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Schwindel im Alter

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Hören und Gleichgewicht

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Zusammenfassung

Schwindelbeschwerden gehören zu den häufgsten Beschwerden, die Patienten jenseits des 65. Lebensjahrs, der überwiegend im Schrifttum angenommenen Altersgrenze, zum Arztbesuch veranlassen. 10 % der Patienten in allgemeinärztlichen Praxen klagen isoliert oder in Kombination mit weiteren Beschwerden über Schwindel und Gleichgewichtsstörungen. Die Beschwerden werden vielfach unterschätzt oder als altersentsprechend angesehen[32]. Die Patienten leiden unter Attackenschwindel, viele unter Unsicherheitsgefühl und dauernder Einschränkung der Blickfixierung, des Stehens und des Gehens. Unsicherheit in der räumlichen Orientierung verbunden mit reduzierter Funktion des Stützund Bewegungsapparats führen häufig zu unerwarteten Sturzereignissen. Der plötzliche Fall des älteren Patienten ist daher im Fokus der Neurootologie und Geriatrie[1]. Der hohe Anteil älterer Patienten ist vor allem durch die Zuspitzung der Alterspyramide und die höhere Mobilität der Senioren als erfreuliche Konsequenz der kardiologischen Versorgung und ihrer Fortschritte bedingt.

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References

  1. National Institute for Clinical Excellence (2004) Clinical practice guideline for the assessment and prevention of falls in older people. Guidelines commissioned by the National Institute for Clinical Excellence (NICE): 1–284

    Google Scholar 

  2. Antic BD, Peric P, Stefanovic SL (2008) [Disease of lower cranial nerves caused by vascular compression]. Acta Chir Iugosl. 55: 27–31

    Google Scholar 

  3. Asaka T, Yokoji H, Ito J, Yamaguchi K, Matsushima A (2006) Autosomal recessive ataxia with peripheral neuropathy and elevated AFP: novel mutations in SETX. Neurology 66: 1580–1581

    Article  PubMed  CAS  Google Scholar 

  4. Asmundson GJ, Stein MB, Ireland D (1999) A factor analytic study of the dizziness handicap inventory: does it assess phobic avoidance in vestibular referrals? J. Vestib. Res. 9: 63–68

    PubMed  CAS  Google Scholar 

  5. Baezner H, Blahak C, Poggesi A, Pantoni L, Inzitari D, Chabriat H, Erkinjuntti T, Fazekas F, Ferro JM, Langhorne P, O’Brien J, Scheltens P, Visser MC, Wahlund LO, Waldemar G, Wallin A, Hennerici MG (2008) Association of gait and balance disorders with age-related white matter changes: the LADIS study. Neurology 70: 935–942

    Article  PubMed  CAS  Google Scholar 

  6. Baloh RW (1998) Differentiating between peripheral and central causes of vertigo. Otolaryngol. Head Neck Surg. 119: 55–59

    Article  PubMed  CAS  Google Scholar 

  7. Bergstrom B (1973) Morphology of the vestibular nerve. 3. Analysis of the calibers of the myelinated vestibular nerve fibers in man at various ages. Acta Otolaryngol. 76: 331–338

    Article  PubMed  CAS  Google Scholar 

  8. Bergstrom B (1973b) Morphology of the vestibular nerve. II. The number of myelinated vestibular nerve fibers in man at various ages. Acta Otolaryngol. 76: 173–179

    Article  PubMed  CAS  Google Scholar 

  9. Berlit P (1998) [Isolated vertigo in vertebro-basilar ischemia-does it exist?]. HNO 46: 296–300

    Article  PubMed  CAS  Google Scholar 

  10. Bittar RS, Pedalini ME, Lorenzi MC, Formigoni LG (2002) Treating vertigo with vestibular rehabilitation: results in 155 patients. Rev. Laryngol. Otol Rhinol. (Bord.) 123: 61–65

    CAS  Google Scholar 

  11. Black FO, Effron MZ, Burns DS (1982) Diagnosis and management of drop attacks of vestibular origin: Tumarkin’s otolithic crisis. Otolaryngol.Head Neck Surg. 90: 256–262

    PubMed  CAS  Google Scholar 

  12. Corna S, Nardone A, Prestinari A, Galante M, Grasso M, Schieppati M (2003) Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit. Arch. Phys. Med. Rehabil. 84: 1173–1184

