Expanding the Differential Diagnosis of Chronic Dizziness
Abstract
OBJECTIVE: To improve treatment outcomes for patients with chronic dizziness by identifying clinical conditions associated with persistent symptoms and delineating key diagnostic features that differentiate its causes and direct attention to specific treatments. DESIGN: Prospective cohort study from 1998 to 2004. SETTING: Tertiary care balance center. PATIENTS: A total of 345 men and women, aged 15 to 89 years, referred for evaluation of chronic dizziness (duration of > or =3 months) of uncertain cause. INTERVENTIONS: Patients were systematically directed through multiple specialty examinations until definitive diagnoses were made. MAIN OUTCOME MEASURE: Final diagnoses associated with dizziness. RESULTS: Nearly all patients with chronic subjective dizziness were diagnosed with psychiatric or neurologic illnesses. These included primary and secondary anxiety disorders (n = 206 [59.7%]) and central nervous system conditions (n = 133 [38.6%]), specifically migraine headaches, mild traumatic brain injuries, and neurally mediated dysautonomias. A small number of patients (6 [1.7%]) had dysrhythmias. Four of 5 patients with migraine or dysrhythmias had comorbid anxiety. CONCLUSIONS: Chronic dizziness has several common causes, including anxiety disorders, migraine, traumatic brain injuries, and dysautonomia, that require different treatments. Key features of the clinical history distinguish these illnesses from one another and from active neurotologic conditions. The high prevalence of secondary anxiety may give a false impression of psychogenicity.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The majority of conditions that precede PPPD are acute or episodic in nature.
“The majority of conditions that precede PPPD are acute or episodic in nature.”
The most common precipitating conditions are peripheral or central vestibular disorders (25-30% of cases), attacks of vestibular migraine (15-20%), panic attacks or anxiety that manifest prominent dizziness (15% each), concussive injuries of the brain or whiplash injuries of the neck (10-15%), and autonomic disorders (7%).
“The most common precipitating conditions are peripheral or central vestibular disorders (25–30% of cases), attacks of vestibular migraine (15–20%), panic attacks or anxiety that manifest prominent dizziness (15% each), concussive injuries of the brain or whiplash injuries of the neck (10–15%), and autonomic disorders (7%).”
Positive results on these questionnaires indicate that an anxiety or depressive disorder is likely, either as the sole cause of vestibular symptoms or co-existing with PPPD.
“Positive results indicate that an anxiety or depressive disorder is likely, either as the sole cause of vestibular symptoms or co-existing with PPPD [12, 58, 75, 79].”
The average duration of illness at the time of tertiary consultation was 4.5 years with some patients experiencing symptoms for decades.
“The average duration of illness at the time of tertiary consultation was 4.5 years with some patients experiencing symptoms for decades [13, 79].”
No epidemiologic studies are available for PPPD, but its prevalence and incidence may be estimated from research done on patients with PPV, VV, CSD, and chronic dizziness following acute vestibular syndromes.
“No epidemiologic studies are available for PPPD, but its prevalence and incidence may be estimated from research done on patients with PPV, VV, CSD, and chronic dizziness following acute vestibular syndromes [7, 12, 23, 28, 30, 79].”
The average age of patients presenting for evaluation of PPV, CSD, and PPPD is the mid-40s, with a range from adolescence to late adulthood.
“The average age of patients presenting for evaluation of PPV, CSD, and PPPD is the mid-40 s, with a range from adolescence to late adulthood [10, 79, 100].”
Clinical epidemiologic data from tertiary care centers with special interest in PPV and CSD showed their prevalence to be 15-20% among all patients presenting for evaluation of vestibular symptoms, making them the most common diagnoses among young adults and the second most common among all adults, trailing only BPPV.
“Clinical epidemiologic data from tertiary care centers with special interest in PPV [13] and CSD [79] showed their prevalence to be 15–20% among all patients presenting for evaluation of vestibular symptoms, making them the most common diagnoses among young adults and the second most common among all adults, trailing only BPPV.”
CSD was a step in that direction based in part on the physical features of PPV.
“CSD was a step in that direction based in part on the physical features of PPV [79].”
