McCaslin Devin L, Jacobson Gary P, Burrows Holly L, Littlefield Philip, Haynes David S
Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN 37232-8025, USA.
J Am Acad Audiol. 2010 May;21(5):293-300. doi: 10.3766/jaaa.21.5.2.
Patients presenting with chronic dizziness and no identifiable vestibular impairments have been described as having "extravestibular" symptoms, or "psychogenic dizziness." In 2005, Staab and Ruckenstein described a syndrome they referred to as "chronic subjective dizziness" (CSD), which characterized this concept more clearly. According to Staab and Ruckenstein (2003), the primary physical symptoms of CSD are continual nonvertiginous dizziness or subjective imbalance that persists for 3 mo or longer. Patients suffering from CSD often describe their dizziness as a rocking or swaying when sitting or standing. This case study describes a 41-yr-old female who originally presented with complaints of noise-induced vertigo. The patient's history, imaging studies, and balance function examinations led to the diagnosis of a right-sided superior canal dehiscence (SCD). After surgical repair of the dehiscence, the quantitative electrophysiological tests returned to normal. However, the patient's scores on measures of anxiety, depression, and self-perceived dizziness handicap increased significantly postoperatively. This case illustrates the transformation of a peripheral end-organ impairment (i.e., SCD) into a psychiatric condition (i.e., CSD).
出现慢性头晕且无明确前庭功能障碍的患者被描述为具有“前庭外”症状或“精神性头晕”。2005年，施塔布和鲁肯斯坦描述了一种他们称为“慢性主观性头晕”（CSD）的综合征，该综合征更清晰地界定了这一概念。根据施塔布和鲁肯斯坦（2003年）的研究，CSD的主要身体症状是持续的非眩晕性头晕或主观失衡，持续3个月或更长时间。患有CSD的患者常将其头晕描述为坐立或站立时的摇晃感。本病例研究描述了一名41岁女性，最初她主诉噪声性眩晕。患者的病史、影像学检查和平衡功能检查结果确诊为右侧上半规管裂（SCD）。裂隙手术修复后，定量电生理测试恢复正常。然而，患者术后焦虑、抑郁及自我感知头晕障碍评分显著升高。本病例说明了外周终末器官损伤（即SCD）向精神疾病（即CSD）的转变。
