[Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus].

The literature review presents approaches to the management of patients with vestibular disorders. The principles of organization of vestibular rehabilitation in peripheral vestibular hypofunction, indications for appointment, factors influencing its implementation, technique, methods of evaluating effectiveness are considered in detail. Attention is drawn to the fact that the selection of exercises and the duration of vestibular rehabilitation is carried out individually and depends on many factors, including the nature of vestibular deficiency and the specific characteristics of the patient.

[Bilateral peripheral vestibulopathy].

Bilateral vestibulopathy is a relatively widespread and at the same time rarely diagnosed cause of chronic postural instability. Numerous toxic factors, dysmetabolic, autoimmune and neurodegenerative processes can lead to this condition. The main clinical manifestations of bilateral vestibulopathy are balance disorders and visual disturbances (oscillopsia), which can significantly increase the risks of falls in such patients.

[The role of cognitive impairment in the development of balance disorders in cerebrovascular diseases].

Cerebrovascular diseases and, in particular, ischemic stroke, are an important medical and social problem, remaining not only one of the leading causes of mortality, but also often leading to severe and irreversible disability. Cerebrovascular diseases, in addition to obvious focal neurological symptoms, are manifested by cognitive disorders of varying modality and severity, among which visual-spatial disorders remain almost the least studied. Many areas of the brain are responsible for providing visual-spatial functions, some of which also take part in maintaining balance.

[Dizziness in Parkinson's disease].

Objective: To study clinical features of vestibular disorders in patients with Parkinson's disease (PD) and to develop methods of their treatment.

Material And Methods: The study included 90 patients with PD who were divided into two groups: the main group (60 patients with PD and vestibular symptoms (VS)) and the control group (30 patients with PD without VS). All patients underwent clinical neurological examination, assessment of cognitive functions, affective and autonomic disorders as well as neurovestibular examination.

[Betahistine in vestibular disorders: current concepts and perspectives].

The goal of this paper is to review the pharmacological profile of betahistine and evidence for using it in the treatment of common vestibular disorders. Betahistine is a weak agonist for histamine H1 receptors and strong antagonist for histamine H3 receptors. It demonstrates the maximum benefit in different types of peripheral vertigo, especially in Meniere's disease.

[Various types of vertigo and balance disorders in patients with Meniere's disease].

Vertigo and balance disorders in Meniere's disease (MD) may have various etiology. The aim of the review is discussing pathogenetic mechanisms of the typical vertiginous paroxysms in MD, resulting from endolymphatic hydrops as well as analysis of etiology, pathogenesis, clinical course and basic treatment of paroxysmal and permanent forms of vertigo and balance disorders, caused by other conditions, associated with MD. We discussed the course of MD complicated by vestibular migraine, benign positional paroxysmal vertigo, functional dizziness, bilateral vestibulopathy and vestibular drop-attacks.

[A study of the efficacy and safety of a new modified-release betahistine formulation in the treatment of vestibular vertigo and Meniere's disease].

Objective: To evaluate the efficacy and safety of modified-release (MR) betahistine (48 mg once daily) versus betaserc (24 mg twice daily) in patients with Meniere's disease or vestibular vertigo.

Material And Methods: A multicentre, double-blind, randomized clinical study in patients with an established diagnosis of Meniere's disease (35%) or vestibular vertigo (65%) was carried out. A total of 264 patients were randomized (132 in each group).

[Bilateral vestibulopathy in elderly patients].

Balance disorders and recurring falls are the most frequent causes of medical treatment in old age. Chronic cerebral vascular insufficiency is considered to be the cause of instability in most of these cases, and its role in the development of postural instability in old age is likely to be greatly overrated. At the same time, the role of chronic peripheral vestibular disorders, by contrast, is underestimated.

[A role of vascular risk factors in the development of peripheral vestibulopathy].

The development of peripheral vestibular disorders are often thought to be associated with vascular mechanisms, taking into account terminal type of inner ear blood supply and other predisposing factors. A number of studies indicates a high frequency of vascular risk factors in the patients with vestibular neuronitis and benign paroxysmal positional vertigo (BPPV). According to other results, migraine is widely spread among patients with Meniere's disease and BPPV.

[Persistent postural perceptual dizziness of the elderly].

Persistent postural perceptual dizziness (PPPD) is a common cause of complaints to dizziness and unitability among patients of all-ages. The disease is characterized by a permanent feeling of non-rotatory dizziness or unsteadiness that at first can be caused by an acute vestibular dizziness, somatic disturbance that causes sudden unsteadiness and loss of balance or, for example, by a panic attack. Despite the permanent feeling of unsteadiness and dizziness, a regular instrumental examination cannot reveal important changes that can explain personal feeling.

[Vestibular disorders in patients with Parkinson's disease].

The article addresses causes of dizziness and a role of vestibular dysfunction in the instability structure in patients with Parkinson's disease. An analysis of recent studies using various methods of neurovestibular examination suggests the development of both peripheral and central vestibular dysfunction in patients with Parkinson's disease.

[Acute vestibular disorder in the elderly: stroke or peripheral vestibulopathy].