Cites
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.617 · Cited by 12,052 · see citing works
Guidelines on Management (diagnosis and treatment) of syncope ? update 2004
Brignole, M., Alboni, P., Benditt, D. G., Bergfeldt, L., Blanc, J., Thomsen, P. E. B., van Dijk, J. G., Fitzpatrick, A. P., Hohnloser, S. H., Janousek, J., et al. (2004) · EP Europace · doi:10.1016/j.eupc.2004.08.008 · Cited by 648 · see citing works
Migraine in the United States: Epidemiology and patterns of health care use
Lipton, R. B., Scher, A. I., Kolodner, K., Liberman, J., Steiner, T. J., & Stewart, W. F. (2002) · Neurology · doi:10.1212/wnl.58.6.885 · Cited by 616 · see citing works
Summary of the WHO collaborating centre for neurotrauma task force on mild traumatic brain injury
Holm, L. W., Cassidy, J. D., Carroll, L., & Borg, J. (2005) · Journal of Rehabilitation Medicine · doi:10.1080/16501970510027321 · Cited by 467 · see citing works
Migraine-Related Vestibulopathy
Cass, S. P., Ankerstjerne, J. K. B., Yetışer, S., FURMAN, J. M. R., Balaban, C. D., & Aydoǧan, B. (1997) · Annals of Otology Rhinology & Laryngology · doi:10.1177/000348949710600302 · Cited by 310 · see citing works
Which comes first? Psychogenic dizziness versus otogenic anxiety
Staab, J. P., & Ruckenstein, M. J. (2003) · The Laryngoscope · doi:10.1097/00005537-200310000-00010 · Cited by 265 · see citing works
Self-citationCharacterizing and Treating Dizziness after Mild Head Trauma
Hoffer, M. E., Gottshall, K. R., Moore, R., Balough, B. J., & Wester, D. C. (2004) · Otology & Neurotology · doi:10.1097/00129492-200403000-00009 · Cited by 197 · see citing works
Migraine-anxiety related dizziness (MARD): a new disorder?
Furman, J. M. R. (2004) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2004.048926 · Cited by 187 · see citing works
Anxiety disorders and other psychiatric subgroups in patients complaining of dizziness
Eckhardt‐Henn, A., Breuer, P., Thomalske, C., Hoffmann, S. O., & Hopf, H. C. (2002) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00226-8 · Cited by 180 · see citing works
GODEMANN, F., SIEFERT, K., HANTSCHKEBRUGGEMANN, M., NEU, P., SEIDL, R., & STROHLE, A. (2005) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2004.12.006 · Cited by 154 · see citing works
A prospective trial of sertraline for chronic subjective dizziness
Staab, J. P., Ruckenstein, M. J., & Amsterdam, J. D. (2004) · The Laryngoscope · doi:10.1097/00005537-200409000-00025 · Cited by 140 · see citing works
Self-citationStaab, J. P., & Ruckenstein, M. J. (2005) · Archives of Otolaryngology - Head and Neck Surgery · doi:10.1001/archotol.131.8.675 · Cited by 120 · see citing works
Self-citationAnxiety in the First Attack of Vertigo
Pollak, L., Klein, C., Stryjer, R., Vera, K., & Rabey, J. M. (2003) · Otolaryngology · doi:10.1016/s0194-5998(03)00454-6 · Cited by 74 · see citing works
Baloh, R. W. (1999) · Postgraduate Medicine · doi:10.3810/pgm.1999.02.555 · Cited by 37 · see citing works
Episodic vertigo: central nervous system causes
Baloh, R. W. (2002) · Current Opinion in Neurology · doi:10.1097/00019052-200202000-00004 · Cited by 30 · see citing works
Exertional Dizziness and Autonomic Dysregulation
Staab, J. P., Ruckenstein, M. J., Solomon, D., & Shepard, N. T. (2002) · The Laryngoscope · doi:10.1097/00005537-200208000-00005 · Cited by 30 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Staab, J. P., Eckhardt-Henn, A., Horii, A., Jacob, R., Strupp, M., Brandt, T., & Bronstein, A. (2017) · Journal of Vestibular Research · doi:10.3233/ves-170622 · Cited by 840 · see citing works
