What accounts for vertigo one year after neuritis vestibularis - anxiety or a dysfunctional vestibular organ?

Abstract

One year after neuritis vestibularis, 29% from a sample of 75 patients still complained of vertigo. The objective of this investigation was to study why patients suffer from persisting vertigo. The alternative hypotheses were that the vertigo experienced could be explained either by a persisting vestibular dysfunction or by psychopathological changes. To elucidate this question, patients were examined with dynamic posturography, the symptom check list (SCL 90 R), the state-trait anxiety inventory (STAI), the agoraphobic cognitions questionnaire (ALQ) and the body sensations questionnaire (BSQ). After one year, only two patients had overall pathological results in the posturography. Following the assumption that sub-clinical dysfunction of the organs of balance can also lead to an altered body perception in combination with anxiety, the pathological results of posturographic sub-tests were related to experiences of vertigo. Here also there were no significant associations. However, vertigo correlated highly significantly with body-related anxiety and anxiety-related apprehension. In conclusion, chronic vertigo after an acute vestibular disorder could be regarded as a somatopsychic process. Persisting experience of vertigo is not explained by sub-clinical organic changes. Anxiety seems to be the crucial factor in persisting vertigo.