Department of Rehabilitation Medicine, Emory University School of Medicine, Georgia, USA.
Curr Opin Neurol. 2013 Feb;26(1):96-101. doi: 10.1097/WCO.0b013e32835c5ec4.
This review examines the research from 2011 through 2012 on treatment efficacy in two common vestibular disorders - vestibular hypofunction and benign paroxysmal positional vertigo (BPPV).
Significant numbers of randomized controlled trials now support the use of specific exercises for the treatment of patients with unilateral peripheral vestibular hypofunction. We do not know if some treatment approaches are more effective than others. There is preliminary evidence that head movement may be the component critical to recovered function and decreased symptoms. Some patient characteristics and initial assessment results appear to predict treatment outcome but the evidence is incomplete. Treatment of posterior canal BPPV canalithiasis is well established. New evidence supports certain treatments for horizontal canal BPPV.
Treatments for unilateral vestibular hypofunction and for posterior canal BPPV are effective; however, there are many as yet unanswered questions such as why some patients with vestibular hypofunction do not improve with a course of vestibular exercises. We also do not know what would be the best treatment for anterior canal BPPV or for multiple-canal involvement BPPV.
本综述考察了 2011 年至 2012 年期间针对两种常见前庭疾病（前庭功能低下和良性阵发性位置性眩晕，BPPV）治疗效果的研究。
大量随机对照试验现在支持针对单侧周围性前庭功能低下患者使用特定运动疗法。我们尚不清楚某些治疗方法是否比其他方法更有效。有初步证据表明头部运动可能是恢复功能和减少症状的关键组成部分。一些患者特征和初始评估结果似乎可以预测治疗效果，但证据并不完整。后半规管嵴顶结石型 BPPV 的治疗已得到充分确立。新证据支持针对水平半规管 BPPV 的某些治疗方法。
单侧前庭功能低下和后半规管 BPPV 的治疗方法是有效的；然而，仍有许多悬而未决的问题，例如为什么有些前庭功能低下患者不能通过一系列前庭运动疗法得到改善。我们也不知道对于前半规管 BPPV 或多管受累 BPPV 的最佳治疗方法是什么。