Self-citationPopkirov, S., Staab, J. P., & Stone, J. (2018) · Practical Neurology · doi:10.1136/practneurol-2017-001809 · Cited by 334 · see citing works
Self-citationNeff, B. A., Staab, J. P., Eggers, S. D., Carlson, M. L., Schmitt, W. R., Van Abel, K. M., Worthington, D. K., Beatty, C. W., Driscoll, C. L., & Shepard, N. T. (2012) · Otology & Neurotology · doi:10.1097/mao.0b013e31825d644a · Cited by 231 · see citing works
Dieterich, M., & Staab, J. P. (2016) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000417 · Cited by 227 · see citing works
Self-citationBalaban, C. D., Jacob, R. G., & FURMAN, J. M. R. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.19 · Cited by 214 · see citing works
Staab, J. P. (2012) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/01.con.0000421622.56525.58 · Cited by 202 · see citing works
Self-citationVisual Dependency and Dizziness after Vestibular Neuritis
Cousins, S., Cutfield, N. J., Kaski, D. N., Palla, A., Seemungal, B. M., Golding, J. F., Staab, J. P., & Bronstein, A. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0105426 · Cited by 200 · see citing works
Self-citationDizziness: a diagnostic approach.
Post, R. E., & Dickerson, L. M. (2010) · PubMed · Cited by 169 · see citing works
Vestibular migraine: An update on current understanding and future directions
Huang, T.-C., Wang, S., & Kheradmand, A. (2019) · Cephalalgia · doi:10.1177/0333102419869317 · Cited by 168 · see citing works
Persistent Postural-Perceptual Dizziness
Staab, J. P. (2020) · Springer eBooks · doi:10.1007/978-3-032-18264-7_62 · Cited by 162 · see citing works
Self-citationIndovina, I., Riccelli, R., Chiarella, G., Petrolo, C., Augimeri, A., Giofrè, L., Lacquaniti, F., Staab, J. P., & Passamonti, L. (2015) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00334 · Cited by 140 · see citing works
Self-citationEtiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea
Kim, H., Lee, J.-O., Choi, J., & Kim, J. (2020) · Journal of Neurology · doi:10.1007/s00415-020-09831-2 · Cited by 144 · see citing works
Lee, J., Lee, E., Kim, J., Lee, Y., Jeong, Y., Choi, B. S., Kim, J., & Staab, J. P. (2018) · Human Brain Mapping · doi:10.1002/hbm.24080 · Cited by 138 · see citing works
Self-citationAnxious, introverted personality traits in patients with chronic subjective dizziness
Staab, J. P., Rohe, D. E., Eggers, S. D. Z., & Shepard, N. T. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.11.008 · Cited by 133 · see citing works
Balaban, C. D., FURMAN, J. M. R., & Staab, J. P. (2013) · Seminars in Neurology · doi:10.1055/s-0033-1356462 · Cited by 133 · see citing works
Self-citationCognitive behavior therapy for chronic subjective dizziness: a randomized, controlled trial
Edelman, S., Mahoney, A., & Cremer, P. D. (2011) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2011.10.009 · Cited by 130 · see citing works
Dizziness: Anxiety, health care utilization and health behavior—
Wiltink, J., Tschan, R., Michal, M., Subič-Wrana, C., Eckhardt‐Henn, A., Dieterich, M., & Beutel, M. E. (2008) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2008.09.012 · Cited by 129 · see citing works
Functional (psychogenic) dizziness
(2016) · Handbook of clinical neurology · doi:10.1016/b978-0-12-801772-2.00037-0 · Cited by 119 · see citing works
Self-citationClinical characteristics of patients with persistent postural-perceptual dizziness
Bittar, R. S. M., & Lins, E. M. D. V. S. (2014) · Brazilian Journal of Otorhinolaryngology · doi:10.1016/j.bjorl.2014.08.012 · Cited by 117 · see citing works
Ruckenstein, M. J., & Staab, J. P. (2009) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2008.09.011 · Cited by 116 · see citing works
