Teggi R, Caldirola D, Colombo B, Perna G, Comi G, Bellodi L, Bussi M
Department of ENT, San Raffaele Hospital, Vita-Salute University, Milan, Italy.
J Laryngol Otol. 2010 Mar;124(3):285-90. doi: 10.1017/S0022215109991976. Epub 2009 Dec 3.
This study sought to establish the prevalence of vestibular disorders, migraine and definite migrainous vertigo in patients with psychiatric disorders who were referred for treatment of dizziness, without a lifetime history of vertigo.
Retrospective study.
Out-patients in a university hospital.
Fifty-two dizzy patients with panic disorders and agoraphobia, 30 with panic disorders without agoraphobia, and 20 with depressive disorders underwent otoneurological screening with bithermal caloric stimulation. The prevalence of migraine and migrainous vertigo was assessed. The level of dizziness was evaluated using the Dizziness Handicap Inventory.
Dizzy patients with panic disorders and agoraphobia had a significantly p = 0.05 regarding the prevalence of peripheral vestibular abnormalities in the group of subjects with PD and agoraphobia and in those with depressive disorders. Migraine was equally represented in the three groups, but panic disorder patients had a higher prevalence of migrainous vertigo definite migrainous vertigo. Almost all patients with a peripheral vestibular disorder had a final diagnosis of definite migrainous vertigo according to Neuhauser criteria. These patients had higher Dizziness Handicap Inventory scores. The Dizziness Handicap Inventory total score was higher in the subgroup of patients with panic disorders with agoraphobia also presenting unilateral reduced caloric responses or definite migrainous vertigo, compared with the subgroup of remaining subjects with panic disorders with agoraphobia (p < 0.001).
Our data support the hypothesis that, in patients with panic disorders (and especially those with additional agoraphobia), dizziness may be linked to malfunction of the vestibular system. However, the data are not inconsistent with the hypothesis that migrainous vertigo is the most common pathophysiological mechanism for vestibular disorders.
本研究旨在确定因头晕前来治疗且无眩晕终生病史的精神疾病患者中前庭疾病、偏头痛和明确的偏头痛性眩晕的患病率。
回顾性研究。
大学医院门诊患者。
对52例伴有惊恐障碍和广场恐惧症的头晕患者、30例无广场恐惧症的惊恐障碍患者以及20例抑郁症患者进行了冷热试验耳神经学筛查。评估偏头痛和偏头痛性眩晕的患病率。使用头晕残障量表评估头晕程度。
伴有惊恐障碍和广场恐惧症的头晕患者在外周前庭异常患病率方面，惊恐障碍伴广场恐惧症组与抑郁症组相比差异有统计学意义（p = 0.05）。偏头痛在三组中的表现相当，但惊恐障碍患者中偏头痛性眩晕（明确的偏头痛性眩晕）的患病率更高。几乎所有外周前庭疾病患者根据Neuhauser标准最终诊断为明确的偏头痛性眩晕。这些患者的头晕残障量表得分更高。与其余伴有惊恐障碍和广场恐惧症的患者亚组相比，伴有惊恐障碍和广场恐惧症且存在单侧冷热反应降低或明确偏头痛性眩晕的患者亚组的头晕残障量表总分更高（p < 0.001）。
我们的数据支持这样的假设，即在惊恐障碍患者（尤其是伴有广场恐惧症的患者）中，头晕可能与前庭系统功能障碍有关。然而，这些数据也与偏头痛性眩晕是前庭疾病最常见的病理生理机制这一假设并不矛盾。
