Chronic Subjective Dizziness Versus Conversion Disorder: Discussion of Clinical Findings and Rehabilitation Purpose Audiologists frequently encounter patients who complain of chronic dizziness or imbalance, in the absence of active vestibular or neurological deficits. Knowledge about conditions that cause this clinical presentation will allow audiologists to make important contributions to accurate diagnosis and effective management of these patients. This article reviews 2 such ... Clinical Focus: Grand Rounds
Clinical Focus: Grand Rounds  |   June 01, 2010
Chronic Subjective Dizziness Versus Conversion Disorder: Discussion of Clinical Findings and Rehabilitation
 
Author Affiliations & Notes
  • Julie A. Honaker
    University of Nebraska–Lincoln
  • Jane M. Gilbert
    Mayo Clinic, Rochester, MN
  • Jeffrey P. Staab
    Mayo Clinic, Rochester, MN
  • Contact author: Julie A. Honaker, Department of Special Education and Communication Disorders, University of Nebraska–Lincoln, 272 Barkley Memorial Center, Lincoln, NE 68583-0738. E-mail: jhonaker2@unl.edu.
Article Information
Balance & Balance Disorders / Special Populations / Psychogenic Disorders / Clinical Focus / Grand Rounds
Clinical Focus: Grand Rounds   |   June 01, 2010
Chronic Subjective Dizziness Versus Conversion Disorder: Discussion of Clinical Findings and Rehabilitation
American Journal of Audiology, June 2010, Vol. 19, 3-8. doi:10.1044/1059-0889(2009/09-0013)
History: Received June 2, 2009 , Accepted December 11, 2009
 
American Journal of Audiology, June 2010, Vol. 19, 3-8. doi:10.1044/1059-0889(2009/09-0013)
History: Received June 2, 2009; Accepted December 11, 2009
Web of Science® Times Cited: 3

Purpose Audiologists frequently encounter patients who complain of chronic dizziness or imbalance, in the absence of active vestibular or neurological deficits. Knowledge about conditions that cause this clinical presentation will allow audiologists to make important contributions to accurate diagnosis and effective management of these patients. This article reviews 2 such conditions, chronic subjective dizziness (CSD) and conversion disorder.

Method A case of CSD and another of conversion disorder are presented, with a literature review of their clinical presentations, key diagnostic features, and treatment strategies. The role of the audiologist in assessing patients with these conditions and facilitating appropriate treatment referrals is discussed.

Conclusions The audiologist is in a key position to identify individuals with CSD and conversion disorder, 2 conditions that can be effectively managed if properly recognized. The authors demonstrate an effective team approach program that includes the audiologist’s contribution to differential diagnosis, education of patients and other clinicians about these conditions, and development of recommendations for neurological, psychiatric, otologic, and physical therapy referrals.

Acknowledgment
A portion of this article was presented at the American Academy of Audiology’s annual conference on April 1–4, 2009, in Dallas, TX.
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