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Autonomic nervous system function in chronic dizziness.

Jeffrey P Staab1, Michael J Ruckenstein

  • 1Department of Psychiatry, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA. jeffrey.staab@uphs.upenn.edu

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|May 22, 2007
PubMed
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Autonomic dizziness, a cause of chronic dizziness, was validated in this study. Current autonomic testing may miss abnormalities, suggesting updated protocols are needed for accurate diagnosis.

Area of Science:

  • Neurology
  • Cardiology
  • Physiology

Background:

  • Chronic nonvertiginous dizziness is often challenging to diagnose.
  • Autonomic dysfunction can manifest as dizziness, particularly with exertion or postural changes.

Purpose of the Study:

  • To validate autonomic dizziness as a clinical diagnosis.
  • To estimate its prevalence in a tertiary referral population.
  • To assess the utility of specific autonomic challenges for diagnosis.

Main Methods:

  • Laboratory investigation of autonomic activity in 15 individuals with suspected autonomic dizziness.
  • Utilized head upright tilt (HUT), CO2 inhalation followed by HUT, and hyperventilation followed by HUT.
  • Monitored cardiovascular, respiratory, and subjective responses.

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Main Results:

  • Autonomic dysfunction was identified in 12 subjects, with 10 showing abnormal responses to HUT.
  • Two subjects exhibited prolonged hypocarbia after hyperventilation.
  • Current testing paradigms might miss significant abnormalities.

Conclusions:

  • The clinical syndrome of autonomic dizziness is validated.
  • Existing autonomic testing protocols may require updates to detect relevant abnormalities in dizziness patients.