Combined therapy (vasoactive drug treatment and optokinetic training) for rehabilitation in different vestibular dysfunctions

Authors

Dr.med. Ágnes Szirmai (Budapest, Hungary)
Dr. MD Enikő Polczer (, Hungary)
Dr. MD László Tamás (, Hungary)

Proceedings

ASN-Volume 9 - 2015

Topics

Neurootology
Equilibrium
Neurootology
Neurootologic therapy
Neurootology
Neurootology
Neurootologic therapy
Pharmacotherapy
Neurootology
Neurootologic therapy
Physiotherapy

Keywords

bilateral vestibulopathy, central vestibular lesions, optokinetic training, peripheral vestibular lesion, vasoactive drug, vestibular training.

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Abstract

Abstract

Objectives:
Rehabilitation of patients with balance disorders is a great challenge for physicians.
The aim of our prospective study was to examine the results of combined vestibular rehabilitation treatment in different types of vestibular lesions (central dysfunction, unilateral and bilateral type of peripheral lesion).
Methods
The patients having chronic vertigo symptoms were treated with parenteral vasoactive drug infusion and with instrument-assisted optokinetic and smooth pursuit training, and the patients made self-sufficient statokinetic training (vestibulospinal tests combined with head rotation tests with open and closed eyes) according to our written guidelines. For the analysis of the efficiency of the therapy, the Dizziness Handicap Inventory was used.
Results
High impairments were shown in all groups regarding the quality of life (average DHI scores were 83.3; 8.2 and 72.5 in bilateral, central, and in peripheral lesions, respectively. After the treatment, significant improvements were measured in the central (DHI became 51.3) and the unilateral peripheral lesion group (DHI 56.2), due to central compensation. In the bilateral lesion group there was not any significant improvement (DHI: 77.7).
Conclusion:
Our results showed that vasoactive drug treatment with optokinetic training could decrease subjective complaints connected to the central and the unilateral peripheral balance system dysfunctions. The mechanism of the improvement could be the increased gain for central compensation. Our results showed that when good therapeutic results were missing, emotional problems of patients were increasing. Our opinion is that the complex rehabilitation is as important in central vestibular dysfunctions as it is in the unilateral peripheral vestibular lesions.