Phobic postural vertigo

The syndrome of phobic postural vertigo is characterized by a combination of non-rotational dizziness, subjective disturbance in the upright posture and during gait, despite normal clinical balance tests. Postural vertigo most frequently occurs in form of attacks. It may be accompanied by anxiety and panic symptoms. It is almost invariably associated with particular constellations of perceptual stimuli or social situations. There is a tendency for rapid conditioning, generalization, and avoidance behavior to develop. An obsessive-compulsive type personality in patients is often found. Frequently, onset of condition follows periods of particular psychosocial stress or after somatic illnesses usually a vestibular disorder. Despite a considerable rate of improvement in vertigo complaints, a psychiatric comorbidity in a subgroup of patients must be respected during the course of illness. Educative information on the mechanism and possible releasing factors and behavioural therapeutic techniques with self-controlled exposure behaviour are the main therapeutic approaches.