Vestibular Disorders: Pearls and Pitfalls

Choi, Woo-Yong; Gold, Daniel R.

doi:10.1055/s-0039-1698752

Cited by 3 publications

(2 citation statements)

References 127 publications

(150 reference statements)

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“…Dizziness can also result from pathologies of the central nervous system, such as concussion, migraine, tumors, and traumatic brain injury ( 244 ). There are over 20 vestibular disorders, and most present with the common symptoms of vertigo, dizziness, oscillopsia, and unsteadiness ( 245 ). One study assessing vestibular disorders and somatization interaction found that Meniere’s disease and vestibular migraines have the highest psychiatric comorbidity ( 246 ).…”

Section: Dizziness Unsteadiness Light-headedness or Faintnessmentioning

confidence: 99%

Biobehavioral approach to distinguishing panic symptoms from medical illness

Tunnell,

Corner,

Roque

et al. 2024

Front. Psychiatry

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Panic disorder is a common psychiatric diagnosis characterized by acute, distressing somatic symptoms that mimic medically-relevant symptoms. As a result, individuals with panic disorder overutilize personal and healthcare resources in an attempt to diagnose and treat physical symptoms that are often medically benign. A biobehavioral perspective on these symptoms is needed that integrates psychological and medical knowledge to avoid costly treatments and prolonged suffering. This narrative review examines six common somatic symptoms of panic attacks (non-cardiac chest pain, palpitations, dyspnea, dizziness, abdominal distress, and paresthesia), identified in the literature as the most severe, prevalent, or critical for differential diagnosis in somatic illness, including long COVID. We review somatic illnesses that are commonly comorbid or produce panic-like symptoms, their relevant risk factors, characteristics that assist in distinguishing them from panic, and treatment approaches that are typical for these conditions. Additionally, this review discusses key factors, including cultural considerations, to assist healthcare professionals in differentiating benign from medically relevant symptoms in panic sufferers.

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Section: Dizziness Unsteadiness Light-headedness or Faintnessmentioning

confidence: 99%

Biobehavioral approach to distinguishing panic symptoms from medical illness

Tunnell,

Corner,

Roque

et al. 2024

Front. Psychiatry

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“…With the expansion of the clinical examination, the vHIT, having good sensitivity and specificity, is crucial in making or supporting the diagnoses of vestibular disorders, such as vestibular neuritis (VN), bilateral vestibular loss, and acoustic neuroma, as well as assessing vestibular compensation during the rehabilitation process ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Association Analysis of HIMP and SHIMP Quantitative Parameters in Patients With Vestibular Neuritis and Healthy Participants

Chen

Zhang

et al. 2021

Front. Neurol.

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Background: The Head Impulse Paradigm (HIMP) and Suppression Head Impulse Paradigm (SHIMP) are objective, quantitative methods that directly test the vestibulo-ocular reflex (VOR) and are increasingly becoming a standard in evaluating patients with vestibular disorders.Objective: The main objective was to assess the correlations between HIMP and SHIMP parameters in patients with superior vestibular neuritis (VN) and healthy participants. Additionally, the correlations between the parameters of each method were analyzed.Methods: A retrospective cohort, non-randomized study was designed. HIMP and SHIMP were performed on 40 patients with VN and 20 healthy participants (40 ears). HIMP and SHIMP parameters were measured and calculated. Pearson's or Spearson's correlations were used to establish the associations among them.Results: A strong positive correlation was found between HIMP and SHIMP gain (Pearson's r = 0.957, p = 0.000), while strong negative correlations were detected between HIMP and SHIMP saccade amplitudes (r = −0.637, p = 0.000) and percentages of overt saccades (r = −0.631, p = 0.000). In HIMP, strong and moderate positive correlations were identified between gain and saccade amplitude (R2 = 0.726, p = 0.000) and gain and saccade percentage (R2 = 0.558, p = 0.000), respectively. By contrast, an extremely weak positive correlation was observed between gain and latency (R2 = 0.053, p = 0.040). In SHIMP, strong and moderate positive correlations were found between gain and saccade percentage (R2 = 0.723, p = 0.000) and gain and saccade amplitude (R2 = 0.525, p = 0.000), respectively, but no correlation was detected between gain and latency (R2 = 0.006, p = 0.490).Conclusions: HIMP and SHIMP-related parameters were highly correlated (inter-method). Within each method (intra-method), moderate to strong correlations in VOR assessment were observed. These results further contribute to our understanding of the relationship between HIMP and SHIMP as well as to the diagnosis.

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