Journal of Neurology

, Volume 252, Issue 5, pp 564–569 | Cite as

Phobic postural vertigo

A long-term follow–up (5 to 15 years) of 106 patients
  • D. Huppert
  • M. Strupp
  • N. Rettinger
  • J. Hecht
  • T. BrandtEmail author


One hundred and six patients diagnosed between 1987 and 1998 to have somatoform phobic postural vertigo were examined in a follow–up study with a selfevaluating questionnaire. The improvement rate after a mean follow–up time of 8.5 years (5 to 15.9 years) was 75% (27% of the patients reported a complete remission). While the majority of these patients experienced improvement or remission during the first year after assessment of diagnosis and a short–term psychotherapeutic approach, some patients also had considerable improvement even after two or more years. There was a negative correlation between the duration of the condition before assessment of the diagnosis and the improvement/regression rate. The improvement/regression rate was independent of gender, age, preceding vestibular or nonvestibular organic disorders, and the various medical, physical, or psychotherapeutic interventions. Transient relapses occurred in 47% of the improved patients once or repeatedly. The probability of developing a relapse remained constant throughout the entire follow–up. None of the patients required a revision of the initial diagnosis on the basis of the questionnaire.

Key words

phobic postural vertigo postural sway follow–up somatoform disorders 


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  1. 1.
    Brandt T (1996) Phobic postural vertigo. Neurology 46:1515–1519PubMedGoogle Scholar
  2. 2.
    Brandt T, Dieterich M (1986) Phobischer Attacken-Schwankschwindel, ein neues Syndrom. Münch Med Wochenschr 128:247–250Google Scholar
  3. 3.
    Brandt T,Dieterich M, Strupp M (2004) Vertigo and dizziness, common complaints. Springer: LondonGoogle Scholar
  4. 4.
    Brandt T, Huppert D, Dieterich M (1994) Phobic postural vertigo: A first follow-up. J Neurol 241:191–195PubMedGoogle Scholar
  5. 5.
    Bronstein AM (1995) Visual vertigo syndrome: clinical and posturography findings. J Neurol Neurosurg Psychiatry 59:472–476PubMedGoogle Scholar
  6. 6.
    Bronstein AM (2004) Vision and vertigo: Some aspects of vestibular disorders. J Neurol 251:381–387PubMedGoogle Scholar
  7. 7.
    Brown JJ, Baloh RW (1987) Persistent mal de débarquement syndrome: a motion-induced subjective disorder of balance. J Otolaryngol 8:219–223Google Scholar
  8. 8.
    Eckardt-Henn A, Breuer P, Thomalske C, Hoffmann SO, Hopf HC (2003) Anxiety disorders and other psychiatric subgroups in patients complaining of dizziness. J Anxiety Disord 431:1–20Google Scholar
  9. 9.
    Erwin BA, Heinberg RG, Juster H, Mindlin M (2002) Comorbid anxiety and mood disorder among persons with social anxiety disorders. Behav Res Ther 40:19–35PubMedGoogle Scholar
  10. 10.
    Furman JM, Jacob RG (1997) Psychiatric dizziness. Neurology 48:1161–1166PubMedGoogle Scholar
  11. 11.
    Hain T, Hanna P, Rheinberger M (1999) Mal de débarquement. Arch Otolaryngol Head Neck Surg 125:615–620PubMedGoogle Scholar
  12. 12.
    Holmberg J, Karberg M, Fransson P-A, Magnusson M (2003) Phobic postural vertigo: body sway during vibratory proprioceptive stimulation. Neuro Report 14:1007–1011Google Scholar
  13. 13.
