Panic disorder in otoneurogical expertise
Abstract
The evaluation of cochleovestibular dysfunction in psychiatric
patients often causes difficult problem in our neurootological
practice. The most difficult challenge is the cases of combined
lesion: psychiatric disorders with organic cochleovestibular diseases.
Authors discuss the neurobiological base of panic disorders and the
cochleovestibular dysfunction. In the multicentric study 63 patients
were examined with vertigo and panic disease. Patients were divided in
two groups, group I. (20 patients-primary panic disease with
consecutive vertigo, group II. – 43 vertiginous patients with
secondary panic disease). The most interesting question is why exactly
vertigo is the main symptom of the patients, while panic disease can
cause other severe symptoms, resembling on heart attack or dyspnoea,
or abdominal crisis. Vertigo has bi-directional connection with
psychiatric disorders. The panic disorder can be superposed upon
chronic vertigo and the psychiatric patients with cochleovestibular
lesion have worse chances for complete recovery. The examination of
the psychiatric patients with vertigo is very time-consuming and
requires much more empathy, than vertiginous patients with normal
mental state. Anxiety has somatic and behavioral symptoms in most of
the patients. Treatment of vertigo in panic patients and in panic
disorder of vertiginous patients requires good co-operation between
neurootologist and psychiatrist.