Functional dizziness: from diagnostic criteria to clinical profiles and therapy. Expert consensus
M. V. Zamergrad,
V. A. Parfenov,
O. D. Ostroumova,
A. L. Guseva,
O. V. Zaytseva,
Yu. P. Sivolap,
I. V. Kukes,
V. A. Voronov https://doi.org/10.14412/2074-2711-2024-4-4-13
Abstract
Functional dizziness (FD) is the most common form of chronic dizziness, accounting for up to 20% of all cases of chronic dizziness and is diagnosed in 40% of patients referred to specialized clinics. This article discusses the pathogenesis, clinical manifestations and diagnostic features of FD. An overview of standard and new methods of drug therapy and methods of vestibular rehabilitation for patients with FD is provided. Experts conclude that FD, currently defined as persistent postural perceptual dizziness (PPPD), is the most common cause of chronic non-rotational dizziness. PPPD is thought to be multifactorial; central and peripheral vestibular disorders, anxiety disorders and traumatic brain injury are noted as possible precipitating causes. The diagnosis of PPPD is based on the presence of a feeling of unsteadiness or non-rotational dizziness occurring more than half of the days over a period of three months or longer, when other possible causes of dizziness have been ruled out. When managing a patient with PPPD, it is necessary to inform the patient about the nature of the disease, provide a patient with an education program and apply psychotherapy and vestibular rehabilitation methods. The use of buspirone prolonged-release tablets (Vespirate®) and vestibular rehabilitation in clinical practice is discussed.
Keywords
dizziness,
functional dizziness,
persistent postural perceptual dizziness,
buspirone,
selective serotonin reuptake inhibitors
Supporting agencies: The expert council on functional dizziness was held by the Association of Interdisciplinary Medicine with the support of “Valenta Pharm” JSC
About the Authors
M. V. Zamergrad
Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; Russian Clinical and Research Center of Gerontology, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Maxim Valeyrevich Zamergrad
Department of Neurology with a course of reflexology and manual therapy
125993; 2/1, Barrikadnaya St., Build. 1; 129226; 16, 1st Leonova St.; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
V. A. Parfenov
N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
Department of Nervous Diseases and Neurosurgery
119021; 11, Rossolimo St., Build. 1; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
O. D. Ostroumova
Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Department of Neurology with a course of reflexology and manual therapy
125993; 2/1, Barrikadnaya St., Build. 1; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
A. L. Guseva
N.I. Pirogov Russian Research Medical University, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Faculty of General Medicine; Acad. B.S. Preobrazhensky Department of Otorhinolaryngology
117152; 18A, Zagorodnoe Shosse, Build. 2; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
O. V. Zaytseva
National Medical Research Center for Otorhinolaryngology, Federal Medico-Biological Agency of Russia
Russian Federation
Competing Interests:
Russian Federation
123182; 30, Volokolamskoye Shosse, Build. 2; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
Yu. P. Sivolap
Patrice Lumumba Peoples' Friendship University of Russia (RUDN University)
Russian Federation
Competing Interests:
Russian Federation
Faculty of Continuing Medical Education; Department of Psychiatry, Psychotherapy and Psychosomatic Pathology
117198; 6, Miklukho-Maklaya St.; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
I. V. Kukes
Autonomous non-profit organization “International Association of Clinical Pharmacologists and Pharmacists”
Russian Federation
Competing Interests:
Russian Federation
109240; 11, Yauzskaya St., Build. 10; Moscow
Competing Interests:
The conflict of interests did not affect the results of the study
V. A. Voronov
Treatment and Consultation Center “Noise and Dizziness”, North-Western State Medical University named after I.I. Mechnikov, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
191015; 11, Yauzskaya St., Build. 10; St. Petersburg
Competing Interests:
The conflict of interests did not affect the results of the study
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Zamergrad MV, Parfenov VA, Ostroumova OD, Guseva AL, Zaytseva OV, Sivolap YP, Kukes IV, Voronov VA. Functional dizziness: from diagnostic criteria to clinical profiles and therapy. Expert consensus. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2024;16(4):4-13. (In Russ.) https://doi.org/10.14412/2074-2711-2024-4-4-13
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