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Chronic Dizziness Often Has Psychiatric, Neurologic Etiology

New research points to common causes of chronic dizziness

FRIDAY, Feb. 23 (HealthDay News) -- Nearly 60 percent of patients with chronic dizziness have anxiety disorders while others have central nervous system disorders such as migraine, according to a report in the February issue of the Archives of Otolaryngology--Head & Neck Surgery.

Jeffrey P. Staab, M.D., of the University of Pennsylvania Health System in Philadelphia, and a colleague prospectively followed 345 patients aged 15 to 89 who were referred to a tertiary care balance center for evaluation of chronic dizziness between 1998 and 2004. Patients were tracked through specialty examinations until a final diagnosis was made.

Nearly all patients with chronic subjective dizziness had psychiatric or neurologic illnesses including 59.7 percent with anxiety disorders and 38.6 percent with central nervous system disorders such as migraine, mild traumatic brain injuries and neurally mediated dysautonomias. Six patients had irregular heartbeats.

"Key features of the clinical history distinguish these illnesses from one another and from active neurotologic conditions," the researchers note. For example, patients whose dizziness stems from panic and phobic anxiety disorders often have anxiety when anticipating situations associated with dizziness, fearful avoidance of such situations and panic attacks.

"These results may improve diagnostic precision and therapeutic outcomes for patients with this frequently enigmatic clinical presentation," the authors write.

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