Self-citationRiccelli, R., Passamonti, L., Toschi, N., Nigro, S. L., Chiarella, G., Petrolo, C., Lacquaniti, F., Staab, J. P., & Indovina, I. (2017) · Frontiers in Neurology · doi:10.3389/fneur.2017.00529 · Cited by 109 · see citing works
Self-citationPosttraumatic Vertigo and Dizziness
Giza, C. C., & Fife, T. D. (2013) · Seminars in Neurology · doi:10.1055/s-0033-1354599 · Cited by 94 · see citing works
Inadequate interaction between open- and closed-loop postural control in phobic postural vertigo
Wuehr, M., Pradhan, C., Novozhilov, S., KRAFCZYK, S., Brandt, T. H., Jahn, K., & Schniepp, R. (2012) · Journal of Neurology · doi:10.1007/s00415-012-6797-7 · Cited by 90 · see citing works
Migraine, vertigo and migrainous vertigo: Links between vestibular and pain mechanisms
Balaban, C. D. (2011) · Journal of Vestibular Research · doi:10.3233/ves-2011-0428 · Cited by 88 · see citing works
Principles of vestibular physical therapy rehabilitation
Whitney, S. L., & Sparto, P. J. (2011) · Neurorehabilitation · doi:10.3233/nre-2011-0690 · Cited by 85 · see citing works
Schniepp, R., Wuehr, M., Huth, S., Pradhan, C., Brandt, T., & Jahn, K. (2014) · Journal of Neurology · doi:10.1007/s00415-014-7259-1 · Cited by 81 · see citing works
Thompson, K. J., Goetting, J. C., Staab, J. P., & Shepard, N. T. (2015) · PubMed · doi:10.3233/ves-150551 · Cited by 81 · see citing works
Self-citationHabs, M., Strobl, R., Grill, E., Dieterich, M., & Becker‐Bense, S. (2020) · Journal of Neurology · doi:10.1007/s00415-020-10150-9 · Cited by 79 · see citing works
Lins, E. M. D. V. S., Bittar, R. S. M., & Staab, J. P. (2016) · Journal of Vestibular Research · doi:10.3233/ves-160583 · Cited by 78 · see citing works
Self-citationYu, Y., Xue, H., Zhang, Y., & Zhou, J. (2018) · BioMed Research International · doi:10.1155/2018/8518631 · Cited by 73 · see citing works
Persistent postural perceptual dizziness is on a spectrum in the general population
Powell, G., Derry-Sumner, H., Rajenderkumar, D., Rushton, S. K., & Sumner, P. (2020) · Neurology · doi:10.1212/wnl.0000000000009373 · Cited by 73 · see citing works
Yan, Z., Cui, L., Yu, T., Liang, H., Wang, Y., & Chen, C.-F. (2016) · International Journal of Audiology · doi:10.1080/14992027.2016.1211763 · Cited by 70 · see citing works
Indovina, I., Riccelli, R., Staab, J. P., Lacquaniti, F., & Passamonti, L. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.09.005 · Cited by 68 · see citing works
Self-citationEkwall, A. K., Lindberg, Å., & Magnusson, M. (2009) · Gerontology · doi:10.1159/000235812 · Cited by 67 · see citing works
Passamonti, L., Riccelli, R., Lacquaniti, F., Staab, J. P., & Indovina, I. (2019) · Journal of Vestibular Research · doi:10.3233/ves-190653 · Cited by 65 · see citing works
Self-citationPersistent vertigo and dizziness after mild traumatic brain injury
Fife, T. D., & Kalra, D. (2015) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12678 · Cited by 62 · see citing works
Persistent Postural-Perceptual Dizziness
Staab, J. P. (2023) · Neurologic Clinics · doi:10.1016/j.ncl.2023.04.003 · Cited by 70 · see citing works
Self-citationNigro, S. L., Indovina, I., Riccelli, R., Chiarella, G., Petrolo, C., Lacquaniti, F., Staab, J. P., & Passamonti, L. (2018) · Brain Imaging and Behavior · doi:10.1007/s11682-018-9900-6 · Cited by 61 · see citing works
Self-citationMal de debarquement syndrome: new insights
Cha, Y. (2015) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12701 · Cited by 60 · see citing works
Persistent Postural-Perceptual Dizziness: A Matter of Higher, Central Dysfunction?
