Why does vertigo become chronic after neuropathia vestibularis?
OBJECTIVE
Vertigo is one of the most frequent complaints in general medical practice and is often linked to psychiatric disorders. A longitudinal study of 67 patients with an acute vestibular disorder was undertaken to clarify if, after experiencing acute vestibular vertigo, certain patients have a higher likelihood of developing chronic, debilitating dizziness despite no evidence of a damaged peripheral vestibular system.


METHODS
The severity of dizziness was determined in 67 patients with vestibular neuronitis, 6 months after their release from hospital, using the Vertigo Symptom Scale from Yardley et al. The intensity of anxiety directly after vertigo was experienced, body-related cognitions, illness coping, personality structure, and the recovery of the organ of equilibrium were recorded in order to explain the severity of vertigo that occurred after 6 months. The function of the organ of equilibrium was assessed by using a caloric test.


RESULTS
Over a period of 6 months, 13 of the 67 patients (19.4%) reported continuing dizziness after neuropathia vestibularis. Eleven of the 13 patients showed high scores on a scale for measuring vertigo-related symptoms, which can be interpreted as being equivalent to anxiety. The variables of gender, catastrophic thoughts and a dependent personality accounted for 35% of why vertigo became chronic.


CONCLUSIONS
Neuropathia vestibularis represents a risk factor for the development of chronic vertigo. Chronic vertigo after neuropathia vestibularis appears to be equivalent to anxiety and is partly conditional on catastrophic thoughts at the beginning.
Godemann
Frank
F
Department of Psychiatry, Free University of Berlin, Berlin, Germany. f.godemann@alexius.de
Koffroth
Christiane
C
Neu
Peter
P
Heuser
Isabella
I
D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D002150:Caloric Tests; D002908:Chronic Disease; D004251:DNA Transposable Elements; D004244:Dizziness / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D029721:Drosophila Proteins; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases; D010551:Personality / Q000145:classification; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D018626:Retroelements; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D020338:Vestibular Neuronitis / Q000150:complications* / Q000175:diagnosis / Q000523:psychology
D004251:DNA Transposable Elements; D029721:Drosophila Proteins; D018626:Retroelements; D010447:Peptide Hydrolases; C063089:Copia protein, Drosophila