Could Your Dizziness, Something More Serious or Something Different?
Do you often find yourself getting dizzy, coupled with breathlessness with activity or even at rest? Patients with chronic dizziness identifying clinical conditions are associated with persistent symptoms and delineating key diagnostic features that differentiate its causes and direct attention to specific treatments.
In the article; Expanding the Differential Diagnosis of Chronic Dizziness by Jeffrey P. Staab and Michael J. Ruckenstein published in February 2007 edition of JAMA Otolaryngology Head & Neck Surgery; Chronic subjective dizziness is a specific clinical syndrome with the cardinal feature of persistent nonspecific dizziness that cannot be explained by active medical conditions.
Diagnosis was identified by the following physical symptoms and examination findings:
- Persistent (duration of ≥3 months) sensations of nonvertiginous dizziness, lightheadedness, heavy-headedness, or subjective imbalance present on most days.
- Chronic (duration of ≥3 months) hypersensitivity to one’s own motion, which is not direction specific, and to the movements of objects in the environment.
- Exacerbation of symptoms in settings with complex visual stimuli such as grocery stores or shopping malls or when performing precision visual tasks such as reading or using a computer.
- Absence of currently active physical neurotologic illnesses, definite medical conditions, use of medications that may cause dizziness, or inability of such conditions to account for the full extent of dizziness or disability. Medical history could include episodes of true vertigo or ataxia as long as the conditions causing those symptoms were resolved.
- Results from radiographic imaging of the brain that exclude neurotologically significant anatomical lesions.
In the prospective cohort study from 1998 to 2004, a total of 345 men and women, aged 15 to 89 years, were systematically directed through multiple specialty examinations until definitive diagnoses were made. Results show nearly all patients with chronic subjective dizziness were diagnosed with psychiatric or neurologic illnesses. These included primary and secondary anxiety disorders [59.7%] and central nervous system conditions [38.6%], specifically migraine headaches, mild traumatic brain injuries, and neurally mediated dysautonomias. A small number of patients [1.7%]) had dysrhythmias. Four of 5 patients with migraine or dysrhythmias had comorbid anxiety.
The study further concluded that chronic dizziness has several common causes, including anxiety disorders, migraine, traumatic brain injuries, and dysautonomia, that require different treatments. Key features of the clinical history distinguish these illnesses from one another and from active neurotologic conditions. The high prevalence of secondary anxiety may give a false impression of psychogenicity.
Give us a call today at 915-503-1333 for further information. Let’s help you regain your balance. Our facility setting is for typical and atypical forms of dizziness “You Don’t Have To Live With It” Help is available.