Holle, D., Steinberg, B. S., Wurthmann, S., Naegel, S., Ayzenberg, I., Diener, H., Katsarava, Z., & Obermann, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0142468 · Cited by 59 · see citing works
Persistent Postural-Perceptual Dizziness (PPPD) from Brain Imaging to Behaviour and Perception
Castro, P., Bancroft, M. J., Arshad, Q., & Kaski, D. N. (2022) · Brain Sciences · doi:10.3390/brainsci12060753 · Cited by 61 · see citing works
Eggers, S. D. Z., Staab, J. P., Neff, B. A., Goulson, A. M., Carlson, M. L., & Shepard, N. T. (2011) · Otology & Neurotology · doi:10.1097/mao.0b013e31822a1c67 · Cited by 55 · see citing works
Self-citationDoble, J. E., Feinberg, D. L., Rosner, M., & Rosner, A. J. (2010) · PM&R · doi:10.1016/j.pmrj.2010.01.011 · Cited by 52 · see citing works
Comprehensive Clinical Profile of Mal De Debarquement Syndrome
Cha, Y., Cui, Y. Y., & Baloh, R. W. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.00261 · Cited by 52 · see citing works
White Paper: Movement System Diagnoses in Neurologic Physical Therapy
Hedman, L. D., Quinn, L., Gill-Body, K. M., Brown, D. A., Quiben, M., Riley, N., & Scheets, P. L. (2018) · Neurology Report · doi:10.1097/npt.0000000000000215 · Cited by 50 · see citing works
Piker, E. G., Jacobson, G. P., McCaslin, D. L., & Grantham, S. L. (2008) · Journal of the American Academy of Audiology · doi:10.3766/jaaa.19.4.6 · Cited by 49 · see citing works
Chronic subjective dizziness: Analysis of underlying personality factors
Chiarella, G., Petrolo, C., Riccelli, R., Giofrè, L., Olivadese, G., Gioacchini, F. M., Scarpa, A., Cassandro, E., & Passamonti, L. (2016) · Journal of Vestibular Research · doi:10.3233/ves-160590 · Cited by 48 · see citing works
Vestibular symptoms and history taking
Bisdorff, A. R. (2016) · Handbook of clinical neurology · doi:10.1016/b978-0-444-63437-5.00006-6 · Cited by 48 · see citing works
Teh, C. S.-L., & Prepageran, N. (2021) · Journal of Vestibular Research · doi:10.3233/ves-210087 · Cited by 47 · see citing works
Cha, Y., Deblieck, C., & Wu, A. D. (2016) · Otology & Neurotology · doi:10.1097/mao.0000000000001045 · Cited by 46 · see citing works
Eren, O. E., Filippopulos, F. M., Sönmez, K., Möhwald, K., Straube, A. M., & Schöberl, F. (2018) · Journal of Neurology · doi:10.1007/s00415-018-8894-8 · Cited by 47 · see citing works
Comorbidities in vestibular migraine
Eggers, S. D. Z., Neff, B. A., Shepard, N. T., & Staab, J. P. (2014) · Journal of Vestibular Research · doi:10.3233/ves-140525 · Cited by 46 · see citing works
Self-citationRocking dizziness and headache: A two-way street
Cha, Y., & Cui, Y. (2013) · Cephalalgia · doi:10.1177/0333102413487999 · Cited by 44 · see citing works
Nonlinear Variability of Body Sway in Patients with Phobic Postural Vertigo
Schniepp, R., Wuehr, M., Pradhan, C., Novozhilov, S., KRAFCZYK, S., Brandt, T., & Jahn, K. (2013) · Frontiers in Neurology · doi:10.3389/fneur.2013.00115 · Cited by 43 · see citing works
A Cognitive-Behavioral Model of Persistent Postural-Perceptual Dizziness
Whalley, M. G., & Cane, D. A. (2017) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2016.03.003 · Cited by 40 · see citing works
Guo, J., Wang, J., Liang, P., Tian, E., Liu, D., Guo, Z., Chen, J., Zhang, Y., Zhou, Z., Kong, W., et al. (2024) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2024.5360 · Cited by 43 · see citing works
Multifactorial Characteristics of Pediatric Dizziness and Imbalance
Wang, A., Zhou, G., Lipson, S. E., Kawai, K., Corcoran, M., & Brodsky, J. R. (2020) · The Laryngoscope · doi:10.1002/lary.29024 · Cited by 40 · see citing works
