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In acute unilateral vestibulopathy, corticosteroids improve the recovery of peripheral vestibular function, but there is not sufficient current evidence for a general recommendation. There is also insufficient evidence that 48 or 144 mg\/day betahistine has an effect in M\u00e9ni\u00e8re's disease. Therefore, higher dosages are currently recommended; in animal studies, it was shown that betahistine increases cochlear blood flow. In vestibular paroxysmia, oxcarbazepine was effective (one yet not randomized controlled trial (RCT)). Aminopyridines are recommended for the treatment of downbeat nystagmus (two RCTs) and episodic ataxia type 2 (EA2, one RCT). There are so far no RCTs on vestibular migraine, so currently no treatment can be recommended. Acetyl\u2010<jats:sc>dl<\/jats:sc>\u2010leucine improves cerebellar ataxia (three observational studies); it also accelerates central compensation in an animal model of acute unilateral lesion, but RCTs were negative. There are ongoing RCTs on vestibular paroxysmia with carbamazepine (VESPA), acute unilateral vestibulopathy with betahistine (BETAVEST), vestibular migraine with metoprolol (PROVEMIG), benign paroxysmal positional vertigo with vitamin D (VitD@BPPV), EA2 with 4\u2010aminopyridine versus acetazolamide (EAT\u20102\u2010TREAT), and cerebellar ataxias with acetyl\u2010<jats:sc>dl<\/jats:sc>\u2010leucine (ALCAT).<\/jats:p>","DOI":"10.1111\/nyas.12774","type":"journal-article","created":{"date-parts":[[2015,4,22]],"date-time":"2015-04-22T16:34:25Z","timestamp":1429720465000},"page":"27-36","source":"Crossref","is-referenced-by-count":30,"title":["Pharmacotherapy of vestibular and cerebellar disorders and downbeat nystagmus: translational and back\u2010translational research"],"prefix":"10.1111","volume":"1343","author":[{"given":"Michael","family":"Strupp","sequence":"first","affiliation":[{"name":"Department of Neurology, German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences University Hospital Munich  Campus Grosshadern Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Zwergal","sequence":"additional","affiliation":[{"name":"Department of Neurology, German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences University Hospital Munich  Campus Grosshadern Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Feil","sequence":"additional","affiliation":[{"name":"Department of Neurology, German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences University Hospital Munich  Campus Grosshadern Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Bremova","sequence":"additional","affiliation":[{"name":"Department of Neurology, German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences University Hospital Munich  Campus Grosshadern Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Brandt","sequence":"additional","affiliation":[{"name":"Department of Neurology, German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences University Hospital Munich  Campus Grosshadern Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-5999-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489.2010.531052"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-85729-591-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1354594"},{"key":"e_1_2_9_6_1","first-page":"1","article-title":"Sequential [18F]FDG \u03bcPET whole\u2010brain imaging of central vestibular compensation: a model of deafferentation\u2010induced brain plasticity","author":"Zwergal A.","year":"2014","journal-title":"Brain Struct Funct."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2014.08.013"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-2009-0343"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32833de71f"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033280"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181ca843d"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182267e24"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.48"},{"key":"e_1_2_9_14_1","first-page":"CD008607","article-title":"Corticosteroids for the treatment of idiopathic acute vestibular dysfunction (vestibular neuritis)","author":"Fishman J.M.","year":"2011","journal-title":"Cochrane. 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