    Holst E v, Mittelstaedt H (1950) Das Reafferenzprinzip (Wechselwirkungen zwischen Zentralnervensystem und Peripherie). Naturwissenschaften 37:464–476Google Scholar
  14. 14.
    Huppert D, Kunihiro T, Brandt T (1995) Phobic postural vertigo (154 patients): its association with vestibular disorders. J Audiol 4:97–103Google Scholar
  15. 15.
    Jacob RG, Brandt T, Furman JM (2004) Psychiatric aspects of dizziness and imbalance. In: Bronstein AM, Brandt T, Woollacott MH, Nutt JG (eds) Clinical Disorders of Balance, Posture and Gait. Arnold: London, pp 245–285Google Scholar
  16. 16.
    Kapfhammer HP, Mayer C, Hock U, Huppert D, Dieterich M, Brandt T (1997) Course of illness in phobic postural vertigo. Acta Neurol Scand 95:23–28PubMedGoogle Scholar
  17. 17.
    Keller MB, Yonkers KA, Warshaw MG, Pratt LA, Gollan JK, Massion AO, White K, Swartz AR, Reich J, Lavori PW (1994) Remission and Relapse in Subjects with Panic Disorder and Panic with Agoraphobia. J Nerv Ment Dis 182:290–296PubMedGoogle Scholar
  18. 18.
    Marks IM (1981) Space “phobia”: A pseudo-agoraphobic syndrome. J Neurol Neurosurg Psychiatry 44:387–391PubMedGoogle Scholar
  19. 19.
    Murphy T (1993) Mal de débarquement syndrome: A forgotten entity? Otolaryngol Head Neck Surg 109:10–13PubMedGoogle Scholar
  20. 20.
    Noyes R, Reich J, Christiansen J, Suelzer M, Pfohl B, Coryell WA (1990) Outcome of Panic Disorders. Arch Gen Psychiatry 47:809–818PubMedGoogle Scholar
  21. 21.
    Noyes R, Holt CS (1994) Anxiety disorders. In:Winokur G, Clayton PJ (eds) The medical basis of psychiatry. 2nd ed. Philadelphia: SaundersGoogle Scholar
  22. 22.
    Persson G, Alström JE, Nordlund CL (1984) Prognostic factors with four treatment methods for phobic disorders. Acta Psychiatr Scand 69:307–318PubMedGoogle Scholar
  23. 23.
    Pollak L, Klein C, Stryjer R, Kushnir M, Fletcher S, Teitler J (2003) Phobic postural vertigo: a new proposed entity. Isr Med Assoc J 10:720–723Google Scholar
  24. 24.
    Querner V, Krafczyk S, Dieterich M, Brandt T (2002) Phobic postural vertigo. Body sway during visually induced roll vection. Exp Brain Res 143:269–275PubMedGoogle Scholar
  25. 25.
    Querner V, Krafczyk S, Dieterich M, Brandt T (2000) Patients with somatoform phobic postural vertigo: the more difficult the balance task, the better the balance performance. Neurosci Lett 284:21–24PubMedGoogle Scholar
  26. 26.
    Stahl SM, Soefje S (1995) Panic attacks and panic disorder: The great neurologic impostors. Semin Neurol 15:126–132PubMedGoogle Scholar
  27. 27.
    Strupp M, Glaser M, Karch C, Rettinger N, Brandt T (2003) The most common form of dizziness in middle age: phobic postural vertigo. Nervenarzt 74:911–914PubMedGoogle Scholar
  28. 28.
    Yardley L, Redfern MS (2001) Psychological factors influencing recovery from balance disorders. J Anxiety Disord 15:107–119PubMedGoogle Scholar
  29. 29.
    Yonkers KA, Warshaw MG, Massion AO, Keller MB (1996) Phenomenology and Course of Generalised Anxiety Disorder. Br J Psychiatry 168:308–313PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • D. Huppert
    • 1
  • M. Strupp
    • 1
  • N. Rettinger
    • 1
  • J. Hecht
    • 1
  • T. Brandt
    • 1
    Email author
  1. 1.Dept. of NeurologyUniversity of Munich, Klinikum GroßhadernMünchenGermany

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