Persistent Postural-Perceptual Dizziness in Children and Adolescents
Wang, A., Fleischman, K. M., Kawai, K., Corcoran, M., & Brodsky, J. R. (2021) · Otology & Neurotology · doi:10.1097/mao.0000000000003212 · Cited by 40 · see citing works
Subtypes of Persistent Postural-Perceptual Dizziness
Yagi, C., Morita, Y., Kitazawa, M., Yamagishi, T., Ohshima, S., Izumi, S., Takahashi, K., & Horii, A. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.652366 · Cited by 38 · see citing works
Central vestibular dysfunction: don’t forget vestibular rehabilitation
Zhang, S., Liu, D., Tian, E., Wang, J., Guo, Z., & Kong, W. (2022) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2022.2106129 · Cited by 39 · see citing works
Functional and psychiatric vestibular disorders
Staab, J. P. (2016) · Handbook of clinical neurology · doi:10.1016/b978-0-444-63437-5.00024-8 · Cited by 37 · see citing works
Self-citationVestel, C. D., Hertogh, W. D., Rompaey, V. V., & Vereeck, L. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.880714 · Cited by 36 · see citing works
Influence of sex hormones on vestibular disorders
Mucci, V., Hamid, M. A., Jacquemyn, Y., & Browne, C. J. (2021) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001019 · Cited by 35 · see citing works
Anxiety among individuals with visual vertigo and vestibulopathy
Zur, O., Schoen, G., Dickstein, R., Feldman, J., Berner, Y., Dannenbaum, E., & Fung, J. (2015) · Disability and Rehabilitation · doi:10.3109/09638288.2014.1002577 · Cited by 35 · see citing works
Migraine Features in Patients with Persistent Postural-Perceptual Dizziness
Sarna, B., Risbud, A., Lee, A., Muhonen, E. G., Abouzari, M., & Djalilian, H. R. (2021) · Annals of Otology Rhinology & Laryngology · doi:10.1177/00034894211007233 · Cited by 35 · see citing works
Naguib, M. B., Madian, Y. T., Refaat, M., Mohsen, O. A. A. H., Tabbakh, M. T. E., & Abo-Setta, A. (2011) · The Journal of Laryngology & Otology · doi:10.1017/s002221511100291x · Cited by 33 · see citing works
Autonomic nervous system function in chronic dizziness
Staab, J. P., & Ruckenstein, M. J. (2007) · Otology & Neurotology · doi:10.1097/mao.0b013e31805c74a7 · Cited by 31 · see citing works
Self-citationVisually-induced dizziness is associated with sensitivity and avoidance across all senses
Powell, G., Derry-Sumner, H., Shelton, K., Rushton, S., Hedge, C., Rajenderkumar, D., & Sumner, P. (2020) · Journal of Neurology · doi:10.1007/s00415-020-09817-0 · Cited by 31 · see citing works
Persistent postural-perceptual dizziness: A functional neuro-otologic disorder
Yagi, C., Kimura, A., & Horii, A. (2024) · Auris Nasus Larynx · doi:10.1016/j.anl.2023.12.008 · Cited by 32 · see citing works
Voxel Based Morphometry Alterations in Mal de Debarquement Syndrome
Cha, Y., & Chakrapani, S. (2015) · PLoS ONE · doi:10.1371/journal.pone.0135021 · Cited by 30 · see citing works
Na, S., Im, J. J., Jeong, H. S., Lee, E., Lee, T.-K., Chung, Y., & Song, I. (2018) · Journal of Neural Transmission · doi:10.1007/s00702-018-1948-3 · Cited by 28 · see citing works
Kutz, J. W. (2010) · Medical Clinics of North America · doi:10.1016/j.mcna.2010.05.011 · Cited by 28 · see citing works
Cao, Z., Liu, X., Ju, Y., & Zhao, X. (2021) · Journal of Neurology · doi:10.1007/s00415-021-10558-x · Cited by 27 · see citing works
Long-term symptoms in dizzy patients examined in a university clinic
Wilhelmsen, K. T., Ljunggren, A. E., Goplen, F. K., Eide, G. E., & Nordahl, S. H. G. (2009) · BMC Ear Nose and Throat Disorders · doi:10.1186/1472-6815-9-2 · Cited by 27 · see citing works
What’s in a Name? Chronic Vestibular Migraine or Persistent Postural Perceptual Dizziness?
