Functional (psychogenic) dizziness

M. Dieterich, Jeffrey P Staab, T. Brandt

Research output: Chapter in Book/Report/Conference proceedingChapter

23 Citations (Scopus)

Abstract

Functional and psychiatric disorders that cause vestibular symptoms (i.e., vertigo, unsteadiness, and dizziness) are common. In fact, they are more common than many well-known structural vestibular disorders. Neurologists and otologists are more likely to encounter patients with vestibular symptoms due to persistent postural-perceptual dizziness or panic disorder than Ménière's disease or bilateral vestibular loss. Successful approaches to identifying functional and psychiatric causes of vestibular symptoms can be incorporated into existing practices without much difficulty. The greatest challenge is to set aside dichotomous thinking that strongly emphasizes investigations of structural diseases in favor of a three-pronged approach that assesses structural, functional, and psychiatric disorders simultaneously. The pathophysiologic mechanisms underlying functional and psychiatric causes of vestibular symptoms are better understood than many clinicians realize. Research methods such as advanced posturographic analysis and functional brain imaging will push this knowledge further in the next few years. Treatment plans that include patient education, vestibular rehabilitation, cognitive and behavioral therapies, and medications substantially reduce morbidity and offer the potential for sustained remission when applied systematically. Diagnostic and therapeutic approaches are necessarily multidisciplinary in nature, but they are well within the purview of collaborative care teams or networks of clinicians coordinated with the neurologists and otologists whom patients consult first.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages447-468
Number of pages22
Volume139
DOIs
StatePublished - 2016

Publication series

NameHandbook of Clinical Neurology
Volume139
ISSN (Print)00729752
ISSN (Electronic)22124152

Fingerprint

Dizziness
Psychiatry
Perceptual Disorders
Functional Neuroimaging
Panic Disorder
Vertigo
Cognitive Therapy
Patient Education
Rehabilitation
Morbidity
Therapeutics
Research
Otolaryngologists
Neurologists

Keywords

  • balance
  • chronic subjective dizziness
  • dizziness
  • eye movements
  • gait
  • persistent postural-perceptual dizziness
  • phobic postural vertigo
  • psychogenic
  • stance
  • vertigo
  • vestibular system

ASJC Scopus subject areas

  • Medicine(all)
  • Neurology
  • Clinical Neurology

Cite this

Dieterich, M., Staab, J. P., & Brandt, T. (2016). Functional (psychogenic) dizziness. In Handbook of Clinical Neurology (Vol. 139, pp. 447-468). (Handbook of Clinical Neurology; Vol. 139). Elsevier B.V.. https://doi.org/10.1016/B978-0-12-801772-2.00037-0

Functional (psychogenic) dizziness. / Dieterich, M.; Staab, Jeffrey P; Brandt, T.

Handbook of Clinical Neurology. Vol. 139 Elsevier B.V., 2016. p. 447-468 (Handbook of Clinical Neurology; Vol. 139).

Research output: Chapter in Book/Report/Conference proceedingChapter

Dieterich, M, Staab, JP & Brandt, T 2016, Functional (psychogenic) dizziness. in Handbook of Clinical Neurology. vol. 139, Handbook of Clinical Neurology, vol. 139, Elsevier B.V., pp. 447-468. https://doi.org/10.1016/B978-0-12-801772-2.00037-0
Dieterich M, Staab JP, Brandt T. Functional (psychogenic) dizziness. In Handbook of Clinical Neurology. Vol. 139. Elsevier B.V. 2016. p. 447-468. (Handbook of Clinical Neurology). https://doi.org/10.1016/B978-0-12-801772-2.00037-0
Dieterich, M. ; Staab, Jeffrey P ; Brandt, T. / Functional (psychogenic) dizziness. Handbook of Clinical Neurology. Vol. 139 Elsevier B.V., 2016. pp. 447-468 (Handbook of Clinical Neurology).
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