    Article  PubMed  Google Scholar 

  13. Dieterich M, Bense S, Lutz S, Drzezga A, Stephan T, Bartenstein P, Brandt T (2003) Dominance for vestibular cortical function in the non-dominant hemisphere. Cereb.Cortex 13: 994–1007

    Article  PubMed  CAS  Google Scholar 

  14. Engstrom H, Bergstrom B, Rosenhall U (1974) Vestibular sensory epithelia. Arch. Otolaryngol. 100: 411–418

    PubMed  CAS  Google Scholar 

  15. Frommberger U, Hurth-Schmidt S, Dieringer H, Tettenborn B, Buller R, Benkert O (1993) [Panic disorder and vertigo. On the psychopathologic differentiation between neurologic and psychiatric disease]. Nervenarzt 64: 377–383

    PubMed  CAS  Google Scholar 

  16. Furman JM, Balaban CD, Pollack IF (1997) Vestibular compensation in a patient with a cerebellar infarction. Neurology 48: 916–920

    PubMed  CAS  Google Scholar 

  17. Harada K, Oda M, Yamamoto M, Nomura T, Ohbayashi S, Kitsuda C (1993) A clinical observation of benign paroxysmal positional vertigo (BPPV) after vestibular neuronitis (VN). Acta Otolaryngol.Suppl 503: 61–63

    Article  PubMed  CAS  Google Scholar 

  18. Imbaud GS (2007) [Vertigo, dizziness and falls in the elderly]. Ann. Otolaryngol. Chir Cervicofac. 124: 189–196

    Article  Google Scholar 

  19. Jacob RG, Moller MB, Turner SM, Wall C III (1985) Otoneurological examination in panic disorder and agoraphobia with panic attacks: a pilot study. Am. J. Psychiatry 142: 715–720

    PubMed  CAS  Google Scholar 

  20. Jacobson GP, Calder JH (1998) A screening version of the Dizziness Handicap Inventory (DHI-S). Am. J. Otol 19: 804–808

    PubMed  CAS  Google Scholar 

  21. Janzen VD, Russell RD (1988) Conservative management of Tumarkin’s otolithic crisis. J. Otolaryngol. 17: 359–361

    PubMed  CAS  Google Scholar 

  22. Katsarkas A (1999) Benign paroxysmal positional vertigo (BPPV): idiopathic versus post-traumatic. Acta Otolaryngol. 119: 745–749

    Article  PubMed  CAS  Google Scholar 

  23. Kevetter GA, Zimmerman CL, Leonard RB (2005) Hair cell numbers do not decrease in the crista ampullaris of geriatric gerbils. J.Neurosci.Res. 80: 279–285

    Article  PubMed  CAS  Google Scholar 

  24. Kikuchi S, Yamasoba, T (2007) Neuro-otological findings in patients with very small (border zone) cerebellar infarcts. Acta Otolaryngol. Suppl: 56–60

    Article  Google Scholar 

  25. Kim KW, MacFall JR, Payne ME (2008) Classifcation of white matter lesions on magnetic resonance imaging in elderly persons. Biol. Psychiatry 64: 273–280

    Article  PubMed  Google Scholar 

  26. Kitahara T, Kondoh K, Morihana T, Okumura S, Horii A, Takeda N, Kubo T (2003) Steroid effects on vestibular compensation in human. Neurol.Res. 25: 287–291

    Article  PubMed  Google Scholar 

  27. Klockars T, Kentala E (2007a) Inheritance of Meniere’s disease in the Finnish population. Arch. Otolaryngol. Head Neck Surg. 133: 73–77

    Article  PubMed  Google Scholar 

  28. Klockars T, Kentala E (2007b) Inheritance of Meniere’s disease in the Finnish population. Arch. Otolaryngol. Head Neck Surg. 133: 73–77

    Article  PubMed  Google Scholar 

  29. Lee H, Yi HA, Lee SR, Ahn BH, Park BR (2005) Drop attacks in elderly patients secondary to otologic causes with Meniere’s syndrome or non-Meniere peripheral vestibulopathy. J. Neurol. Sci. 232: 71–76

    Article  PubMed  Google Scholar 

  30. Lockemann U, Westhofen M (1991) [Course of early vestibular compensation after acute labyrinthine lesions. A clinical-experimental longitudinal study]. Laryngorhinootologie 70: 326–329

    Article  PubMed  CAS  Google Scholar 

  31. Loughran S, Gatehouse S, Kishore A, Swan IR (2006) Does patient-perceived handicap correspond to the modified clinical test for the sensory interaction on balance? Otol. Neurotol. 27: 86–91

