(PHILADELPHIA) – Approximately 9 million
to 15 million people in the U.S. suffer from recurrent bouts of
dizziness and 3 million experience symptoms of dizziness nearly
every day. According to a paper that appears in the February
issue of Archives of
Otolaryngology–Head & Neck Surgery,
researchers at the University of Pennsylvania School of
Medicine found that chronic subjective dizziness (CSD)
may have several common causes, including anxiety
disorders, migraine,
mild traumatic brain
injuries, and neurally mediated dysautonomias – disorders
in the autonomic
nervous system, which controls involuntary actions.
Among the various forms of dizziness, clinicians have found CSD
to be particularly vexing. “Patients with CSD experience
persistent dizziness not related to vertigo, imbalance, and hypersensitivity
to motion, which is heightened in highly visual settings, such
as walking in a busy store or driving in the rain,” says Jeffrey
P. Staab, MD, MS, Assistant Professor, Departments of
Psychiatry and Otorhinolaryngology at Penn, and coauthor of the
paper.
Staab and coauthor, Michael
J. Ruckenstein, MD,
Associate Professor, Department
of Otorhinolaryngology at Penn, studied 345 men
and women age 15 to 89 (average age 43.5) who had dizziness for
three months or longer due to unknown causes. From
1998 to 2004, the patients were tracked from their referral to
Penn’s Balance Center through multiple specialty examinations
until they were given a diagnosis.
“All but six patients were diagnosed as having psychiatric or neurologic conditions, including primary or secondary anxiety
disorders, migraine, traumatic brain injury and neurally mediated
dysautonomias,” said Ruckenstein. Most patients (59.7%)
had CSD with anxiety, 38.6% had CSD and illnesses of the central
nervous system (migraine, traumatic brain injuries, or dysautonomias),
and 1.7% had CSD and irregular
heartbeats.
Two-thirds of patients had medical conditions associated with
the onset of dizziness, whereas one-third had anxiety disorders
as the initial cause. Therefore, CSD may be triggered by
either neurologic or psychiatric conditions.
Key diagnostic features were identified in the clinical history
for each illness. For example, those with migraines often
had nausea or vomiting, anxiety disorders were associated with
fear and worry, and those with dysautonomias tended to become dizzy
when they exerted themselves. “Careful inquiry about
these key features during exams may lead to better diagnoses and
more specific treatment recommendations for the many patients with
chronic dizziness who have not found a cause for their symptoms
and those who have been given diagnoses that have not brought them
relief,” says Staab.
This study was not supported by commercial funding.
###
PENN Medicine is a $2.9 billion enterprise
dedicated to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine consists
of the University of Pennsylvania School of Medicine (founded in
1765 as the nation's first medical school) and the University of
Pennsylvania Health System.
Penn's School of Medicine is ranked #2 in the nation for receipt
of NIH research funds; and ranked #3 in the nation in U.S. News
& World Report's most recent ranking of top research-oriented
medical schools. Supporting 1,400 fulltime faculty and 700 students,
the School of Medicine is recognized worldwide for its superior
education and training of the next generation of physician-scientists
and leaders of academic medicine.
The University of Pennsylvania Health System includes three hospitals,
all of which have received numerous national patient-care honors [Hospital
of the University of Pennsylvania; Pennsylvania Hospital, the nation's
first hospital; and Penn Presbyterian Medical Center]; a faculty practice
plan; a primary-care provider network; two multispecialty satellite
facilities; and home care and hospice.
Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.
The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Home to a proud history of “firsts” in medicine, Penn Medicine teams have pioneered discoveries and innovations that have shaped modern medicine, including recent breakthroughs such as CAR T cell therapy for cancer and the mRNA technology used in COVID-19 vaccines.
The University of Pennsylvania Health System’s patient care facilities stretch from the Susquehanna River in Pennsylvania to the New Jersey shore. These include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Lancaster General Health, Penn Medicine Princeton Health, and Pennsylvania Hospital—the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.
Penn Medicine is an $11.1 billion enterprise powered by more than 49,000 talented faculty and staff.