Treatment And Prognosis

Patients with symptoms of imbalance often require symptomatic relief as well as treatment of the underlying systemic disorder. Benzodiazepines such as clonazepam are particularly useful in controlling symptoms of vertigo, and to a lesser extent, disequilibrium, and offer a degree of anxiety reduction that meclizine does not. Essential to the treatment of imbalance is management of the underlying systemic condition. This may be relatively simple in cases where the symptoms are related to overmedication or a relatively treatable condition such as migraine, but much of the time, the balance function that has been lost cannot be regained and therapy must be directed toward vestibular rehabilitation (23). Prognosis for patients with severe bilateral peripheral vestibular loss is poorer than for unilateral dysfunction, while patients with disruption of central pathways may be able to compensate significantly if the systemic disease process is controlled. Ongoing efforts to develop sensory substitution protocols may provide patients with severe vestibular loss increased rehabilitative potential (24).

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