Dizziness associated with panic disorder and agoraphobia: case report and literature review

Balance Disturbances in Asthmatic Patients

“…Anxiety symptoms are also associated with other clinical phenomena, such as dizziness and equilibrium abnormalities (10)(11)(12). In fact, dizziness and vestibular dysfunction are reported by up to 90% of patients with *Corresponding author: Ângelo Geraldo José Cunha, M.D., Av.…”

Imipramine for vestibular dysfunction in panic disorder: a prospective case series

“…When total slow phase velocity was less than 20 o / second, stimulations were considered hyporesponsive, and hyper-responsive when greater than 140 o /second 11,12 . We considered central signs to comprise at least one of the following findings: [1] disorganized pursuit and reduction of pursuit gain; [2] saccades dysmetria with undershoot, overshoot, or asymmetrical latency or velocity; [3] rebound nystagmus; [4] visual fixation suppression of nystagmus of less than 60 per cent; [5] pure vertical or torsional spontaneous or positional nystagmus; or [6] positional nystagmus when bilateral, beating to the uppermost or lowermost ear, showing no latency, low frequency, lack of fatigability and habituation, without concomitant vertigo 14,15 . The otoneurological evaluations were conducted before the initiation of treatment with imipramine, and were repeated after three months of treatment with imipramine.…”

“…In the absence of rotational vertigo, dizziness has been considered another somatoform symptom common to anxiety disorders 1 . Psychiatric disorders have been associated with chronic dizziness in the so-called idiopathic dizziness 2 , and different studies have shown that patients that suffer from acute vestibular conditions often develop psychiatric disorders 3,4 . Patients with anxiety disorders have a higher rate of peripheral vestibular dysfunction compared to control populations, especially in panic disorder with agoraphobia 5 .…”

Chronic dizziness presenting in a patient with panic disorder: response to imipramine

“…Many patients with chronic dizziness without a clear organic origin, also called idiopathic dizziness, may have an association with a psychiatric disorder 3 . Nevertheless many patients with organic dizziness may also initiate or worsen a psychiatric disorder 4,5 . The association between dizziness and psychiatric disorders is well known, but it still is understudied, mainly due to a lack of a multidisciplinary evaluation of these patients.…”

“…Dizziness is one of the symptoms of panic attacks, as are palpitations, shortness of breath and chest pain or discomfort, but psychiatrists usually do not refer panic disorder patients for otoneurologic evaluations as they refer them to cardiologic evaluations. This lack of adequate evaluation may lead patients away from an adequate diagnosis and treatment 4 . The following case report illustrates the importance of an adequate psychiatric and otoneurologic evaluation of a patient with chronic dizziness referred to an anxiety disorder outpatient unit.…”