Panic disorder in otoneurogical expertise
Abstract
The evaluation of cochleovestibular dysfunction in psychiatric patients often causes difficult problem in neurootological expertise. The most difficult challenge is the combined lesion: psychiatric disorders with organic cochleovestibular diseases.
Authors discuss the neurobiological base of panic disorders and the cochleovestibular dysfunction. Authors of the multicentric study examined 63 patients with vertigo and panic disease. Twenty patients with primary panic disease and consecutive vertigo were in group I, while in group II 43 vertiginous patients with secondary panic disease were examined. The most interesting question is: have the patients organic vestibular lesion, which explains: why just the vertigo is the problem of the panic patients, whereas in other patients the 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.
The treatment of the vertigo in panic patients and in the panic disorder of vertiginous patients requires good cooperation between neurootologist and psychiatrist.
