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Functional (psychogenic) dizziness.

M Dieterich¹, J P Staab², T Brandt³

¹Department of Neurology, Ludwig-Maximilians-University Munich, Klinikum Grosshadern, Munich, Germany; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University Munich, Klinikum Grosshadern, Munich, Germany.

Handbook of Clinical Neurology

|October 11, 2016

Summary

This summary is machine-generated.

Functional and psychiatric disorders are common causes of vestibular symptoms like vertigo and dizziness, often overlooked. A simultaneous assessment of structural, functional, and psychiatric factors is key for effective diagnosis and treatment.

Keywords:

balance chronic subjective dizziness dizziness eye movements gait persistent postural-perceptual dizziness phobic postural vertigo psychogenic stance vertigo vestibular system

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Area of Science:

Neurology
Psychiatry
Vestibular Science

Background:

Functional and psychiatric disorders are more prevalent causes of vestibular symptoms (vertigo, unsteadiness, dizziness) than structural vestibular disorders.
Neurologists and otologists frequently encounter patients with symptoms linked to persistent postural-perceptual dizziness or panic disorder.
Current diagnostic approaches often prioritize structural causes, necessitating a shift in clinical thinking.

Purpose of the Study:

To highlight the commonality of functional and psychiatric disorders as causes of vestibular symptoms.
To advocate for a comprehensive diagnostic approach integrating structural, functional, and psychiatric assessments.
To underscore the potential for improved patient outcomes through systematic, multidisciplinary treatment.

Main Methods:

Review of existing literature on functional and psychiatric contributions to vestibular symptoms.
Discussion of advanced diagnostic tools like functional brain imaging and posturography.
Emphasis on a three-pronged diagnostic strategy assessing structural, functional, and psychiatric elements concurrently.

Main Results:

Functional and psychiatric disorders are significant, often underdiagnosed, causes of vestibular dysfunction.
The pathophysiologic mechanisms of these disorders are increasingly understood.
Multidisciplinary treatment plans including education, vestibular rehabilitation, therapies, and medication are effective.

Conclusions:

A paradigm shift from dichotomous to a three-pronged diagnostic approach is essential for vestibular disorders.
Integrated diagnostic and therapeutic strategies improve patient morbidity and remission potential.
Collaborative care models are crucial for managing complex vestibular conditions effectively.