Vertigo: recent findings on diagnosis and treatment of peripheral and central vestibular syndromes

Abstract

Much progress has been made over the last years in the field of diagnosis and treatment of vestibular
syndromes. Here we aimed to review the main developments in common peripheral and central vertigo
syndromes.
New therapeutic maneuvers have come to light considering horizontal and anterior semicircular canal
benign paroxysmal positional vertigo. Furthermore, a differential potential for iatrogenic posterior-tohorizontal canal conversion has been observed when comparing Epley to Semont maneuver for posterior
canal positional vertigo. New therapeutic guidelines as well as novel and accurate diagnostic procedures
have emerged in the field of vestibular neuritis. Ménière’s disease is another peripheral disorder that
placed new treatment options and imaging findings in the center of focus. Regarding central vestibular
syndromes, novel algorithms help in diagnosis of stroke with vertiginous symptoms and case series with
better descriptions of supratentorial vestibular damage have come to light. Improved epidemiological data
as well as case descriptions with peripheral vestibular mimics have emerged in the field of multiple sclerosis.
Furthermore, consensus has been reached among vertigo and headache experts regarding the clinical link
and diagnostic criteria in migraine related vertigo. Finally, there is an ongoing scientific discussion on the
criteria characterizing functional vertigo.