Comorbid disorders and therapy of persistent postural perceptual dizziness

Autor: E. N. Zastenskaya, L. M. Antonenko
Jazyk: ruština
Rok vydání: 2023
Předmět:
Zdroj: Неврология, нейропсихиатрия, психосоматика, Vol 15, Iss 4, Pp 66-73 (2023)
Druh dokumentu: article
ISSN: 2074-2711
2310-1342
DOI: 10.14412/2074-2711-2023-466-73
Popis: Persistent postural perceptual dizziness (PPPD) is the most common cause of vague chronic vertigo and severely limits patients' quality of life.Limited data are available on comorbidities, the typical treatment of patients with PPPD, and the efficacy of combination therapy for PPPD.Objective: to identify comorbid disorders and evaluate the efficacy of complex therapy in patients with PPPD.Material and methods. Sixty patients (mean age 42.5±13.8 years) with PPPD were studied. All patients were prescribed complex treatment that included antidepressants (selective serotonin reuptake inhibitors), vestibular exercises, and an educational program. In 28 patients, Arlevert (combination of cinnarizine 20 mg + dimenhydrinate 40 mg) was used as drug therapy. A clinical otoneurologic examination, videonystagmography, assessments by Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Spielberger State-Trait Anxiety Inventory (STAI), Dizziness Handicap Inventory (DHI) and otoneurologic examination were performed at baseline and at the end of treatment (mean, one month).Results. All patients had previous misdiagnoses, among which vertebrobasilar insufficiency and chronic cerebral ischemia predominated. Thirty two (53.33%) patients with PPPD had anxiety-depressive disorders (ADD) as the main comorbidity, 20 (33.33%) patients had migraine, 8 (13.33%) patients had previously had peripheral vestibular disorders that were not diagnosed. The severity of dizziness according to the otoneurological questionnaire and the DHI decreased after one month of therapy in the group with PPPD and ADD from 44.00±16.80 to 29.6±12.80 points (p
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