Tarnutzer, A. A., & Kaski, D. N. (2023) · Brain Sciences · doi:10.3390/brainsci13121692 · Cited by 25 · see citing works
Mempouo, E., Lau, K., Green, F., Bowes, C., & Ray, J. (2021) · The Journal of Laryngology & Otology · doi:10.1017/s0022215121002127 · Cited by 26 · see citing works
McCaslin, D. L., Shepard, N. T., Hollman, J. H., & Staab, J. P. (2021) · Otology & Neurotology · doi:10.1097/mao.0000000000003393 · Cited by 28 · see citing works
Self-citationMedically unexplained symptoms and somatisation in ENT
Ullas, G., McClelland, L., & Jones, N. S. (2013) · The Journal of Laryngology & Otology · doi:10.1017/s0022215113000339 · Cited by 25 · see citing works
Persistence of Symptoms in Primary Somatoform Vertigo and Dizziness
Tschan, R., Best, C., Wiltink, J., Beutel, M. E., Dieterich, M., & Eckhardt‐Henn, A. (2013) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318288e2ad · Cited by 25 · see citing works
Anxiety, Mood, and Personality Disorders in Patients with Benign Paroxysmal Positional Vertigo
Kozak, H. H., Dündar, M. A., Uca, A. U., Uğuz, F., Turgut, K., Altaş, M., Tekin, G., & Aziz, S. K. (2016) · Nöro Psikiyatri Arşivi · doi:10.5152/npa.2016.18143 · Cited by 25 · see citing works
Radziej, K., Schmid, G., Dinkel, A., Zwergal, A., & Lahmann, C. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.05.005 · Cited by 24 · see citing works
Presbivertigem como causa de tontura no idoso
Felipe, L., Cunha, L. C. M., da Cunha, F. C. M., Cintra, M. T. G., & Gonçalves, D. U. (2008) · Pró-Fono Revista de Atualização Científica · doi:10.1590/s0104-56872008000200005 · Cited by 24 · see citing works
Morisod, B., Mermod, M., & Maire, R. (2017) · Journal of Vestibular Research · doi:10.3233/ves-170628 · Cited by 23 · see citing works
Schröder, L., von Werder, D., Ramaioli, C., Wächtler, T., Henningsen, P., Glasauer, S., & Lehnen, N. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.685590 · Cited by 22 · see citing works
Clinical clues to a dizzying headache
Staab, J. P. (2011) · Journal of Vestibular Research · doi:10.3233/ves-2011-0426 · Cited by 23 · see citing works
Self-citationVestibular migraine and persistent postural perceptual dizziness
Eggers, S. D. Z., & Staab, J. P. (2024) · Handbook of clinical neurology · doi:10.1016/b978-0-12-823357-3.00028-8 · Cited by 22 · see citing works
Self-citationClinical classification and neuro-vestibular evaluation in chronic dizziness
Oh, S., Kim, D., Yang, T.-H., Shin, B., & Jeong, S. (2014) · Clinical Neurophysiology · doi:10.1016/j.clinph.2014.03.030 · Cited by 21 · see citing works
Indovina, I., Conti, A., Lacquaniti, F., Staab, J. P., Passamonti, L., & Toschi, N. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.00874 · Cited by 20 · see citing works
Self-citationHonaker, J. A., Gilbert, J. M., & Staab, J. P. (2010) · American Journal of Audiology · doi:10.1044/1059-0889(2009/09-0013 · Cited by 19 · see citing works
Self-citationPersistent Postural Perceptual Dizziness in Episodic Vestibular Disorders
Gambacorta, V., D’Orazio, A., Pugliese, V., Giovanni, A. D., Ricci, G., & Faralli, M. (2022) · Audiology Research · doi:10.3390/audiolres12060058 · Cited by 20 · see citing works
