Persistent Postural-Perceptual Dizziness in Children and Adolescents

Wang, Alicia; Fleischman, Katie M.; Kawai, Kosuke; Corcoran, Meghan; Brodsky, Jacob R.

doi:10.1097/mao.0000000000003212

Cited by 26 publications

(21 citation statements)

References 57 publications

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“…O paciente mais típico de TPPP é mulher entre 40 e 60 anos 32 . Mas pode acometer também crianças e adolescentes, principalmente do sexo feminino 33 .…”

Section: Prevalênciaunclassified

Tontura Postural Perceptual Persistente

Söhsten¹

2022

Preprint

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IntroduçãoO equilíbrio é hoje entendido de uma forma bem mais complexa, como resultado da interação das aferências visuais, proprioceptivas, vestibulares, as quais são processadas pelo sistema nervoso central. O córtex visual, vestibular, somatassensorial, motor, o sistema límbico, as regiões interoceptivas e cerebelares modulam uma resposta que será efetivada pelo sistema músculo-esquelético. Os traços da personalidade influenciam a forma como essas áreas se comunicam e qual região predomina na resposta. Além disso, o ambiente e diversos estímulos (visuais, de movimento, emocionais) participam desse processo. Dentro desse contexto, é mais fácil entender a tontura postural perceptual persistente (TPPP), que sai da visão periférica, restrita a acometimento labiríntico ou de nervo vestibular e avalia o equilíbrio de uma forma mais holística. O sistema vestibular também parece ser susceptível a modulação de processos cognitivos associados a atenção, memória de trabalho ou imagem mental que são potencializados pela ansiedade e expectativa 1 . Um pouco da história da TPPPA observação de influências do ambiente na tontura não é recente. Em 1871, Karl Westphal, neurologista alemão, descreveu a agorafobia, indivíduos que desenvolviam tontura debilitante, desorientação espacial, e ansiedade, em locais abertos e ambientes muito movimentados 2 .Entre 1980 e 1990, Brandt and Dieterich, neurologistas alemães, reportaram casos de pacientes com tontura não vertiginosa não explicada por disfunções otoneurológicas e denominaram de Vertigem Fóbica Postural (VFP) 3 .No começo do século XXI, Staab (psiquiatra americano) e Ruckenstein (otorrinolaringologista americano) confirmaram os sintomas clínicos da VFP e acrescentaram fatores comportamentais; renomearam a disfunção como Tontura Crônica Subjetiva (TCS) 4 .

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“…O paciente mais típico de TPPP é mulher entre 40 e 60 anos 32 . Mas pode acometer também crianças e adolescentes, principalmente do sexo feminino 33 .…”

Section: Prevalênciaunclassified

Tontura Postural Perceptual Persistente

Söhsten¹

2022

Preprint

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“…PPPD is one of the most common and treatable causes of chronic dizziness in the pediatric population [ 42 ]. This disease is associated with an impairment in quality of life, including a reduction in school attendance and sports practice.…”

Section: Reviewmentioning

confidence: 99%

“…This disease is associated with an impairment in quality of life, including a reduction in school attendance and sports practice. This disorder has been increasing over the time, and nowadays there is a prevalence in the pediatric and adolescent population of 7.3% [ 42 ]. Symptoms associated with this disorder are on-vertiginous dizziness and a sense of imbalance exacerbated by position changes, standing, turning, and visual flow.…”

Section: Reviewmentioning

confidence: 99%

“…Symptoms associated with this disorder are on-vertiginous dizziness and a sense of imbalance exacerbated by position changes, standing, turning, and visual flow. This disorder may last for many months and even years before receiving diagnosis and treatment [ 42 ]. Another important fact of this disorder is the concomitant presence of anxiety and depression in this population, with higher rates of neuroticism and low extroversion as well as psychological chronic stress led by autonomic amygdala response to feared physical sensations such as pain or dizziness [ 42 ].…”

Section: Reviewmentioning

confidence: 99%

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Facts of Vertigo in Adolescents: Controversies and Challenges – A Narrative Review

Castillo‐Bustamante¹,

Cabrera²,

Angulo³

et al. 2022

Cureus

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Vertigo is a common complaint in the general population affecting 5% of adults in one year. At least 29.5% of adults have referred vertigo during life. Even though the prevalence of vertigo is well known in adults the epidemiologic data in adolescents is sparse. To date, it is known that adolescent females are usually affected by vertigo and some conditions such as depression and anxiety are found in this population. However, the lack of information about the prevalence of most common types of vertigo in adolescents, predisposing factors, challenges, and controversies in clinics in the literature, present a challenge for clinicians regarding the approach and follow-up of this population. Herein, we performed a literature review including data about the prevalence, most common types of vertigo and controversial events in the approach of vertigo in adolescents over the last two decades.

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“…At a neurotological centre, benign paroxysmal positional vertigo (BPPV), Menière’s disease (MD) and vestibular neuritis (VN) can be mentioned as the most frequent diagnoses [ 2 ]. Although, other disorders, just like vestibular migraine (VM) [ 3 ], Persistent Postural-Perceptual Dizziness (PPPD) [ 4 ], and other vestibulopathies, can also influence the patients’ quality of life (QoL) and be associated with psychiatric comorbidities. Psychiatric comorbidities are present in around 30–50% of the patients suffering from dizziness or vertigo [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Depression scores and quality of life of vertiginous patients, suffering from different vestibular disorders

Molnár

Maihoub

Mavrogeni³

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose To contrast the quality of life (QoL) impairment and depression scores of patients suffering from different vestibular disorders. Methods 301 patients were examined due to vertiginous complaints at the Neurotology Centre of the Department of Otolaryngology and Head and Neck Surgery of Semmelweis University. These patients completed the Hungarian version of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory, and the Symptom Checklist-90-Revised questionnaires. Results According to neurotological examination, the distribution of the different diagnoses was as follows: Menière’s disease (n = 101), central vestibular disorders (n = 67), BPPV (n = 47), vestibular neuritis (n = 39), other unilateral peripheral vestibulopathy (n = 18), PPPD (Persistent Postural-Perceptual Dizziness) (n = 16), vestibular migraine (n = 8), and vestibular Schwannoma (n = 5). The results of the DHI questionnaire have indicated worsened QoL in 86.4%, out of which 33.6% was defined as severe. The Beck scale has shown depressive symptoms in 42.3% of the cases, with severe symptoms in 6.3%. Significantly higher total DHI and Beck scale results were observed in patients with central vestibular disorders, vestibular migraine, PPPD and peripheral vestibulopathy, contrasted to the results of the other four diagnosis groups. The onset of the symptoms did not significantly affect the severity of QoL worsening and depression symptoms. Conclusion In this study, the QoL of vertiginous patients was worse in general, with the occurrence of depression symptoms. A difference was observed in the case of the values of patients with different vestibular disorders, indicating the importance of different factors, e.g., central vestibular compensation, behavioural strategies and psychological factors.

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Persistent Postural-Perceptual Dizziness in Children and Adolescents

Cited by 26 publications

References 57 publications

Tontura Postural Perceptual Persistente

Tontura Postural Perceptual Persistente

Facts of Vertigo in Adolescents: Controversies and Challenges – A Narrative Review

Depression scores and quality of life of vertiginous patients, suffering from different vestibular disorders

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