Vertigo and
dizziness are among the most common complaints with a lifetime prevalence of about 30%. The various forms of vestibular disorders can be treated with pharmacological
therapy, physical therapy, psychotherapeutic measures or, rarely, surgery. In this review, the current pharmacological treatment options for peripheral and central vestibular, cerebellar and ocular
motor disorders will be described. They are as follows for peripheral vestibular disorders. In
vestibular neuritis recovery of the peripheral vestibular function can be improved by treatment with oral
corticosteroids. In Menière's disease a recent study showed long-term high-dose treatment with
betahistine has a significant effect on the frequency of the attacks. The use of
aminopyridines introduced a new therapeutic principle in the treatment of downbeat and upbeat nystagmus and
episodic ataxia type 2 (EA 2). These
potassium channel blockers presumably increase the activity and excitability of cerebellar Purkinje cells, thereby augmenting the inhibitory influence of these cells on vestibular and cerebellar nuclei. A few studies showed that
baclofen improves
periodic alternating nystagmus, and
gabapentin and
memantine,
pendular nystagmus. However, many other
eye movement disorders such as ocular flutter
opsoclonus, central positioning, or
see-saw nystagmus are still difficult to treat. Although progress has been made in the treatment of
vestibular neuritis, downbeat and upbeat nystagmus, as well as EA 2, state-of-the-art trials must still be performed on many vestibular and ocular
motor disorders, namely Menière's disease, bilateral vestibular failure, vestibular paroxysmia, vestibular
migraine, and many forms of central
eye movement disorders.