Acute vestibular disorder is a frequent cause of urgent hospitalization in elderly patients. A CNS vascular disorder is often thought to be a cause of vertigo and a patient is diagnosed with stroke or transitory ischemic attack (TIA) or vertebral-basilar insufficiency. Despite the higher risk of cerebrovascular disease in the elderly, stroke and TIA are not the only cause of acute vestibular disorder.

[Seven principles in the treatment of vestibular vertigo and results of the study of VIRTUOSO].

This article reports the results of the international post-marketing observational program VIRTUOSO aimed at the evaluation of the efficacy of betahistine dihydrochloride at the dose of 48 mg/day for 1-2 months in patients with paroxysmal vertigo of various origins. The clinical response was rated as good, very good or excellent in 74.1% of the patients (p<0.

[Metavestibular disorders and disorders of higher vestibular function].

Vertigo, instability, oscillopsia and concomitant autonomic disorders are classical and well-known symptoms of vestibular disorders. At the same time, recent studies suggest that there are more complicated vestibular dysfunctions caused by the cortical projections of the vestibular system. The central vestibular system includes parietal temporal cortex and insular, anterior intraparietal sulcus, posterior parietal and medial parts of the superior temporal gyrus, singular gyrus retrosplenial cortex, hippocampus and parahippocampal area.

[Vestibular vertigo in hemispheric strokes].

The literature on cases of hemispheric stroke manifesting with acute vertigo is reviewed. The authors describe a 56-year-old patient with recurrent acute vestibular syndrome due to hemispheric ischemic stroke. Imaging study revealed ischemic stroke with lesions in a parietal-occipital region of the left hemisphere.

[Functional (psychogenic) vertigo].

Psychogenic (functional) vertigo is in second place by frequency after benign positional paroxysmal vertigo. It is often difficult to make the diagnosis, diagnostic program is expensive and traditional treatment often is not effective. This literature review covers current concepts on the terminology, clinical signs, pathogenesis and treatment approaches with regard to functional vertigo.

Effectiveness of betahistine (48 mg/day) in patients with vestibular vertigo during routine practice: The VIRTUOSO study.

Background: Vestibular vertigo is associated with substantially reduced quality of life. Betahistine is effective in improving vertigo-associated symptoms, with longer treatment periods leading to greater improvements; however, it is not known whether these effects persist after treatment cessation.

Methods: VIRTUOSO was a prospective, multinational, non-comparative, post-marketing observational programme investigating the effectiveness of betahistine (48 mg/day) and the course of vertigo after the discontinuation of treatment.

[Diagnosis and treatment of benign paroxysmal positional vertigo in common clinical practice].

Aim: To analyze typical medical practice in managing patients with benign paroxysmal positional vertigo (BPPV).

Subjects And Methods: 33 patients (5 men and 28 women; mean age, 58 years) with BPPV who had been referred for consultation to the Medical Diagnostic Department, Clinic of Nervous Diseases, I.M.

[The peripheral vestibular disorders encountered in the routine out-patient practical work].

The objective of the present study was to elucidate the frequency of causes underlying the development of dizziness and vertigo in the patients seeking advice and care at an outpatient healthcare facility. A total of 590 patients with complaints of dizziness and vertigo were examined. It was found out that the peripheral disorders of the vestibular analyzer were the most frequent causes of dizziness and vertigo in the majority of the examined patients.

[Dizziness and anxiety disorders in the elderly].

Perhaps each dizzy patient feels anxiety. Varying emotional disorders are particularly common in elderly patients with dizziness. The causes of the frequent concurrence of dizziness and mental disorders (anxiety and depression) are diverse.

The linguistic validation of Russian version of Dutch four-dimensional symptoms questionnaire (4DSQ) for assessing distress, depression, anxiety and somatization in patients with borderline psychosomatic disorders.

Background: The four-dimensional symptom questionnaire (4DSQ) is an originally Dutch self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. In order to produce the appropriate translated Russian version the process of linguistic validation has been initiated. This process has been done according to the "Linguistic Validation Manual for Health Outcome Assessments" developed by MAPI institute.

[The Four-Dimensional Symptom Questionnaire (4DSQ) to assess distress, depression, anxiety and somatization in autonomic and borderline psychosomatic disorders].

Objective: Autonomic nervous system disorders are a frequent reason that makes patients to seek medical advice from general physicians and neurologists in outpatient clinics. The Dutch Four-Dimensional Symptoms Questionnaire (4DSQ) used for measuring distress, depression, anxiety and somatization is an adequate tool for identifying psychogenic factors for the development of autonomic disorders. An aim of the study was to localize the questionnaire to the Russian population.

[Characteristics of dizziness in elderly].

Clinical features of the main diseases that may cause dizziness in elderly and approaches to its treatment are reviewed. The treatment plan and increase of its effectiveness as well as prevention of the complications and improvement of quality of life of patients should be based on these features.

[Benign paroxysmal positional vertigo in a female with arterial hypertension and meningioma].

Diagnosis of benign paroxysmal positional vertigo (BPPV) often causes difficulties, in particular, in elderly people with concomitant diseases. The article presents a case of a 77 year-old woman with BPPV. A patient's complaint on vertigo was mistakenly diagnosed as brain ischemia because the patient had long suffered from uncontrolled arterial hypertension.