Advertisement

Somatoform Vertigo and Dizziness Syndromes

  • Thomas Brandt
  • Marianne Dieterich
  • Michael Strupp
Chapter

Abstract

These syndromes account for a large proportion of complex forms of dizziness, imbalance, and fear of falling.

Phobic postural vertigo is an important and the most frequent form of somatoform vertigo/dizziness. The patients complain of postural dizziness and subjective stance and gait unsteadiness without this being evident to an observer; moreover, their results in neuro-otological tests are normal. Anxious control of postural balance is causative and accompanied by co-contraction of antigravity muscles. Therapy is based on psychoeducational explanation and behavioral therapy.

Keywords

Efference Copy Phobic Disorder Vestibular Neuritis Vestibular Migraine Episodic Ataxia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Andersson G, Asmundson GJ, Denev J, Nilsson J, Larsen HC. A controlled trial of cognitive behavior therapy combined with vestibular rehabilitation in the treatment of dizziness. Behav Res Ther. 2006;44:1265–73.PubMedCrossRefGoogle Scholar
  2. Barsky AJ, Wyshak GL. Hypochondriasis and somatosensory amplification. Br J Psychiatry. 1990;157:404–9.PubMedCrossRefGoogle Scholar
  3. Best C, Eckhardt-Henn A, Diener G, Bense S, Breuer P, Dieterich M. Interaction of somatoform and vestibular disorders. J Neurol Neurosurg Psychiatry. 2006;77:658–64.PubMedCrossRefGoogle Scholar
  4. Best C, Eckhardt-Henn A, Tschan R, Bense S, Dieterich M. Psychiatric morbidity and comorbidity in different vestibular vertigo syndrome: results of a prospective longitudinal study over one year. J Neurol. 2009a;256:58–65.PubMedCrossRefGoogle Scholar
  5. Best C, Eckhardt-Henn A, Tschan R, Dieterich M. Who is a risk for psychiatric distressed after vestibular disorder? Results from a prospective one-year follow-up. Neuroscience. 2009b;164:1579–87.PubMedCrossRefGoogle Scholar
  6. Brandt T. Phobic postural vertigo. Neurology. 1996;46:1515–9.PubMedCrossRefGoogle Scholar
  7. Brandt T, Dieterich M. Phobischer Attacken-Schwankschwindel, ein neues Syndrom. Munch Med Wochenschr. 1986;128:247–50.Google Scholar
  8. Brandt T, Huppert D, Dieterich M. Phobic postural vertigo: a first follow-up. J Neurol. 1994;241:191–5.PubMedCrossRefGoogle Scholar
  9. Brandt T, Strupp M, Novozhilov S, Krafczyk S. Artificial neural network posturography detects the transition of vestibular neuritis to phobic postural vertigo. J Neurol. 2012;259:182–4.PubMedCrossRefGoogle Scholar
  10. Bronstein AM. The visual vertigo syndrome. Acta Otolaryngol (Stockh). 1995;520:45–8.CrossRefGoogle Scholar
  11. Bronstein AM. Vision and vertigo: some visual aspects of vestibular disorders. J Neurol. 2004;251:381–7.PubMedCrossRefGoogle Scholar
  12. Dieterich M, Eckhardt-Henn A. Neurologische und somatoforme Schwindelsyndrome. In: Henningsen P, Gündel H, Ceballos-Baumann A, editors. Neuro-Psychosomatik. Grundlagen und Klinik neurologischer Psychosomatik. Stuttgart: Schattauer; 2006. p. 253–65.Google Scholar
  13. Eckhardt-Henn A, Breuer P, Thomalske C, Hoffmann SO, Hopf HC. Anxiety disorders and other psychiatric subgroups in patients complaining of dizziness. J Anxiety Disord. 2003;431:1–20.Google Scholar
  14. Eckhardt-Henn A, Best C, Bense S, Breuer P, Diener G, Tschan R, et al. Psychiatric comorbidity in different organic vertigo syndromes. J Neurol. 2008;255:420–8.PubMedCrossRefGoogle Scholar
  15. Furman JM, Jacob RG. Psychiatric dizziness. Neurology. 1997;48:1161–6.PubMedCrossRefGoogle Scholar
  16. Godemann F, Schabowska A, Naetebusch B, Heinz A, Ströhle A. The impact of cognitions on the development of panic and somatoform disorders: a prospective study in patients with vestibular neuritis. Psychol Med. 2006;36:99–108.PubMedCrossRefGoogle Scholar
  17. Heinrichs N, Edler C, Eskens S, Mielczarek MM, Moschner C. Predicting continued dizziness after an acute peripheral vestibular disorder. Psychosom Med. 2007;69:700–7.PubMedCrossRefGoogle Scholar
