medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-19-91-98medsovet-6537Research ArticleГОЛОВНАЯ БОЛЬ И ГОЛОВОКРУЖЕНИЕHEADACHE AND VERTIGOСовременные аспекты лечения различных видов головокруженияCurrent aspects of the treatment of different types of vertigohttps://orcid.org/0000-0002-4400-8632АнтоненкоЛ. М.AntonenkoL. M.

Антоненко Людмила Михайловна, д.м.н., профессор, кафедра нервных болезней и нейрохирургии

119021, Россия, Москва, ул. Россолимо, д. 11, стр. 1

Lyudmila M. Antonenko, Dr. Sci. (Med.), Professor, Department of Nervous System Diseases and Neurosurgery

11, Bldg. 1, Rossolimo St., Moscow, 119435, Russia

luda6917@yandex.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation2021301120210199198Copyright © Антоненко Л.М., 20212021Антоненко Л.М.Antonenko L.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6537

Головокружение – одна из самых частых жалоб пациентов в повседневной клинической практике. Распространенность головокружения значительно увеличивается у пациентов старшего возраста. В большинстве случаев головокружение обусловлено патологией периферического отдела вестибулярной системы: доброкачественное пароксизмальное позиционное головокружение, вестибулярный нейронит, болезнь Меньера. Эпизоды повторяющегося вестибулярного головокружения без нарушения слуха могут быть связаны с вестибулярной мигренью, диагностика которой в нашей стране остается на низком уровне. Разработаны современные схемы лечения пациентов с различными причинами головокружения и неустойчивости. Высокая эффективность достигается при комплексном подходе к ведению пациентов с головокружением, который включает вестибулярную гимнастику, психологические тренинги и лекарственные средства, способствующие уменьшению выраженности и частоты приступов головокружения, а также улучшают вестибулярную компенсацию. Во многих исследованиях показана высокая эффективность низкодозового комбинированного препарата циннаризина 20 мг + дименгидрината 40 мг для лечения периферического и центрального головокружения, который хорошо переносится и не замедляет вестибулярную компенсацию. Проводилось сравнение эффективности низкодозового комбинированного препарата циннаризин + дименгидринат и бетагистина дигидрохлорида в лечении пациентов с односторонним вестибулярным нейронитом, болезнью Меньера и др. заболеваниями периферического и центрального отделов вестибулярной системы. Результаты исследований показали не меньшую эффективность комбинированного препарата циннаризин + дименгидринат в лечении болезни Меньера, чем бетагистина, более выраженное улучшение вестибулярной функции при лечении вестибулярного нейронита комбинированным препаратом, чем бетагистином. Для пациентов с периферической вестибулопатией различной этиологии лечение комбинированным препаратом оказалось более эффективным, чем терапия бетагистином.

Dizziness is one of the most frequent complaints of patients in daily clinical practice. The prevalence of vertigo increases significantly in older patients. In most cases, vertigo is caused by pathology of the peripheral vestibular system: benign paroxysmal positional vertigo, vestibular neuronitis, Meniere’s disease. Episodes of recurrent vestibular vertigo without hearing loss can be associated with vestibular migraine, a diagnosis of which remains low in our country. Modern treatment regimens have been developed for patients with various causes of vertigo and unsteadiness. High effectiveness is achieved with a comprehensive approach to the management of patients with vertigo, which includes vestibular exercises, psychological training, and medications that help to reduce the severity and frequency of vertigo attacks and improve vestibular compensation. Many studies have shown high efficacy of the low-dose combination drug cinnarizine 20 mg + dimenhydrinate 40 mg for the treatment of peripheral and central vertigo, which is well tolerated and does not delay vestibular compensation. The efficacy of the low-dose combination drug cinnarizine + dimenhydrinate and betahistine dihydrochloride was compared in the treatment of patients with unilateral vestibular neuronitis, Meniere’s disease, and other diseases of the peripheral and central vestibular system. Studies have shown no less efficacy of the combined drug cinnarizine + dimenhydrinate in the treatment of Meniere’s disease than of betahistine, a more pronounced improvement in vestibular function in the treatment of vestibular neuronitis with the combined drug than with betahistine. For patients with peripheral vestibulopathy of various etiologies, treatment with the combination drug was more effective than therapy with betahistine.

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The authors declare that there are no conflicts of interest present.