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. 2007 Oct;27(5):243-7.

Vestibular testing in patients with panic disorder and chronic dizziness

R Teggi  1 , D Caldirola, S Bondi, G Perna, L Bellodi, M Bussi
Affiliations

Vestibular testing in patients with panic disorder and chronic dizziness

R Teggi et al. Acta Otorhinolaryngol Ital. 2007 Oct.

Abstract
in English, Italian

In order to investigate the relationship between chronic dizziness and vestibular function in patients with panic disorder, in the present study neurotologic findings in 15 patients with panic disorder and chronic dizziness were compared with those in 15 patients with chronic dizziness, without panic disorder. All underwent neurotologic screening for spontaneous, positional and positioning nystagmus with head-shaking and head-thrust tests, an audiometric examination and electronystagmography with bithermal stimulation according to Freyss. A significantly higher number of patients with panic disorder and chronic dizziness showed pathological neurotologic findings in comparison to subjects with chronic dizziness only (9 and 2 patients, respectively; p < 0.05). Most patients with panic disorder showed signs of peripheral vestibular disorders. These results suggest that the complaint of dizziness in patients with panic disorder may be linked to a malfunction of the vestibular system and vestibular disorders may play a role in the pathophysiology of panic disorder. Possible mechanisms underlying this finding are discussed. In patients with panic disorder and chronic dizziness between panic attacks, a careful neurotologic examination is warranted.

Allo scopo di studiare la relazione esistente tra disturbi dell’equilibrio e funzionalità vestibolare in pazienti con disturbi di panico (PD) abbiamo confrontato i reperti neuro-otologici di 15 pazienti affetti da PD e disturbi dell’equilibrio con quelli di 15 pazienti con disturbi dell’equilibrio senza PD. Tutti i soggetti hanno effettuato un esame otoneurologico comprensivo di rilevazione del nistagmo spontaneo, posizionale e da posizionamento, head-shaking e head-thrust test, esame audiometrico, elettronistagmografia con stimolazione bitermica secondo Freyss. Un numero significativamente più elevato di pazienti affetti anche da PD hanno mostrato anomalie all’esame otoneurologico rispetto al gruppo affetto solo da vertigine (rispettivamente 9 e 2 pazienti, p < 0,05). La maggior parte dei pazienti con PD hanno evidenziato segni di sofferenza vestibolare periferica. I nostri risultati suggeriscono che i disturbi di equilibrio nei pazienti con PD possano essere legati a patologie vestibolari e che tali disturbi possano giocare un ruolo nell’evoluzione dei PD. I possibili meccanismi alla base di tali reperti sono discussi. A nostro avviso un esame otovestibolare completo deve essere suggerito a tutti i pazienti con PD e vertigine non concomitante all’attacco di panico.

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Figures

Fig. 1
Fig. 1
Rate of normal and pathological neurotological findings in patients with PD and in patients with chronic dizziness only. In PD group, 3 patients showed central signs, two of them also with peripheral damage signs and one without (hyper-responsive pattern); in patients with chronic dizziness only, one patient showed central signs, with also VOR asymmetry.
See this image and copyright information in PMC

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