Prolonged Vertigo Associated with Nystagmus: an Organic or a Psychiatric Disorder? – Discussing a Case Report

  • Naeimehossadat Hosseini Isfahan university of medical sciences , Isfahan , Iran
  • Amir Moghaddam-Ahmadi Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  • Mohammad Ali Abdolkarimi Dawarani Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  • Reza Bidaki Rafsanjan University of Medical Sciences, Rafsanjan, Iran
  • Aboozar TajikSafa Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Keywords: Nystagmus, Vertigo, Somatization disorder

Abstract

Background:It is mostly organic diseases that are considered when a neurological sign or symptom is present in the history of a patient; however, there may be psychiatric problems also present which could be missed. We report a case to discuss the possibility of the presence of an organic or psychiatric underlying disorder when facing neurological problems.Case Presentation:We report a case of chronic headache accompanied by vertigo and multiple medical problems including nystagmus and abdominal pain without any significant findings on physical exam that was diagnosed to have a somatization disorder (Not Otherwise Specified or NOS).Conclusion:We did not find any documents regarding the presence of true nystagmus as a functional, factitious or psychosomatic disorder; however, voluntary nystagmus has been reported in some cases with a series of fast (saccadic) back-to-back eye movements, without any interval or slow phase. It is recommended that psychiatrists and neurologists search for a psychiatric disorder as well; even if the problem is supposed to have an organic nature like nystagmus or vertigo, especially when associated with a prolonged, resistant, or unusual course.

References

Gilain C, Englebert A. Vertigo and psychological disorders. B-ENT. 2008;4(8):49 -58.

Hain TC, Yacovino D. Pharmacologic treatment of persons with dizziness. Neurol Clin. 2005;23(3):831-53.

Strupp M, Brandt T. Diagnosis and treatment of vertigo and dizziness. Dtsch Arztebl Int. 2008;105(10):173-80.

Warner EA, Wallach PM, Adelman HM, Sahlin-Hughes K. Dizziness in primary care patients. J Gen Intern Med. 1992;7(4):454-63.

Abadi RV. Mechanisms underlying nystagmus. J R Soc Med. 2002;95(5):231-4.

Association AP. Diagnostic and statistical manual of mental disorders: DSM-IV-TR: American Psychiatric Publishing, Inc; 2000.

Kallivayalil RA, Punnoose VP. Understanding and managing somatoform disorders: Making sense of non-sense. Indian J Psychiatry. 2010; 52(1):240-5.

Schiefer U, Wilhelm H, Hart W. Clinical Neuro-Ophthalmology: A Practical Guide. Berlin Heidelgberg: Springer-Verlag;2007. p.203-14.

Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed: Elsevier; 2012. Vol 1, p. 609, 621-2, 657.

Published
2013-06-16
How to Cite
Hosseini, N., Moghaddam-Ahmadi, A., Abdolkarimi Dawarani, M. A., Bidaki, R., & TajikSafa, A. (2013). Prolonged Vertigo Associated with Nystagmus: an Organic or a Psychiatric Disorder? – Discussing a Case Report. Galen Medical Journal, 2(2), 83-86. https://doi.org/10.31661/gmj.v2i2.31
Section
Case Report/Series