Behavior therapy for vestibular rehabilitation

Patients with panic disorder and patients with vestibular disorders often s hare symptomatology, such as dizziness, spatial disorientation, and anxiety in particular environments. Because of the similar clinical presentations, it is not always apparent whether these symptoms are due primarily to a ve stibular disorder or to panic disorder. Depending on where and how these pa tients enter the medical system, their symptoms may be remedied by treatmen t from behavioral therapists or physical therapists trained in vestibular r ehabilitation. Although vestibular rehabilitation developed independently o f behavioral treatment for anxiety disorders, there are remarkable similari ties in treatment conceptualization and implementation. For example, both u se exposure procedures designed to produce habituation of dizziness and dis orientation, as well as enhancing functional compensation. Furthermore, the re appears to be a subset of individuals with panic disorder who also have vestibular pathology and thus, may benefit From both interventions. In this paper, similarities and differences in the clinical presentation, treatmen t goals, and specific interventions for patients with panic disorder or ves tibular pathology is examined, and future implications are discussed. (C) 2 001 Elsevier Science Inc. All rights reserved.