精神源性眩晕(综述)
Psychiatric Origin of Vertigo (Review)

DOI: 10.12677/acm.2012.22003, PP. 11-16

Keywords: 眩晕；慢性眩晕；前庭自旋转实验；前庭康复；海兹量表
Dizziness, VAT, CSD, HADS, Vestibular Rehabilitation

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Abstract:

大多数慢性眩晕是由于短暂性躯体性疾病诱发急性眩晕没有得到及时治疗形成完全性代偿，导致长期迁延不愈而形成的。大多数慢性眩晕都或多或少伴发或继发精神源性眩晕，也称之慢性主观性眩晕，是很常见的临床综合症，发病率高达30%~50%，诊断和治疗一直以来颇具挑战。进入21世纪后，这个领域出现了重大进展，产生了一些诊治新概念和新方法。本文旨在综述这些最新进展。
It has been is a challenge to diagnose and treat the chronic dizziness which is usually derived from acute diz-ziness with neurologic or otologic origins or developed with psychiatric diseases. It becomes chronic due to lack of proper treatment to establish complete compensation mechanism at early stage and to deal with intermingled psycho-logical factors properly. It often has psychiatric symptoms and also called chronic subjective dizziness (CSD) with in-cidence rate of 30-50%. However, the significant progress has been made in this field since the beginning of the 21st century especially in diagnosis and treatment. The current paper is to review the most recent development.

