caa a22 4500 445808314 CHVBK 20180317145203.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00415-011-5999-8 doi (NATIONALLICENCE)springer-10.1007/s00415-011-5999-8 Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus [Elektronische Daten] [Michael Strupp, Matthew Thurtell, Aasef Shaikh, Thomas Brandt, David Zee, R. Leigh] We review current pharmacological treatments for peripheral and central vestibular disorders, and ocular motor disorders that impair vision, especially pathological nystagmus. The prerequisites for successful pharmacotherapy of vertigo, dizziness, and abnormal eye movements are the "4 D's”: correct diagnosis, correct drug, appropriate dosage, and sufficient duration. There are seven groups of drugs (the "7 A's”) that can be used: antiemetics; anti-inflammatory, anti-Ménière's, and anti-migrainous medications; anti-depressants, anti-convulsants, and aminopyridines. A recovery from acute vestibular neuritis can be promoted by treatment with oral corticosteroids. Betahistine may reduce the frequency of attacks of Ménière's disease. The aminopyridines constitute a novel treatment approach for downbeat and upbeat nystagmus, as well as episodic ataxia type 2 (EA 2); these drugs may restore normal "pacemaker” activity to the Purkinje cells that govern vestibular and cerebellar nuclei. A limited number of trials indicate that baclofen improves periodic alternating nystagmus, and that gabapentin and memantine improve acquired pendular and infantile (congenital) nystagmus. Preliminary reports suggest suppression of square-wave saccadic intrusions by memantine, and ocular flutter by beta-blockers. Thus, although progress has been made in the treatment of vestibular neuritis, some forms of pathological nystagmus, and EA 2, controlled, masked trials are still needed to evaluate treatments for many vestibular and ocular motor disorders, including betahistine for Ménière's disease, oxcarbazepine for vestibular paroxysmia, or metoprolol for vestibular migraine. The Author(s), 2011 Vertigo nationallicence Dizziness nationallicence Vestibular neuritis nationallicence Ménière's disease nationallicence Vestibular paroxysmia nationallicence Vestibular migraine nationallicence Episodic ataxia type 2 nationallicence Downbeat nystagmus nationallicence Upbeat nystagmus nationallicence Pendular nystagmus nationallicence Periodic alternating nystagmus nationallicence Infantile nystagmus nationallicence Square-wave saccadic intrusion nationallicence Ocular flutter nationallicence Opsoclonus nationallicence Strupp Michael Department of Neurology, University of Munich, Munich, Germany aut Thurtell Matthew Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA aut Shaikh Aasef Neurology Service, Veterans Affairs Medical Center and Case Medical Center, Cleveland, OH, USA aut Brandt Thomas Department of Neurology, University of Munich, Munich, Germany aut Zee David Department of Neurology, John Hopkins Medical Center, Baltimore, MD, USA aut Leigh R. Neurology Service, Veterans Affairs Medical Center and Case Medical Center, Cleveland, OH, USA aut Journal of Neurology Springer-Verlag 258/7(2011-07-01), 1207-1222 0340-5354 258:7<1207 2011 258 415 https://doi.org/10.1007/s00415-011-5999-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-011-5999-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Strupp Michael Department of Neurology, University of Munich, Munich, Germany aut NATIONALLICENCE 700 1- Thurtell Matthew Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA aut NATIONALLICENCE 700 1- Shaikh Aasef Neurology Service, Veterans Affairs Medical Center and Case Medical Center, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Brandt Thomas Department of Neurology, University of Munich, Munich, Germany aut NATIONALLICENCE 700 1- Zee David Department of Neurology, John Hopkins Medical Center, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Leigh R. Neurology Service, Veterans Affairs Medical Center and Case Medical Center, Cleveland, OH, USA aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/7(2011-07-01), 1207-1222 0340-5354 258:7<1207 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer