What accounts for vertigo one year after neuritis vestibularis—anxiety or a dysfunctional vestibular organ?
Abstract
One year after neuritis vestibularis, 29% from a sample of 75 patients still complained of vertigo. The objective of this investigation was to study why patients suffer from persisting vertigo. The alternative hypotheses were that the vertigo experienced could be explained either by a persisting vestibular dysfunction or by psychopathological changes. To elucidate this question, patients were examined with dynamic posturography, the symptom check list (SCL 90 R), the state-trait anxiety inventory (STAI), the agoraphobic cognitions questionnaire (ALQ) and the body sensations questionnaire (BSQ). After one year, only two patients had overall pathological results in the posturography. Following the assumption that sub-clinical dysfunction of the organs of balance can also lead to an altered body perception in combination with anxiety, the pathological results of posturographic sub-tests were related to experiences of vertigo. Here also there were no significant associations. However, vertigo correlated highly significantly with body-related anxiety and anxiety-related apprehension. In conclusion, chronic vertigo after an acute vestibular disorder could be regarded as a somatopsychic process. Persisting experience of vertigo is not explained by sub-clinical organic changes. Anxiety seems to be the crucial factor in persisting vertigo.
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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].”
These investigations found PPPD-like chronic dizziness or persistent VV in about 25% of patients after 3-12 months of follow-up, despite otherwise adequate compensation or recovery from the initial illnesses.
“These investigations found PPPD-like chronic dizziness [7, 28, 30] or persistent VV [23] in about 25% of patients after 3–12 months of follow-up, despite otherwise adequate compensation or recovery from the initial illnesses.”
Investigators studying PPV, CSD, SMD, and VV have identified pathophysiologic processes that may be applicable to PPPD, including anxiety-related personality traits as a possible risk factor and high levels of anxiety and vigilance about acute symptoms during precipitating events as initial pathologic responses.
“Investigators studying PPV, CSD, SMD, and VV have identified pathophysiologic processes that may be applicable to PPPD, including anxiety-related personality traits as a possible risk factor [86, 88, 89] and high levels of anxiety and vigilance about acute symptoms during precipitating events as initial pathologic responses [7, 23, 28, 30].”
These initial psychological responses had far greater effects on long-term outcomes than the initial or subsequent states of patients' peripheral vestibular functioning or vestibulo-ocular reflexes.
“These initial psychological responses had far greater effects on long-term outcomes than the initial or subsequent states of patients’ peripheral vestibular functioning or vestibulo-ocular reflexes.”
Three prospective studies found that high anxiety about dizziness during and after bouts of acute vestibular neuritis or BPPV predicted continued dizziness three, six, and twelve months later.
“Three prospective studies found that high anxiety about dizziness during and after bouts of acute vestibular neuritis or BPPV predicted continued dizziness three [30], six [23], and twelve [28] months later.”
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- Authors
- GODEMANN, F., SIEFERT, K., HANTSCHKEBRUGGEMANN, M., NEU, P., SEIDL, R., & STROHLE, A.
- Affiliations
- St. Joseph-Krankenhaus (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Unfallkrankenhaus Berlin (DE)
- Corresponding author
- GODEMANN, F
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2005-09
- Volume
- 39
- Issue
- 5
- Pages
- 529-534
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W1993374042
- Cited by
- 154
- References
- 26
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 7 · 2023: 14 · 2022: 15 · 2021: 10 · 2020: 13 · 2019: 6 · 2018: 8 · 2017: 8 · 2016: 9 · 2015: 7 · 2014: 10 · 2013: 4 · 2012: 3
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- chronic vertigo, vestibular dysfunction, anxiety, posturography, body perception, bodily sensations
- MeSH terms
- Anxiety, Chronic Disease, Female, Humans, Male, Middle Aged, Posture, Psychiatric Status Rating Scales, Vertigo, Vestibule, Labyrinth, Vestibular Neuronitis
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