    Article  PubMed  Google Scholar 

  32. Luxon LM (1984) „A bit dizzy“. Br. J. Hosp. Med. 32: 315–321

    PubMed  CAS  Google Scholar 

  33. Magnusson M, Norrving B (1993) Cerebellar infarctions and “vestibular neuritis”. Acta Otolaryngol. Suppl 503: 64–66

    Article  Google Scholar 

  34. McClure JA (1986) Vertigo and imbalance in the elderly. J. Otolaryngol. 15: 248–252

    PubMed  CAS  Google Scholar 

  35. Merchant SN, Adams JC, Nadol JB Jr (2005) Pathophysiology of Meniere’s syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol. 26: 74–81

    Article  PubMed  Google Scholar 

  36. Montandon P, Guillemin P, Hausler R (1988) Prevention of vertigo in Meniere’s syndrome by means of transtympanic ventilation tubes. ORL J. Otorhinolaryngol. Relat Spec. 50: 377–381

    PubMed  CAS  Google Scholar 

  37. Morales AC, Gallo-Teran J (2005) [Vestibular drop attacks or Tumarkin’s otolithic crisis in patients with Meniere’s disease]. Acta Otorrinolaringol.Esp. 56: 469–47

    Google Scholar 

  38. Moschner C, Perlman S, Baloh RW (1994) Comparison of oculomotor findings in the progressive ataxia syndromes. Brain 117 (Pt 1): 15–25

    Article  PubMed  Google Scholar 

  39. Murai N, Oda N, Hori I, Shabana M, Kurozawa Y, Funabiki K (2007) The relationship between cerebral T2 hyperintensity and fixation suppression of vestibulo-ocular reflex in elderly patients with dysequilibrium symptoms. Auris Nasus Larynx 34: 165–171

    Article  PubMed  Google Scholar 

  40. Murray KJ, Hill K, Phillips B, Waterston J (2005) A pilot study of falls risk and vestibular dysfunction in older fallers presenting to hospital emergency departments. Disabil. Rehabil. 27: 499–506

    Article  PubMed  Google Scholar 

  41. Norre ME, Beckers A (1989) Vestibular habituation training for positional vertigo in elderly patients. Arch. Gerontol. Geriatr. 8: 117–122

    Article  PubMed  CAS  Google Scholar 

  42. Park JJH, Chen Y, Westhofen M (2009) Meniere’s disease and middle ear pressure — Vestibular function after transtympanic tube placement. Acta Otolaryngol.

    Google Scholar 

  43. Perez-Garrigues H, Lopez-Escamez JA, Perez P, Sanz R, Orts M, Marco J, Barona R, Tapia MC, Aran I, Cenjor C, Perez N, Morera C, Ramirez R (2008) Time course of episodes of definitive vertigo in Meniere’s disease. Arch. Otolaryngol. Head Neck Surg. 134: 1149–1154

    Article  PubMed  Google Scholar 

  44. Piker EG, Jacobson GP, McCaslin DL, Grantham SL (2008) Psychological comorbidities and their relationship to self-reported handicap in samples of dizzy patients. J. Am. Acad. Audiol. 19: 337–347

    Article  PubMed  Google Scholar 

  45. Pollak L, Klein C, Stryjer R, Kushnir M, Teitler J, Flechter S (2003) Phobic postural vertigo: a new proposed entity. Isr. Med. Assoc. J. 5: 720–723

    PubMed  Google Scholar 

  46. Rauch SD, Velazquez-Villasenor L, Dimitri PS, Merchant SN (2001) Decreasing hair cell counts in aging humans. Ann. N.Y. Acad. Sci. 942: 220–227

    Article  PubMed  CAS  Google Scholar 

  47. Richter E (1981) [Scarpa’s ganglion with increasing age, in Meniere’s disease and otosclerosis (author’s transl)]. Laryngol. Rhinol. Otol (Stuttg) 60: 542–5

    Article  CAS  Google Scholar 

  48. Rosenhall U (1973b) Degenerative patterns in the aging human vestibular neuro-epithelia. Acta Otolaryngol. 76: 208–220

    Article  PubMed  CAS  Google Scholar 

  49. Rosenhall U (1973a) Degenerative patterns in the aging human vestibular neuro-epithelia. Acta Otolaryngol. 76: 208–220

