Persistent postural-perceptual dizziness as a regulatory dysfunction of the balance system

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Abstract

The problem of chronic functional dizziness is highly relevant nowadays. In case of a great number of patients suffering from persistent postural-perceptual dizziness, lack of a unified understanding of the pathogenesis, diagnostic mistakes, and, as a result, improper treatment lead to a deterioration in the quality of life and disability.

The purpose of the review is to analyse and highlight the persistent postural-perceptual dizziness problem, to explore the currently existing pathogenetic concepts, methods of diagnosis and treatment of this group of patients.

Domestic and foreign scientific papers have been analysed using the largest world citation databases according to the following keywords: “psychogenic dizziness”, “chronic subjective dizziness”, “vestibular rehabilitation”, “stabilometry”, “persistent postural-perceptual dizziness”, “postural phobic instability”, “selective serotonin reuptake inhibitors”, “cognitive behavioral therapy”.

The data of 78 scientific works of the research subject are the basis of the review. The article presents a brief historical background, contemporary conceptions of pathogenesis, symptoms and clinical manifestations of persistent postural-perceptual dizziness. The particular attention is given to the diagnostic methods and treatment principles. Relevant questionnaires and diagnostic scales as well as the Barany Society criteria are also considered. A multidisciplinary approach to treatment which allows to achieve a lasting positive effect is described.

Segregation of persistent postural-perceptual dizziness into a separate nosological item, understanding of its pathogenesis, an integrated approach to diagnosis with assessment of structural, functional and mental disturbances, just like complex therapeutic strategies make а fully recovery possible.

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About the authors

Liudmila M. Mirzaeva

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: salud@yandex.ru
ORCID iD: 0000-0001-9392-1789
SPIN-code: 5331-5670
Scopus Author ID: 57207576116
ResearcherId: GQO-9959-2022

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015

Victor A. Voronov

North-Western State Medical University named after I.I. Mechnikov

Email: voronov.ent@yandex.ru
ORCID iD: 0000-0002-3859-6298
SPIN-code: 2039-6322

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Diana Yu. Demidenko

North-Western State Medical University named after I.I. Mechnikov

Email: terra_rasa@mail.ru
ORCID iD: 0000-0003-4604-5039
SPIN-code: 9756-4850

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Anna K. Savinova

North-Western State Medical University named after I.I. Mechnikov

Email: sawinowa.anka2012@yandex.ru
ORCID iD: 0000-0003-2439-8976
SPIN-code: 6816-6070

студентка 6 курса

Russian Federation, Saint Petersburg

Arina I. Griva

North-Western State Medical University named after I.I. Mechnikov

Email: griva.arina@yandex.ru
ORCID iD: 0000-0002-1098-1418
SPIN-code: 1754-3550

студентка 6 курса

Russian Federation, Saint Petersburg

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