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. 2015 May-Jun;81(3):276-82.
doi: 10.1016/j.bjorl.2014.08.012. Epub 2014 Sep 6.

Clinical characteristics of patients with persistent postural-perceptual dizziness

Roseli Saraiva Moreira Bittar  1 , Eliane Maria Dias von Söhsten Lins  2
Affiliations

Clinical characteristics of patients with persistent postural-perceptual dizziness

Roseli Saraiva Moreira Bittar et al. Braz J Otorhinolaryngol. 2015 May-Jun.

Abstract
in English, Portuguese

Introduction: Persistent postural-perceptual dizziness is the dizziness that lasts for over three months with no clinical explanation for its persistence. The patient's motor response pattern presents changes and most patients manifest significant anxiety.

Objective: To evaluate the clinical characteristics of patients with persistent postural and perceptual dizziness.

Methods: statistical analysis of clinical aspects of patients with persistent postural-perceptual dizziness.

Results: 81 patients, average age: 50.06±12.16 years; female/male ratio: 5.7/1; main reasons for dizziness: visual stimuli (74%), body movements (52%), and sleep deprivation (38%). The most prevalent comorbidities were hypercholesterolemia (31%), migraine headaches (26%), carbohydrate metabolism disorders (22%) and cervical syndrome (21%). DHI, State-Trait Anxiety Inventory - Trait, Beck Depression Inventory, and Hospital Anxiety and Depression Scale questionnaires were statistically different (p<0.05) when compared to controls. 68% demonstrated clinical improvement after treatment with serotonin reuptake inhibitors.

Conclusion: Persistent postural-perceptual dizziness affects more women than men, with a high associated prevalence of metabolic disorders and migraine. Questionnaires help to identify the predisposition to persistent postural-perceptual dizziness. The prognosis is good with adequate treatment.

Introdução: A denominação tontura postural-perceptual persistente (TPPP) é atribuida à tontura que se mantém por mais de 3 meses em pacientes, sem que exista justificativa clínica para a sua persistência. A maioria dos pacientes possui perfil ansioso ou experimenta alto grau de ansiedade no início dos sintomas. O padrão de resposta motora apresenta-se alterado, com hipervigilância e hipersensibilidade a estímulos visuais e de movimento.

Objetivo: Avaliar as características clínicas de pacientes com diagnóstico de TPPP.

Método: Análise dos aspectos clínicos de pacientes do ambulatório de TPPPe quantificação do perfil ansioso ou depressivo.

Resultados: Foram avaliados 81 pacientes, com média de idade de 50,06 ± 12,16 anos; relação mulher/homem de 5,7/1; principais gatilhos para tontura: estímulos visuais (74%), movimentos corporais (52%) e privação de sono (38%). As comorbidades mais prevalentes foram hipercolesterolemia (31%), migrânea (26%), distúrbios do metabolismo do açúcar (22%) e síndrome cervical (21%). Os questionários DHI, STAI-Traço, Beck para depressão e HADS foram estatisticamente diferentes (P < 0,05) entre pacientes e controles. 68% de melhora clínica com o uso de inibidores da recaptação da serotonina.

Conclusão: TPPP acomete principalmente as mulheres, sendo alta a associação com distúrbios metabólicos e migrânea. Os questionários auxiliam na identificação da predisposição à TPPP. Há bom prognóstico com o tratamento adequado.

Keywords: Ansiedade; Anxiety; Comorbidade; Comorbidity; Depression; Depressão; Dizziness; Tontura.

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