Intact vestibular function is relevant for anxiety related to vertigo.
J Neurol. 2019 May 9. doi: 10.1007/s00415-019-09351-8. [Epub ahead of print]
|Authors/Editors:||Decker J, Limburg K, Henningsen P, Lahmann C, Brandt T, Dieterich M.|
It was an incidental observation in our tertiary outpatient dizziness center that patients with acquired bilateral vestibulopathy (BVP) rarely complain about being anxious about falling. This is surprising, since a bilateral vestibular deficit impairs postural stability and thus causes frequent falls, in particular during locomotion on uneven ground and in darkness when vision cannot substitute. In a controlled cross-sectional study, the rate of recurrent fallers was increased in BVP patients despite a low-to-normal fear of falling as determined by the Falls Efficiency Score International. Two epidemiological studies had shown that patients with vestibular disorders with episodic vertigo, such as vestibular migraine and Menière’s disease, suffer from increased psychiatric comorbidity with anxiety and affective disorders, which was not the case in patients with BVP. Furthermore, a recent study on the susceptibility to fear of heights in BVP patients did not demonstrate an increase in susceptibility (29% in BVP vs 28% of the general population) despite an objective higher risk of falling from height. In contrast, patients with other vestibular syndromes showed an increased susceptibility to fear of heights.