    Article  PubMed  CAS  Google Scholar 

  50. Savitz SI, Caplan LR (2005) Vertebrobasilar disease. N. Engl. J. Med. 352: 2618–2626

    Article  PubMed  CAS  Google Scholar 

  51. Schuknecht HF, Suzuka Y, Zimmermann C (1990) Delayed endolymphatic hydrops and its relationship to Meniere’s disease. Ann. Otol Rhinol.Laryngol. 99: 843–853

    PubMed  CAS  Google Scholar 

  52. Shallo-Hoffmann J, Bronstein AM (2003) Visual motion detection in patients with absent vestibular function. Vision Res. 43: 1589–1594

    Article  PubMed  Google Scholar 

  53. Shojaku H, Watanabe Y, Fujisaka M, Tsubota M, Kobayashi K, Yasumura S, Mizukoshi K (2005) Epidemiologic characteristics of definite Meniere’s disease in Japan. A long-term survey of Toyama and Niigata prefectures. ORL J. Otorhinolaryngol. Relat Spec. 67: 305–309

    PubMed  Google Scholar 

  54. Simoneau GG, Ulbrecht JS, Derr JA, Becker MB, Cavanagh PR (1994) Postural instability in patients with diabetic sensory neuropathy. Diabetes Care 17: 1411–1421

    Article  PubMed  CAS  Google Scholar 

  55. Strupp M, Brandt T (2009) Ocular motor disorders and vertigo in clinical practice.

    Google Scholar 

  56. Strupp M, Glaser M, Karch C, Rettinger N, Dieterich M, Brandt T (2003) [The most common form of dizziness in middle age: phobic postural vertigo]. Nervenarzt 74: 911–914

    Article  PubMed  CAS  Google Scholar 

  57. Takahama AJ, Volz-Sidiropoulou E, Ilgner J, Westhofen M (2008) Validierung der deutsch sprachigen Version des „Dizziness Handicap Inventory“ (DHI) zur Evaluation von Schwindelbeschwerden. German Medical Science/www.egms.de/en/meetings/hnod2008/08hnod410.shtml

    Google Scholar 

  58. Uneri A, Polat S (2008) Vertigo, dizziness and imbalance in the elderly. J. Laryngol. Otol 122: 466–469

    Article  PubMed  CAS  Google Scholar 

  59. Vermeer SE, Hollander M, van Dijk EJ, Hofman A, Koudstaal PJ, Breteler MM (2003) Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study. Stroke 34: 1126–1129

    Article  PubMed  Google Scholar 

  60. von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J. Neurol. Neurosurg.Psychiatry 78: 710–715

    Article  Google Scholar 

  61. Welling DB, Nagaraja HN (2000) Endolymphatic mastoid shunt: a reevaluation of efficacy. Otolaryngol.Head Neck Surg. 122: 340–345

    Article  PubMed  CAS  Google Scholar 

  62. Westhofen M (2007) Otolith-ocular responses in Meniere’s patients before and after endolymphatic shunt operation. J. Vestib. Res. 17: 113–118

    PubMed  Google Scholar 

  63. Westhofen M (2008 a) Labyrinthdysfunktion und Tubenventilationsstörung Kausalität oder Koinzidenz, in: Klinik der menschlichen Sinne, Stoll, W. (ed.), Springer, Wien, New York

    Google Scholar 

  64. Westhofen M (2008b) [Surgical treatment of vestibular vertigo: methods and indications]. HNO 56: 1003–1010

    Article  PubMed  CAS  Google Scholar 

  65. Yeh SJ, Shen WC, Yeh UC, Chia LG (1993) A clinical and MRI study of cerebellar infarctions. Zhonghua Yi. Xue. Za Zhi. (Taipei) 52: 307–313

    CAS  Google Scholar 

  66. Zingler VC, Cnyrim C, Jahn K, Weintz E, Fernbacher J, Frenzel C, Brandt T, Strupp M (2007) Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. Ann. Neurol. 61: 524–532

    Article  PubMed  Google Scholar 

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  1. Direktor der Klinik für Hals-Nasen-Ohrenheilkunde und Plastische Kopf- und Halschirurgie der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    Prof. Dr. med. M. Westhofen

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  1. Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universität Heidelberg, Deutschland

    Peter K. Plinkert  & Christoph Klingmann  & 

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Westhofen, M. (2010). Schwindel im Alter. In: Plinkert, P.K., Klingmann, C. (eds) Hören und Gleichgewicht. Springer, Vienna. https://doi.org/10.1007/978-3-211-99270-8_17

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  • DOI: https://doi.org/10.1007/978-3-211-99270-8_17

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