Update on functional vestibular and gait disorders.

Area of Science:

• Neuroscience
• Otolaryngology
• Neurology

Background:

• Persistent postural-perceptual dizziness (PPPD) is a leading cause of chronic vestibular and balance issues.
• Mal de debarquement (MdDS) is a less common but severe disorder.
• Functional gait disorder is a frequent manifestation of functional neurological disorders, often co-occurring with PPPD.

Purpose of the Study:

• To review recent advancements in understanding and managing three key functional neurological disorders in neuro-otologic practice: PPPD, MdDS, and functional gait disorder.
• To highlight evolving theories and emerging data relevant to these conditions.

Main Methods:

• Review of recent investigations into PPPD, including potential subtypes and pathological mechanisms.
• Analysis of accumulating evidence for vestibulo-ocular reflex readaptation therapy in MdDS.
• Examination of specialized physical and occupational therapy methods for functional gait disorder.

Main Results:

• New insights into the pathological mechanisms of PPPD suggest the need for nuanced models.
• Vestibulo-ocular reflex readaptation therapy shows promise for MdDS, with ongoing refinements.
• Functional gait disorder, often seen with PPPD, benefits from maturing specialized therapies, with intensive treatment potentially yielding optimal outcomes.

Conclusions:

• Functional vestibular and gait disorders are becoming increasingly manageable within neuro-otologic practice.
• Evolving theories and new data are crucial for effective management.
• Integrated approaches combining research insights and refined therapies are key.