Im, J. J., Na, S., Kang, S., Jeong, H. S., Lee, E., Lee, T.-K., Ahn, W., Chung, Y., & Song, I. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.868976 · Cited by 18 · see citing works
Persistent postural-perceptual dizziness: current approaches to diagnosis and treatment
Antonenko, L. M., & Zastenskaya, E. N. (2019) · Neurology neuropsychiatry Psychosomatics · doi:10.14412/2074-2711-2019-4-136-140 · Cited by 19 · see citing works
Fang, Z., Huang, K., Gil, C.-H., Jeong, J.-W., Yoo, H.-R., & Kim, H.-G. (2020) · Scientific Reports · doi:10.1038/s41598-020-58218-w · Cited by 17 · see citing works
Autonomic dysfunction in chronic persistent dizziness
Lee, H., & Kim, H. A. (2014) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2014.06.048 · Cited by 17 · see citing works
Ponsford, J. L., Olver, J., Ponsford, M. W., & Schönberger, M. (2010) · Brain Impairment · doi:10.1375/brim.11.3.253 · Cited by 17 · see citing works
Vestibular rehabilitation in patients with persistent postural-perceptual dizziness
Tramontano, M., Princi, A. A., Angelis, S. D., Indovina, I., & Manzari, L. (2021) · Hearing Balance and Communication · doi:10.1080/21695717.2021.1975986 · Cited by 17 · see citing works
Chae, R., Krauter, R., Pasquesi, L. L., & Sharon, J. D. (2022) · Journal of Vestibular Research · doi:10.3233/ves-210117 · Cited by 16 · see citing works
Migraine management for the otolaryngologist
Brooks, K. A., Tawk, K., Djalilian, H. R., & Hobson, C. E. (2023) · Laryngoscope Investigative Otolaryngology · doi:10.1002/lio2.1109 · Cited by 16 · see citing works
Lins, E. M. D. V. S., Bittar, R. S. M., Bazán, P. R., Amaro, E., & Staab, J. P. (2020) · International Archives of Otorhinolaryngology · doi:10.1055/s-0040-1716572 · Cited by 16 · see citing works
Self-citationPowell, G., Penacchio, O., Derry-Sumner, H., Rushton, S. K., Rajenderkumar, D., & Sumner, P. (2021) · Journal of Vestibular Research · doi:10.3233/ves-190578 · Cited by 17 · see citing works
- Authors
- Staab, J. P., & Ruckenstein, M. J.
- Affiliations
- University of Pennsylvania Health System (US)
- University of Pennsylvania (US)
- ORCID
- Staab, Jeffrey P.
- Venue
- Archives of Otolaryngology–Head & Neck Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2007-02-01
- Volume
- 133
- Issue
- 2
- Pages
- 170
- ISSN
- 0886-4470 (ISSN-L)
- OpenAlex
- W2099190753
- Cited by
- 217
- References
- 16
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 12 · 2023: 24 · 2022: 11 · 2021: 20 · 2020: 18 · 2019: 10 · 2018: 10 · 2017: 5 · 2016: 13 · 2015: 12 · 2014: 11 · 2013: 9 · 2012: 9
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Otolaryngology - Head and Neck Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Keywords
- chronic dizziness, differential diagnosis, anxiety disorders, migraine, mild traumatic brain injury, cardiac arrhythmias, comorbidities, psychogenic dizziness, central nervous system disorders
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety Disorders, Autonomic Nervous System Diseases, Chronic Disease, Diagnosis, Differential, Diagnostic Techniques, Otological, Dizziness, Female, Humans, Male, Middle Aged, Migraine Disorders, Post-Concussion Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
