[Bilateral peripheral vestibulopathy].

D V Zhiznevskiy, M V Zamergrad, O S Levin, A A Azimova
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Abstract

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. In addition, cognitive and affective disorders, which also reduce the quality of life in patients with bilateral vestibulopathy, have been described and actively studied in recent years. The diagnosis of bilateral vestibulopathy is based on the results of a clinical neurovestibular study, including a dynamic visual acuity test and a Halmagyi test. A video head impulse test, a bithermal caloric test and a sinusoidal rotation test are used as instrumental methods confirming the dysfunction of the peripheral vestibular system. However, they are still not widespread in neurological practice. Treatment of bilateral vestibulopathy is reduced to vestibular rehabilitation. Encouraging results have been obtained in a number of studies using galvanic vestibular stimulation and the use of vestibular implants. In addition, cognitive rehabilitation methods are currently being developed, which presumably can also improve compensation for bilateral vestibular loss.

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[双侧外周前庭病变]。
双侧前庭病变是一种相对广泛,同时很少诊断的慢性姿势不稳定的原因。许多有毒因素,代谢障碍,自身免疫和神经退行性过程可导致这种情况。双侧前庭病变的主要临床表现为平衡障碍和视觉障碍(示波障碍),可显著增加这类患者跌倒的风险。此外,认知和情感障碍也降低了双侧前庭病变患者的生活质量,近年来已被描述并积极研究。双侧前庭病变的诊断是基于临床前庭神经研究的结果,包括动态视力测试和Halmagyi测试。视频头脉冲测试,热测试和正弦旋转测试被用作仪器方法确认外周前庭系统功能障碍。然而,它们在神经学实践中仍未广泛应用。双侧前庭病变的治疗简化为前庭康复。在一些使用前庭电刺激和使用前庭植入物的研究中获得了令人鼓舞的结果。此外,目前正在开发的认知康复方法可能也可以改善双侧前庭功能丧失的补偿。
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来源期刊
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
CiteScore
0.80
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0.00%
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0
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