Important Trends in the Vertigo Treatment during the Years 1970 till 2010 on an International Scale

Claussen Claus F. et all

Through the evaluation of more than 130.000 clinical neurootological cases we have designed a topodiagnostic equilibriometry.
Medical action has to deal with the complaints of the patients, the medical diagnostics in morphology and function and the solution of the patient´s complaints by a well adapted therapy. By means of our computerbased expert system CLAMEDEX we then individually design a case oriented pharmacotherapy.
When disturbances can be functionally measured and localized, then there arises a great demand for a systematic treatment.Systematic neurootological treatment of functional neurosensorial diseases follows the 4 major routes:
1. Increasing the cerebral blood flow.
2. Improvement of active transport through the blood brain barrier.
3. Improvement of the neuronal metabolism.
4. Systematic stimulation or depression of principal neurotransmitter activities.
A broad variety of drugs needs to be applied for achieving an optimal treatment.
Antiemetic and antivertiginous drugs.

Neurotransmission oriented therapy:
The neurosensorial function regulating structures can be understood as chemically acting circuits. Therefore it is of great importance that we understand the site of action of our therapy as well as the location of the individual lesions in this system.
Increased blood perfusion of CNS structures:
Many lesions in the neurosensorial system are due to decrease in the blood perfusion. Either the blood perfusion as such is too low or the penetration of the active substances through the vascular walls into the cerebral tissue is reduced.
Therefore we see a therapeutic effect of calcium channel blocking agents like flunarizine .These drugs exert an effect upon vertigo and also on tinnitus. It is also effective in peripheral and central arterial insufficiencies like the vertebro-basilar insufficiency.
Recently, the extracts of Ginkgo biloba containing a mixture of about 70 active substances of phytotherapeutic components has been found beneficial.
Finally drugs which reduce the sludging phenomena of the blood cells as well as the plasma viscosity, such as pentoxifyllin or pentifylline are used.
Treating the multimorbidity:
With an increasing number of geriatric patients we have to face the fact that many of them are suffering from degenerations in the most various organ systems. Old age vertigo and tinnitus are frequently combined with high blood pressure, cardiac insufficiency, diabetes mellitus and other metabolic impairments. In these cases it is important not to submit the patients to a treatment which benefits the blood pressure, the liver function or the glucose metabolism.