  18. Holmberg J, Karlberg M, Harlacher U, Rivano-Fischer M, Magnusson M. Treatment of phobic postural vertigo. A controlled study of cognitive-behavioral therapy and self-controlled ­desensitization. J Neurol. 2006;253:500–6.PubMedCrossRefGoogle Scholar
  19. Holmberg J, Karlberg M, Harlacher U, Magnusson M. One-year follow-up of cognitive ­behavioural therapy for phobic postural vertigo. J Neurol. 2007;254:1189–92.PubMedCrossRefGoogle Scholar
  20. Huppert D, Kunihiro T, Brandt T. Phobic postural vertigo (154 patients): its association with ­vestibular disorders. J Audiol. 1995;4:97–103.Google Scholar
  21. Huppert D, Strupp M, Rettinger N, Hecht J, Brandt T. Phobic postural vertigo – a long-term ­follow-up (5–15 years) of 106 patients. J Neurol. 2005;252:564–9.PubMedCrossRefGoogle Scholar
  22. Kapfhammer HP, Mayer C, Hock U, Huppert D, Dieterich M, Brandt T. Course of illness in phobic postural vertigo. Acta Neurol Scand. 1997;95:23–8.PubMedCrossRefGoogle Scholar
  23. Krafczyk S, Tietze S, Swoboda W, Valkovic P, Brandt T. Artificial neural network: a new diagnostic posturographic tool for disorders of stance. Clin Neurophysiol. 2006;117:1692–8.PubMedCrossRefGoogle Scholar
  24. Marks JM. Space “phobia”: a pseudo-agoraphobic syndrome. J Neurol Neurosurg Psychiatry. 1981;48:729–35.Google Scholar
  25. Murphy TP. Mal de debarquement syndrome: a forgotten entity? Otolaryngol Head Neck Surg. 1993;109:10–3.PubMedGoogle Scholar
  26. Querner V, Krafczyk S, Dieterich M, Brandt T. Patients with somatoform phobic postural vertigo: the more difficult the balance task, the better the balance performance. Neurosci Lett. 2000;285:21–4.PubMedCrossRefGoogle Scholar
  27. Querner V, Krafczyk S, Dieterich M, Brandt T. Somatoform phobic postural vertigo: body sway during optokinetically induced roll vection. Exp Brain Res. 2002;143:269–75.PubMedCrossRefGoogle Scholar
  28. Schmid G, Henningsen P, Dieterich M, Sattel H, Lahmann C. Psychotherapy in vertigo – a systematic review. J Neurol Neurosurg Psychiatry. 2011;82(6):601–6.PubMedCrossRefGoogle Scholar
  29. Staab JP. Chronic subjective dizziness. Continuum (Minneap Minn). 2012;18:1118–41.Google Scholar
  30. Strupp M, Glaser M, Karch C, Rettinger N, Dieterich M, Brandt T. The most common form of dizziness in middle age: phobic postural vertigo. Nervenarzt. 2003;74:911–4.PubMedCrossRefGoogle Scholar
  31. Tschan R, Best C, Beutel M, Knebel A, Wiltink J, Dieterich M, et al. Patients’ psychological well-being and resilient coping protect from secondary somatoform vertigo and dizziness (SVD) one year after vestibular disease. J Neurol. 2011;258:104–12.PubMedCrossRefGoogle Scholar
  32. Tschan R, Eckhardt-Henn A, Scheurich V, Best C, Dieterich M, Beutel M. Steadfast-effectiveness of a cognitive behavioral self-management program of patients with somatoform vertigo and dizziness. Psychother Psychosom Med Psychol. 2012;62(3–4):111–9.PubMedGoogle Scholar
  33. Von Holst E, Mittelstaedt H. Das Reafferenzierungsprinzip (Wechselwirkungen zwischen Zentralnervensystem und Peripherie). Naturwissenschaften. 1950;37:461–76.Google Scholar
  34. Wuehr M, Pradhan C, Novozhilov S, Krafczyk S, Brandt T, Jahn K, Schniepp R. Inadequate interaction between open- and closed-loop postural control in phobic postural vertigo. J Neurol. 2013;260:1314–23.PubMedCrossRefGoogle Scholar
  35. Yardley L, Redfern MS. Psychological factors influencing recovery from balance disorders. J Anxiety Disord. 2001;15:107–19.PubMedCrossRefGoogle Scholar
  36. Yarrow K, Brown P, Gresty MA, Bronstein AM. Force platform recordings in the diagnosis of primary orthostatic tremor. Gait Posture. 2001;13:27–34.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Thomas Brandt
    • 1
  • Marianne Dieterich
    • 2
  • Michael Strupp
    • 2
  1. 1.Clinical Neurosciences and Center for Vertigo & Balance DisordersUniversity of MunichMunichGermany
  2. 2.Department of Neurology and Center for Vertigo & Balance DisordersUniversity of MunichMunichGermany

Personalised recommendations