Rehabilitation in patients with vertigo, a review of the literature

Abstract

Vertigo is an illusory sensation of rotation caused by an asymmetry in neural activity between the left and right vestibular nuclei. It can also be triggered by a sudden unilateral destruction of a normal vestibular organ, nerve, nucleus, or vestibulocerebellum. In the last decade, population-based epidemiological studies, complemented by previous publications from specialized settings, have provided evidence for the prevalence of dizziness and vertigo in the population. Dizziness (including vertigo) affects between 15% and 20% of adults annually, according to large-scale population studies. Vestibular vertigo accounts for a quarter of dizziness complaints and has a 12-month prevalence of 5% and an annual incidence of 1.4%. Prevalence increases with age and is about 2 to 3 times higher in women than in men. Imbalances more frequently associated with a recurrent complaint, particularly affecting healthy older adults, have been studied. Benign Paroxysmal Positional Vertigo (BPPV) and Vestibular Migraine (VM) are often underdiagnosed, while Meniere’s Disease, which is 10 times less common than BPPV, appears to be over diagnosed. Studies on risk factors are only beginning, but have already provided some interesting observations, such as the consistent association between vertigo and migraine, which has greatly contributed to the recognition of vestibular migraine as a distinct vestibular syndrome.