A clinical taxonomy of dizziness and anxiety in the otoneurological setting

Dizziness can be associated with otologic, neurologic, medical, and psychia tric conditions. This paper focuses on the interface between otologic and p sychiatric conditions. Because dizziness often is situation specific, conce pts of space and motion sensitivity (SMS), space and motion discomfort (SMD ), and space and motion phobia (SMP) are needed to understand the interface . We present a framework involving several categories of interactions betwe en balance and psychiatric disorders. The first category is that of dizzine ss caused by psychiatric disorder (psychiatric dizziness), including hyperv entilation-induced dizziness during panic attacks. The second category invo lves chance cooccurrence of a psychiatric disorder and a balance disorder i n the same patient. The third category involves problematic coping with bal ance symptoms (psychiatric overlay). The fourth category provides psycholog ical explanations for the relationship between anxiety and balance disorder s, including somatopsychic and psychosomatic relationships. The final categ ory, neurological linkage, focuses on the overlap in the neurological circu itry involved in balance disorders and anxiety disorders. (C) 2001 Elsevier Science Inc. All rights reserved.