Liječnički vjesnik, Vol. 141 No. 7-8, 2019.
Pregledni rad
https://doi.org/10.26800/LV-141-7-8-24
Functional dizziness in the light of the newly-established entity – Persistent postural-perceptual dizziness
Siniša Maslovara
orcid.org/0000-0001-6480-8146
; Hrvatsko društvo za vestibularnu rehabilitaciju HLZ-a, ORL poliklinika Opće županijske bolnice i bolnice hrvatskih veterana Vukovar, Medicinski fakultet Sveučilišta u Osijeku
Dražen Begić
; Klinika za psihijatriju, Medicinski fakultet Sveučilišta u Zagrebu, KBC Zagreb
Silva Butković-Soldo
; Hrvatsko neurološko društvo Hrvatskoga liječničkog zbora, Klinika za neurologiju KBC-a Osijek, Medicinski fakultet Sveučilišta u Osijeku
Petar Drviš
; Hrvatsko društvo za vestibularnu rehabilitaciju Hrvatskoga liječničkog zbora, Klinika za ORL, Medicinski fakultet Sveučilišta u Splitu, Klinički bolnički centar Split
Ivana Pajić Matić
orcid.org/0000-0002-5778-6695
; Hrvatsko društvo za vestibularnu rehabilitaciju Hrvatskoga liječničkog zbora, ORL odjel Opće bolnice „Dr. Josip Benčević“, Slavonski Brod, Medicinski fakultet Sveučilišta u Osijeku
Anamarija Šestak
; Hrvatsko društvo za vestibularnu rehabilitaciju Hrvatskoga liječničkog zbora, ORL poliklinika Opće županijske bolnice i bolnice hrvatskih veterana Vukovar
Sažetak
Functional dizziness is noted for its frequency and is the second most common cause of dizziness in the general population, most prevalent in the age group of 30–50 years. The classic diagnostic process is aimed
at finding a medical or surgical diagnosis, and in case it is not found, it is said to be caused by a “psychogenic” disease. In recent decades, using a new, integrative way of thinking, there has been a discovery of functional vestibular disorders. They have always been overcome by acute or back vestibular disease due to poor readout of the postural system. The reason for this lies in a close connection to the brain of nerve projections responsible for controlling motion and position of the body in space with those responsible for danger and fear. The Nomenclature and Classification Committee of Barany’s Vestibular Disorders recently established diagnostic criteria for persistent postural-perceptive dizziness (PPPD). This is the most common functional vestibular disorder, which includes the previously established: persistent postural dizziness, visual and chronic subjective dizziness. The dominant symptom of PPPD is non-rotatory dizziness that lasts for at least three months continuously and is always associated with the condition of the body. The hypersensitivity to moving stimuli occurs, including the movements of large visual objects or complex visual stimuli in a wide field of vision and the difficulty of performing precision visual actions. For mild and moderate interferences it is advisable to conduct vestibular rehabilitation, as most patients have provocative factors related to vision and movement. Individually tailored exercises are used to reduce susceptibility to provocative movements, and conditioning exercises are very useful for repairing disturbed body posture. Pharmacotherapeutic treatment with selective serotonin or serotonin and norepinephrine reuptake inhibitors is also indicated. Good results are achieved by the use of cognitive-behavioural psychotherapy, changing of negative automatic thoughts, refocusing attention, re allocation, systematic and gradual exposure or exposure at once, biofeedback etc. The prognosis of the disease is better in patients without comorbidity, while in those with comorbidity it is significantly worse.
Ključne riječi
BENIGN PAROXYSMAL POSITIONAL VERTIGO – diagnosis, physiopathology, psychology, therapy; VESTIBULAR DISEASES – complications, physiopathology; ANXIETY DISORDERS – complications, physiopathology; DIZZINESS – complications, psychology, physiopathology; FEAR – psychology, POSTURE
Hrčak ID:
225751
URI
Datum izdavanja:
27.9.2019.
Posjeta: 7.267 *