clin Pharm. 1986 Aug;5(8):660-8.
6. Strupp M, Arbusow V, Brandt T. Exercise and drug therapy alter recovery from labyrinth lesion in humans. Ann N Y Acad Sci. 2001 Oct;942:79-94.
7. Woodworth BA, Gillespie MB, Lambert PR. The canalith repositioning procedure for benign positional vertigo: a meta-analysis. Laryngoscope. 2004 Jul;114(7):1143-6.
8. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014 Dec 8;(12):CD003162. doi: 10.1002/14651858.CD003162.pub3.
9. Fife TD, Iverson DJ, Lempert T, et al; Quality Standards Subcommittee, American Academy of Neurology. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2008 May 27;70(22):2067-74. doi: 10.1212/01.wnl.0000313378.77444.ac.
10. Guneri EA, Kustutan O. The effects of betahistine in addition to Epley maneuver in posterior canal benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2012 Jan;146(1):104-8. doi: 10.1177/0194599811419093. Epub 2011 Aug 18.
11. Teggi R, Giordano L, Bondi S, et al. Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo in the elderly. Eur Arch Otorhinolaryngol. 2011 Apr;268(4):507-11. doi: 10.1007/s00405-010-1422-9. Epub 2010 Nov 11.
12. Radtke A, Neuhauser H, von Brevern M, Lempert T. A modified Epley's procedure for self-treatment of benign paroxysmal positional vertigo. Neurology. 1999 Oct 12;53(6):1358-60.
13. Tanimoto H, Doi K, Katata K, Nibu KI. Self-treatment for benign paroxysmal positional vertigo of the posterior semicircular canal. Neurology. 2005 Oct 25;65(8):1299-300.
14. Furman JM, Hain TC. «Do try this at home»: self-treatment of BPPV. Neurology. 2004 Jul 13;63(1):8-9.
15. Cohen HS, Sangi-Haghpeykar H. Canalith repositioning variations for benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2010 Sep;143(3):405-12. doi: 10.1016/j.otohns. 2010.05.022.
16. Herdman SJ, Tusa RJ. Complications of the canalith repositioning procedure. Arch Otolaryngol Head Neck Surg. 1996 Mar;122(3):281-6.
17. Thorp MA, Shehab ZP, Bance ML, Rutka JA. Does evidence-based medicine exist in the treatment of Meniere's disease? A critical review of the last decade of publications. Clin Otolaryngol Allied Sci. 2000 Dec;25(6):456-60.
18. Santos PM, Hall RA, Snyder JM, et al. Diuretic and diet effect on Meniere's disease evaluated by the 1985 Committee on Hearing and Equilibrium guidelines. Otolaryngol Head Neck Surg. 1993 Oct;109(4):680-9.
19. Coelho DH, Lalwani AK. Medical management of Meniere's disease. Laryngoscope. 2008 Jun;118(6):1099-108. doi: 10.1097/MLG.0b013e31816927f0.
20. Claes J, Van de Heyning PH. A review of medical treatment for Meniere's disease. Acta Otolaryngol Suppl. 2000;544:34-9.
21. Strupp M, Zingler VC, Arbusow V, et al. Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med. 2004 Jul 22;351(4):354-61.
22. Shupak A, Issa A, Golz A, et al. Prednisone treatment for vestibular neuritis. Otol Neurotol. 2008 Apr;29(3):368-74. doi: 10.1097/MAO.0b013e3181692804.
23. Антоненко ЛМ, Бестужева НВ, Парфенов ВА. Применение препаратов бетагистина при головокружении. Медицинский совет. 2014;(18):34-40. [Antonenko LM, Bestuzheva NV, Parfenov VA. The use of betahistine in vertigo. Meditsinskii sovet. 2014;(18):34-40. (In Russ.)].
24. Parfenov VA, Golyk VA, Matsnev EI, et al. Effectiveness of betahistine (48 mg/day) in patients with vestibular vertigo during routine practice: The VIRTUOSO study. PLoS One. 2017 Mar 30;12(3):e0174114. doi: 10.1371/journal.pone.0174114. eCollection 2017.
25. Furman JM, Marcus DA, Balaban CD. Vestibular migraine: clinical aspects and pathophysiology. Lancet Neurol. 2013 Jul;12(7):706-15. doi: 10.1016/S1474-4422(13)70107-8.
26. Maldonado Fernandez M, Birdi JS, Irving GJ, et al. Pharmacological agents for the prevention of vestibular migraine. Cochrane Database Syst Rev. 2015 Jun 21;(6):CD010600. doi: 10.1002/14651858.CD010600.pub2.
27. Helmchen C, Klinkenstein JC, Krü ger A, et al. Structural brain changes following peripheral vestibulo-cochlear lesion may indicate multisensory compensation. J Neurol Neurosurg Psychiatry. 2011 Mar;82(3):309-16. doi: 10.1136/jnnp.2010.204925. Epub 2010 Aug 27.
28. Brown KE, Whitney SL, Marchetti GF, et al. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil. 2006 Jan;87(1):76-81.
29. Mathog RH, Peppard SB. Exercise and recovery from vestibular injury. Am J Otolaryngol. 1982 Nov-Dec;3(6):397-407.
30. McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015 Jan 13;1:CD005397. doi: 10.1002/14651858. CD005397.pub4.
31. Horak FB, Jones-Rycewicz C, Black FO, Shumway-Cook A. Effects of vestibular rehabilitation on dizziness and imbalance. Otolaryngol Head Neck Surg. 1992 Feb;106(2):175-80.
32. Yardley L, Beech S, Zander L, et al. A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. Br J Gen Pract. 1998 Apr;48(429):1136-40.
33. Krebs DE, Gill-Body KM, Riley PO, Parker SW. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report. Otolaryngol Head Neck Surg. 1993 Oct;109(4):735-41.
For citation:
Kosivtsova O.V., Yavorskaya S.A., Fateeva T.G. Vestibular vertigo treatment in a polymorbid patient. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(1):96-101. (In Russ.) https://doi.org/10.14412/2074-2711-2018-1-96-101
Views: 378
Email this article 