Bittar R S M, Pedalini M E B, Lorenzi M C, Formigoni L G
Otorhinolaryngology Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Rev Laryngol Otol Rhinol (Bord). 2002;123(1):61-5.
Balance is fundamental to our daily activities and the vestibular system, together with vision and proprioceptive functions, are the main structures involved in this process. Dizziness is the main clinical manifestation of malfunction of these systems. The mechanisms of vestibular compensation are one of the most studied aspects since they play an important role in the patient's everyday activities. In this retrospective description of a series of cases the authors present their results in 155 patients that underwent a program of vestibular rehabilitation (VR). The program, first described by Cawthorne and Coosey, is based on mechanisms of potentiation of the cervico-ocular reflex and substitution of the lost vestibular cues for visual and somatosensory cues. The results were satisfactory (remission or partial cure) in 75.5% of the patients, with an average treatment time of up to 2 months and 5 or fewer sessions performed in most of the cases. The results were somewhat inferior in those cases in which a central vestibular lesion or more than one etiologic factor was present. The results of a subgroup of elderly patients (age > 65 years) were similar to those of the total number of studied subjects. Vestibular rehabilitation, associated to the specific etiological treatment, appears to be a very useful tool in the management of patients suffering from dizziness of all ages, although different clinical responses to the therapy may vary according to the presence of a central or a peripheral vestibular lesion or multiple etiological factors.
平衡是我们日常活动的基础，前庭系统与视觉和本体感觉功能一起，是参与这一过程的主要结构。头晕是这些系统功能失调的主要临床表现。前庭代偿机制是研究最多的方面之一，因为它们在患者的日常活动中起着重要作用。在对一系列病例的回顾性描述中，作者展示了155例接受前庭康复（VR）计划患者的结果。该计划最早由考索恩和库西描述，基于增强颈眼反射以及用视觉和体感线索替代失去的前庭线索的机制。75.5%的患者结果令人满意（缓解或部分治愈），平均治疗时间长达2个月，大多数病例进行了5次或更少的治疗。在存在中枢前庭病变或不止一个病因的病例中，结果略差。老年患者亚组（年龄>65岁）的结果与研究对象总数的结果相似。前庭康复与特定的病因治疗相结合，似乎是管理各年龄段头晕患者的非常有用的工具，尽管根据是否存在中枢或外周前庭病变或多种病因，对该疗法的不同临床反应可能会有所不同。
