Acute vestibulopathy

Acute vestibulopathy is characterized by the acute or subacute onset of ver tigo, dizziness or imbalance with or without ocular motor, sensory, postura l or autonomic symptoms and signs, and can last for seconds to up to severa l days. Acute vestibular lesions may result from a hypofunction or from pat hological excitation of various peripheral or central vestibular structures (labyrinth, vestibular nerve, vestibular nuclei, cerebellum or ascending p athways to the thalamus and the cortex). This update focuses on new aspects of the aetiology, pathophysiology, epidemiology, and treatment of (i) acut e peripheral disorders (benign paroxysmal positioning vertigo, vestibular n euritis, Meniere's disease, perilymph fistula, especially 'superior canal d ehiscence syndrome', vestibular paroxysmia); and (ii) acute central vestibu lar disorders (especially 'vestibular migraine'). Finally, the clinical rel evance of recent diagnostic tools (three-dimensional analysis of eye moveme nt, imaging techniques) is discussed. Curr Opin Neurol 14:11-20. (C) 2001 L ippincott Williams & Wilkins.