Psychogenic Dizziness: An Important but Overlooked Differential Diagnosis in the Workup of the Dizzy Patient

Kelm, Zak; Klapchar, Kimberly; Kieliszak, Christopher R.; Selinsky, Christopher

doi:10.7556/jaoa.2018.066

Cited by 8 publications

(8 citation statements)

References 29 publications

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“…Diagnostic entities that largely have a persistent non-organic basis increasingly being referred to as syndromes of cognitive vestibular dysfunction (i.e. chronic subjective dizziness 38 , PPPD 39 , 40 , chronic phobic postural dizziness 41 , medically unexplained dizziness 42 , dizziness with catastrophization 37 , mal d’embarquement 43 , 44 etc.) were also excluded despite acknowledgement an acute vestibular event might be a precipitating cause.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic peripheral vestibular disorders (excluding positional vertigo) in workers following head injury

Misale

Hassannia

Dabiri

et al. 2021

Sci Rep

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Benign paroxysmal positional vertigo has typically been reported to be the most common cause of post-traumatic dizziness. There is however paucity in the literature about other peripheral vestibular disorders post-head injury. This article provides an overview of other causes of non-positional dizziness post-head trauma from our large institutional experience. The UHN WSIB Neurotology database (n = 4291) between 1998 and 2018 was retrospectively studied for those head-injured workers presenting with non-positional peripheral vestibular disorders. All subjects had a detailed neurotological history and examination and vestibular testing including video nystagmography, video head impulse testing (or a magnetic scleral search coil study), vestibular-evoked myogenic potentials, and audiometry. Imaging studies included routine brain and high-resolution temporal bone CT scans and/or brain MRI. Based on a database of 4291 head-injured workers with dizziness, 244 were diagnosed with non-positional peripheral vertigo. Recurrent vestibulopathy (RV) was the most common cause of non-positional post-traumatic vertigo. The incidence of Meniere’s disease in the post-traumatic setting did not appear greater than found in the general population. The clinical spectrum pertaining to recurrent vestibulopathy, Meniere’s disease, delayed endolymphatic hydrops, drop attacks, superior semicircular canal dehiscence syndrome, and uncompensated peripheral vestibular loss are discussed.

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Section: Discussionmentioning

confidence: 99%

Post-traumatic peripheral vestibular disorders (excluding positional vertigo) in workers following head injury

Misale

Hassannia

Dabiri

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Diagnostic entities that largely have a persistent non-organic basis increasingly being referred to as syndromes of cognitive vestibular dysfunction (i.e. chronic subjective dizziness (38) , PPPD (39,40) , chronic phobic postural dizziness (41) , medically unexplained dizziness (42) , dizziness with catastrophization (37) , mal d'embarquement (43,44) etc.) were also excluded despite acknowledgement an acute vestibular event might be a precipitating cause.…”

Section: Uncompensated Xed Vestibular Loss (77/244)mentioning

confidence: 99%

Post-traumatic Peripheral Vestibular Disorders (Excluding Positional Vertigo): Institutional Experience from University Health Network’s Workplace Safety and Insurance Board Head-Injury Program

Misale

Hassannia

Dabiri

et al. 2021

Preprint

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Purpose: Benign paroxysmal positional vertigo has typically been reported to be the most common cause of post-traumatic dizziness. There is however paucity in the literature about other peripheral vestibular disorders post-head injury. This article provides an overview of other causes of non-positional dizziness post-head trauma from our large institutional experience.Methods: The UHN WSIB Neurotology database (n=4,291) between 1998 and 2018 was retrospectively studied for those head-injured workers presenting with non-positional peripheral vestibular disorders. All subjects had a detailed neurotological history and examination and vestibular testing including video nystagmography, video head impulse testing (or a magnetic scleral search coil study), vestibular-evoked myogenic potentials, and audiometry. Imaging studies included routine brain and high-resolution temporal bone CT scans and/or brain MRI.Results: Based on a database of 4,291 head-injured workers with dizziness, 244 were diagnosed with non-positional peripheral vertigo. Recurrent vestibulopathy (RV) was the most common cause of non-positional post-traumatic vertigo. The incidence of Meniere’s disease in the post-traumatic setting did not appear greater than found in the general population. Conclusion: The clinical spectrum pertaining to recurrent vestibulopathy, Meniere’s disease, delayed endolymphatic hydrops, drop attacks, superior semicircular canal dehiscence syndrome, and uncompensated peripheral vestibular loss are discussed.

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“…Disequilibrium: Disequilibrium or imbalance is sensation of falling down mostly while walking. Patients indicate that they are dizzy but "not at the head" and prefer sitting or lying down [7]. It is usually seen in neurological disorders like Parkinson's Disease and peripheral neuropathies.…”

Section: Introductionmentioning

confidence: 99%

“…Non-Specific Dizziness: Some patients may not be able to describe their symptoms and may give vague complaints most of the time may be due to psychiatric disorder [4,7]. Psychiatric causes are 2 nd most prevalent type accounting for 15 percent for giddiness in patients [6,7]. No otorhinolaryngology textbook mentions cervicogenic dizziness as a separate entity.…”

Section: Introductionmentioning

confidence: 99%

A Study of Etiopathogenesis of Different Vertigo Syndromes

Hande

Jain

2021

JPRI

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Background: Dizziness or disturbed postural awareness is common presentation in varying age groups. Dizziness can be classified into various types like Rotatory Vertigo, Imbalance/disequilibrium, Pre syncope/Light headedness and Psychogenic. Classically, there are four vertigo syndromes which are most commonly accepted among Otolaryngologists. However, cervicogenic vertigo is missing from the list of these vertigo syndromes. This study aims to assess the etiological factors for vestibular and central vertigo and other non-vestibular forms of vertigo and dizziness. Methodology: This will be a prospective observational study conducted in the Department of Otorhinolaryngology, Jawaharlal Nehru Medical College, Wardha. About 75 patients presenting with symptoms of dizziness, tinnitus with associated nausea vomiting in the out-patient department will be included in this study. Patients will undergo clinical examination including Special Clinical Tests for vertigo like Dix-Hall pike Manoeuvre, Tandem walking and Dysdiadokokinesis. Collected data will be fed to appropriate statistical programme and analysed. Expected Results: Relevant data on different etiopathogenic causes of vertigo will be obtained. Conclusion: Better understanding of the various etiologies of various vertigo syndromes, their associations in various age groups and systemic diseases help better treatment outcomes.

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Psychogenic Dizziness: An Important but Overlooked Differential Diagnosis in the Workup of the Dizzy Patient

Cited by 8 publications

References 29 publications

Post-traumatic peripheral vestibular disorders (excluding positional vertigo) in workers following head injury

Post-traumatic peripheral vestibular disorders (excluding positional vertigo) in workers following head injury

Post-traumatic Peripheral Vestibular Disorders (Excluding Positional Vertigo): Institutional Experience from University Health Network’s Workplace Safety and Insurance Board Head-Injury Program

A Study of Etiopathogenesis of Different Vertigo Syndromes

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