Chronic subjective dizziness.
CONCLUSIONS
Chronic subjective dizziness (CSD) is frequent and affects twice as many women as men. Anxiety is a strong predisposing factor. The pathophysiologic concept of this disorder assumes that balance function and emotion share common neurologic pathways, which might explain that the balance disorder can provoke fear and vice versa, giving rise to a problem in perception of space and motion. In anxious patients this can turn into a space and motion phobia, with avoidance behaviour.


OBJECTIVE
CSD is a diagnosis based on the hypothesis of an interaction between the vestibular system and the psychiatric sphere. Patients complain of chronic imbalance, worsened by visual motion stimulation, and frequently suffer from anxiety. Vestibular examination reveals no anomalies. We evaluated the incidence and characteristics of CSD in patients referred to our neuro-otology centre (tertiary hospital outpatient clinic).


METHODS
This was a retrospective study of 1552 consecutive patients presenting with vertigo. CSD was diagnosed in 164 patients (female:male=111:53).


RESULTS
CSD represents 10.6% of the dizzy patients in our clinic. Psychiatric disorder, mainly anxiety, was found in 79.3% of the cases. Other frequently associated factors were fear of heights and former vestibular lesion (healed). In all, 79.0% of the patients with CSD had poor balance performance on dynamic posturography testing.
Odman
Micaela
M
Department of Otorhinolaryngology and Cervico-Facial Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Micaela.Oedman@chuv.ch
Maire
Raphaël
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004244:Dizziness / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009041:Motion Sickness / Q000453:epidemiology / Q000523:psychology; D004856:Postural Balance / Q000502:physiology; D012189:Retrospective Studies; D015837:Vestibular Diseases / Q000453:epidemiology / Q000503:physiopathology; D014724:Vestibular Function Tests; D055815:Young Adult