Vertigo and balance disturbances in multiple sclerosis patients Review article
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Published:
Mar 31, 2013
Keywords:
multiple sclerosis, vertigo, balance
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Abstract
Most of the multiple sclerosis patients report vertigo or balance disturbances. Acute vertigo can be the first symptoms of multiple sclerosis relapse and can mimic vestibular neuritis. The main cause of vertigo are demyelinating lesions within central part of the vestibular system, mainly in the root entry zone of the VIIIth nerve. Disequilibrium can also be caused by cerebellar ataxia, deep sensation impairment or internuclear ophtalmoplegia causing oscillopsia. The author describes epidemiology, pathogenesis, symptomatology and treatment of vertigo and balance disturbances in multiple sclerosis.
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References
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17. Shery T., Proudlock F.A., Sarvanathan N. et al.: The effects of gabapentin and memantine in acquired and congenital nystagmus. Br. J. Ophtalmol. 2006; 90: 839-843.
18. Rae-Grant A.D., Eckert N.J., Bartz S. et al.: Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity. Mult. Scler. 1999; 5: 179-83.
19. Marrie R.A., Cutter G.R., Tyry T.: Substantial burden of dizziness in multiple sclerosis. Multiple Sclerosis and Related Disorders 2013; 2: 21-28.
2. Muller R.: Studies on disseminated sclerosis with special reference to symptomatology, course and prognosis. Acta Med. Scand. 1949; 222: 1-214.
3. Ivers R.R., Goldstein N.P.: Multiple sclerosis: An appraisal of current symptoms and signs. Mayo Clinic. Proc. 1963; 38: 457-466.
4. Kahana E., Leibowitz U., Alter M.: Brainstem and cranial nerve involvement in multiple sclerosis. Acta Neurol. Scand. 1973; 49: 269-279.
5. Grenman R.: Involvement of the audiovestibular system in multiple sclerosis: An otoneurologic and audiologic study. Acta Otolaryngol. 1985; 420: 1-95.
6. Herrera W.G.: Vestibular and other balance disorders in multiple sclerosis. Neurol. Clin. 1990; 8: 407-420.
7. Thomke F., Hopf H.C.: Pontine lesions mimicking acute peripheral vestibulopathy. J. Neurol. Neurosurg. Psychiatry 1999; 66: 340-349.
8. Pula J.H., Newman-Toker D.E., Kattah J.C.: Multiple sclerosis as a cause of the acute vestibular syndrome. J. Neurol. 2013 [online: doi: 10.1007/s00415-013-6850-1].
9. Tarnutzer A.A., Berkowitz A.L., Robinson K.A. et al.: Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ 2011; 183: E571-E592.
10. Frohman E.M., Kramer P.D., Dewey R.B. et al.: Benign paroxysmal positioning vertigo in multiple sclerosis: diagnosis, pathophysiology and therapeutic techniques. Mult. Scler. 2003; 9: 250-255.
11. Anagnostou E., Mandellos D., Limbitaki D. et al.: Positional nystagmus and vertigo due to a solitary brachium conjuctivum plaque. J. Neurol. Neurosurg. Psychiatry 2006; 77: 790-792.
12. Selmaj K.: Stwardnienie rozsiane. Termedia. Poznań 2006.
13. Frohman E.M., Zhang H., Dewey R.B. et al.: Vertigo in MS: utility of positional and particle repositioning maneuvers. Neurology 2000; 55: 1566-1568.
14. Uemura T., Cohen B.: Effects of vestibular nuclei lesions on vestibulo-ocular reflexes and posture in monkeys. Acta Otolaryngol. Suppl. (Stockh.) 1973; 315: 1-71.
15. Macleod A.D.: Ondansetron in multiple sclerosis. J. Pain. Symptom. Manage. 2000; 20(5): 388-91.
16. Prosperini L., Fortuna D., Gianni C. et al.: Home-based balance training using the Wii Balance Board: a randomized, crossover pilot study in multiple sclerosis. Neurorehabil. Neural. Repair. 2013 [online: doi: 10.1177/1545968313478484].
17. Shery T., Proudlock F.A., Sarvanathan N. et al.: The effects of gabapentin and memantine in acquired and congenital nystagmus. Br. J. Ophtalmol. 2006; 90: 839-843.
18. Rae-Grant A.D., Eckert N.J., Bartz S. et al.: Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity. Mult. Scler. 1999; 5: 179-83.
19. Marrie R.A., Cutter G.R., Tyry T.: Substantial burden of dizziness in multiple sclerosis. Multiple Sclerosis and Related Disorders 2013; 2: 21-28.