References

[1]	J. P. Staab. Psychiatric origins of dizziness and vertigo. In: Ja- cobson, N. T. Shepard, Eds., Balance Function Assessment and Management. San Diego: Plural Publishing, 2008.
[2]	M. G. Carpenter, A. L. Adkin, L. R. Brawley and J. S. Frank. Postural, physiological and psychological reactions to challeng- ing balance: Does age make a difference? Age and Ageing, 2006, 35(3): 298-303.
[3]	J. M. Furman, R. G. Jacob. A clinical taxonomy of dizziness and anxiety in the otoneurological setting. Journal of Anxiety disor- ders, 2001, 15(1-2): 9-26.
[4]	T. Brandt. Phobic postural vertigo. Neurology, 1996, 46(6): 1515-1519.
[5]	D. Huppert, M. Strupp, N. Rettinger, J. Hecht and T. Brandt. Phobic postural vertigo: A long-term follow-up (5 to 15 years) of 106 patients. Journal of Neurology, 2005, 252(5): 564-569.
[6]	H. P. Kapfhammer, C. Mayer, U. Hock, D. Huppert, M. Dierich and T. Brandt. Course of illness in phobic postural vertigo. Acta Neurologica Scandinavia, 1997, 95(1): 23-28.
[7]	R. G. Jacob, S. R. Woody, D. B. Clark, S. O. Lilienfeld, B. E. Hirsch, G. D. Kucera, et al. Discomfort with space and motion: A possible marker of vestibular dysfunction assessed by the situational characteristics questionnaire. Journal of Psychopathology and Behavioral Assessment, 1993, 15(4): 299-324.
[8]	A. M. Bronstein. Visual vertigo syndrome: Clinical and posturography. Journal of Neurology, Neurosurgery and Psychiarty, 1885, 59(5): 472-476.
[9]	A. M. Bronstein. Vision and vertigo: Some visual aspects of vestibular disorders. Journal of Neurology, 2004, 251(4): 381- 387.
[10]	J. P. Stabb. Chronic dizziness: The interface between psychiatry and neuro-otology. Current Opinion in Neurology, 2006, 19(1): 41-48.
[11]	J. P. Stabb. Assessment and management of psychological problems in the dizzy patient. Continuum: Lifelong Learning in Neurology, 2006, 12(4): 189-213.
[12]	J. P. Stabb, M. J. Ruckenstein. Which comes first? Psychogenic dizziness versus otogenic anxiety. Laryngoscope, 2003, 113(10): 1714-1718.
[13]	J. P. Stabb, M. J. Ruckenstein. Expanding the differential diag- nosis of dizziness. Archives of Otolaryngology-Head and Neck Surgery, 2007, 133(2): 170-176.
[14]	A. L. Adkin, J. S. Frank and M. G. Carpenter. Fear of falling modifies anticipatory postural control. Experimental Brain Re- search, 2002, 143(2): 160-170.
[15]	L. A. Brown, W. H. Gage, M. A. Polych, R. J. Sleik and T. R. Winder. Central set influences on gait. Age-dependent effects of postural threat. Experimental Brain Research, 2002, 145(3): 286-296.
[16]	H. Ohno, M. Wada, J. Saitoh, N. Sunaga and M. Nagai. The affect of anxiety on postural control in humans depends on visual information processing. Neuroscience Letters, 2004, 364(1): 37-39.
[17]	M. G. Carpenter, J. S. Frank, A. L. Adkin, A. Paton and J. H. Allum. Influence of postural anxiety on postural reactions to multi-directional surface rotations. Journal of Neurophysiology, 2004, 92(6): 3255-3265.
[18]	W. H. Gage, R. J. Sleik, M. A. Polych, N. C. Mckenzie and L. A. Brown. The allocation of attention during locomotion is altered by anxiety. Experimental Brain Research, 2003, 150(3): 385- 394.
[19]	I. Viaud-Delmon, Y. P. Ivanenko, A. Berthoz and R. Jouvent. Adaptation as a sensorial profile in trait anxiety: A study with virtual reality. Journal of Anxiety Disorders, 2000, 14(6): 583- 601.
[20]	C. Best, A. Eckhardt-Henn, G. Diener, S. Bense, P. Breuer and M. Dieterich. Interaction of somatoform and vestibular disorders. Journal of Neurology Neurosurgery and Psychiatry, 2006, 77(5): 658-664.
[21]	S. Eagger, L. M. Luxon, R. A. Davies, A. Coelho and M. A. Ron. Psychiatric morbidity in patients with peripheral vestibular disorder: A clinical and neuro-otological study. Journal of Neurology and Neurosurgery Psychiatry, 1992, 55(5): 383-387.
[22]	A. S. Kammerlind, T. E. Ledin, E. I. Skargren and L. M. Odkvist. Long-term follow-up after acute unilateral vestibular loss and comparison between subjects with and without remaining sym- ptoms. Acta Otolaryngol (Stockholm), 2005, 125(9): 946- 953.
[23]	A. Horii, A. Uno, T. Kitahara, K. Mitani, C. Masumura, K. Ki- zawa, et al. Effects of fluvoxamine on anxiety, depression and subjective handicaps of chronic dizziness patients with or with- out neuro-otologic diseases. Journal of Vestibular Research, 2007, 17(1): 1-8.
[24]	J. P. Stabb, M. J. Ruckenstein, D. Solomon and N. T. Shepard. Serotonin reuptake inhibitors for dizziness with psychiatric symptoms. Archives of Otolaryngology-Head and Neck Surgery, 2002, 128(5): 554-560.
[25]	J. Holmberg, M. Karlberg, U. Harlacher, M. Rivano-Fischer and M. Magnusson. Treatment of phobic postural vertigo: A controlled study of congnitive-behavioral therapy and self-controlled desensitization. Journal of Neurology, 2006, 253(4): 500-506.
[26]	R. G. Jacob, S. L. Whitney, D.-S. Gail and J. M. Furman. Vestibular rehabilitation for patients with agoraphobia and vestibular dysfunction: A pilot study. Anxiety Disorders, 2001, 15(1-2): 131-146.
[27]	D. Solomon, N. T. Shepard. Chronic dizziness. Current Treatment Options in Neurology, 2002, 4(4): 281-288.
[28]	S. L. Whitney, J. M. Furman. Vestibular rehabilitation. In: G. P. Jacobson, N. T. Shepard, Eds., Balance Function Assessment and Management. San Diego: Plural Publishing, 2008.
[29]	D. L. Hoffman, D. P. O’Leary and D. J. Munjack. Autorotation test abnormalities of the horizontal and vertical vestibule-ocular reflexes in panic disorder. Otolaryngology-Head and Neck Surgery, 1994, 110(3): 259-269.
[30]	E. A. Grunfeld, M. A. Gresty, A. M. Bronstein and M. Jahanshahi. Screening for depression among neuro-otology patients with and without identifiable vestibular lesions. International Journal of Audiology, 2003, 42(3): 161-165.
[31]	J. P. Stabb, M. J. Ruckenstein and J. D. Amsterdam. A prospective trial of sertraline for chronic subjective dizziness. Laryngoscope, 2004, 114(9): 1637-1641.

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