Migraine Associated Vertigo

The correlation between anxiety, depression, and vertigo: a cross-sectional study

Background

Dizziness, including vertigo, affects approximately 15% to over 20% of adults each year. A significant proportion of patients with vertigo develop secondary psychiatric disorders throughout their disease. On the other hand, patients with psychiatric disorders frequently report dizziness as a co-occurring symptom of their illness. The purpose of this study was to screen the prevalence of depression and anxiety indices in dizzy patients and their relation to the severity of their dizziness handicap by administering two different questionnaires: The dizziness handicap inventory (DHI) and the Hospital Anxiety and Depression Scale (HADS). 

Results

Psychological assessments revealed that 49% of the study group was normal, 29% had anxiety, 7% had depression, and 15% had both anxiety and depression. Besides, vestibular neuritis was associated with a higher mean anxiety score, whereas Meniere's disease was associated with a higher mean depression score. 

Conclusion

As this study has shown, there was a statistically significant positive correlation between anxiety and depression scores and physical, emotional, functional, and total DHI scores. Screening and treatment of co-morbid mental health disorders are critical for appropriate management of vertigo disability that leads to a higher quality of life and fewer complications.

The Enduring Controversy of Cervicogenic Vertigo, and Its Place among Positional Vertigo Syndromes

The idea of cervicogenic vertigo (CV) was proposed nearly a century ago, yet despite considerable scrutiny and research, little progress has been made in clarifying the underlying mechanism of the disease, developing a confirmatory diagnostic test, or devising an appropriately targeted treatment. Given the history of this idea, we offer a review geared towards understanding why so many attempts at clarifying it have failed, with specific comments regarding how CV fits into the broader landscape of positional vertigo syndromes, what a successful diagnostic test might require, and some practical advice on how to approach this in the absence of a diagnostic test.

Benign Positional Paroxysmal Vertigo in Children

The aim of this study was to assess the prevalence and analyze clinical parameters of benign positional paroxysmal vertigo (BPPV) in a pediatric age. A cohort of 423 children under the age of 15 (median age 11. interquartile range 9-13) was submitted to vestibular assessment for balance disorders. Dix-Hallpike and Roll-Supine tests were performed to look for positioning nystagmus using video-infrared goggles. BPPV was found in 43 of 423 children evaluated for balance disorders (10.2%). There were 28 females (65.1%) and 15 (34.9%) males. The posterior canal was involved in 79% of cases and the horizontal canal in 21% of cases. No apogeotropic bilateral or anterior canal form were seen. Thus, BPPV is not an infrequent type of vertigo in children and must be evaluated as soon as possible in order to plan the most appropriate maneuver and restore daily activities as soon as possible, avoiding anxiety and fear.