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Nervenheilkunde 2023; 42(01/02): 59-65
DOI: 10.1055/a-1928-4730
Schwerpunkt

Gangstörungen bei Schwindelerkrankungen

Übersicht zu Diagnostik und TherapieGait disorders in patients with vertigo and dizzinessDiagnostic and therapeutic approaches
Roman Schniepp
1   Neurologische Klinik und Poliklinik der Ludwig-Maximilians-Universität München und Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ)
,
Ken Möhwald
1   Neurologische Klinik und Poliklinik der Ludwig-Maximilians-Universität München und Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ)
,
Max Wuehr
1   Neurologische Klinik und Poliklinik der Ludwig-Maximilians-Universität München und Deutsches Schwindel- und Gleichgewichtszentrum (DSGZ)
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ZUSAMMENFASSUNG

Einschränkungen der Gehfähigkeit sind bei Schwindelerkrankungen häufig und determinieren Funktionalität und Mobilität der Patienten. Stürze und deren psychische und körperliche Folgen sind zudem wichtige Einflussfaktoren für soziale Teilhabe und Lebensqualität.

Der vorliegende Übersichtsartikel informiert über die Möglichkeiten einer strukturierten Erfassung von Gangstörungsmustern bei Schwindel mit Nennung wichtiger differenzialdiagnostischer Aspekte. Zudem wird ein Konzept vorgestellt, mit dem Einschränkungen des Gehens in funktional relevante Bereiche unterteilt sind. Anhand dieses Konzepts werden im zweiten Teil des Artikels allgemeine Behandlungsoptionen der symptomatischen Therapie präsentiert. Diese umfassen neben physikalisch-medizinischen Basistherapien spezifischere Übungsformen des Gleichgewichts-, Koordinations- und Bewegungstrainings. In der Pharmakotherapie von Gangstörungen steht zumeist eine erkrankungsspezifische Zielsetzung im Vordergrund. Für die chronisch bilaterale vestibuläre Funktionsstörung bestehen zudem Ansätze der künstlichen Substitution bzw. Verstärkung.

ABSTRACT

Restrictions in the ability to walk are common in dizziness and determine the functionality and mobility of patients. Falls and their psychological and physical consequences are further important factors influencing social participation and quality of life.

The present review article therefore informs about the potentials of a structured assessment of gait patterns in dizziness with quoting important differential-diagnostic aspects. In addition, a concept of functional gait subdivisions is introduced. Based on this concept, general treatment options of symptomatic therapy are discussed in the second part of the article. These include basic therapies of physiotherapy. More specific training including balance, coordination, and locomotion trainings also complement gait therapy. In the pharmacotherapy of gait disorders, the focus is usually on a disease-specific objective. For chronic bilateral vestibular dysfunction, approaches of artificial substitution or amplification have also been developed.

Schlüsselwörter

Gangstörungen - Schwindel - Gleichgewichtssystem - Stürze

Key words

Gait disorders - dizziness - vertigo - vestibular system - falls


Publication History

Article published online:
13 February 2023

© 2023. Thieme. All rights reserved.

© Georg Thieme Verlag KG Stuttgart · New York
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