What is the diagnosis and treatment for vestibular hypofunction (Vestibular Hypofunction)?

From the FDA Drug Label

Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults The answer to vestibular hypofunction is not directly addressed in the provided drug labels. However, vestibular hypofunction can be related to vertigo associated with diseases affecting the vestibular system.

• Meclizine is indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults 1, 1, 1. It can be inferred that meclizine may be used in patients with vestibular hypofunction, but only if it is associated with vertigo.

From the Research

Vestibular rehabilitation therapy (VRT) is the most effective treatment for vestibular hypofunction, and it should be performed 3-5 times daily for 10-20 minutes per session, with a program typically lasting 6-12 weeks under the guidance of a vestibular physical therapist. The goal of VRT is to promote central nervous system compensation for the vestibular deficit, and it includes exercises such as gaze stabilization, balance training, and habituation exercises 2.

Key Components of VRT

• Gaze stabilization: focusing on objects while moving the head
• Balance training: exercises to improve balance and reduce the risk of falls
• Habituation exercises: repeated exposure to movements that trigger symptoms

Duration and Frequency of VRT

• 3-5 times daily for 10-20 minutes per session
• Program typically lasting 6-12 weeks

Importance of Supervised VRT

• Supervised VRT is recommended, as it allows for personalized exercises and progression of the program 2
• A vestibular physical therapist can provide guidance and support to ensure the patient is performing the exercises correctly and safely

Additional Considerations

• Medications like meclizine or diazepam may provide temporary relief for acute symptoms, but should be used short-term as they can delay compensation 2
• Assistive devices like canes or walkers may be beneficial for patients during recovery
• The effectiveness of VRT is based on neuroplasticity—the brain's ability to reorganize and adapt by using other sensory inputs (visual and proprioceptive) to compensate for the vestibular deficit 2

Patient Outcomes

• Most patients show significant improvement with consistent therapy, though complete recovery depends on whether the condition is unilateral or bilateral and the underlying cause 2
• VRT has been shown to improve symptoms, function, and quality of life in patients with vestibular hypofunction 2, 3