Anxiety in the First Attack of Vertigo

BACKGROUND Although psychiatric disturbances have been reported in chronic vestibular disorders, little is known about the psychological impact of an acute vertigo attack. METHODS We conducted a comparative questionnaire study in 30 patients with a first attack of vestibular dysfunction and in 35 patients with a nonvesicular neurologic deficit of acute onset. RESULTS Patients with vertigo reported more anxiety than patients with nonvestibular neurologic deficits ( P = 0.002), despite the fact that premorbid anxiety was similar in both groups ( P = 0.5). No difference in anxiety levels was found between vertigo patients who vomited and those who were free of vegetative symptoms ( P = 0.97). Vertigo patients felt more disabled than nonvertigo patients ( P = 0.06), irrespective of the objective restrictions caused by the disease. The rate of depression did not differ between the groups of patients ( P = 0.09). CONCLUSION Patients with acute vertigo experience extreme anxiety, and this contributes to their feeling of disproportionate disability. The reason for emotional disturbances in vestibular dysfunction is probably the result of physiological connections between the vestibular and limbic system and deserves further neuroanatomic investigation.