Management of vestibular disorders

Vertigo and dizziness are not disease entities but rather the outcome of many pathological or physiological processes. The prevailing good prognosis of vestibular disorders that manifest with vertigo must be emphasized. Most forms of vertigo have a benign cause and are characterized by spontaneous recovery of vestibular function or central compensation of a peripheral or central vestibular tone imbalance. Vertigo can be effectively relieved by pharmacological treatment (e.g., antiepileptic drugs for vestibular paroxysms), physical therapy (e.g., deliberate maneuvers for benign paroxysmal positioning vertigo), surgery (e.g., decompression of the eighth nerve), or psychotherapy (e.g., behavioral therapy for agoraphobia). There is, however, no common treatment, and vestibular suppressants provide only symptomatic relief of vertigo and nausea. A specific therapeutic approach thus requires recognition of the numerous particular pathomechanisms involved. Such therapy can include causative, symptomatic, or preventive approaches.