Down on heights? One in three has visual height intolerance
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ORIGINAL COMMUNICATION
Down on heights? One in three has visual height intolerance Doreen Huppert • Eva Grill • Thomas Brandt
Received: 9 July 2012 / Revised: 19 September 2012 / Accepted: 21 September 2012 / Published online: 16 October 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract The distressing phenomenon of visual height intolerance (vHI) occurs when a visual stimulus causes apprehension of losing control of balance and falling from some height. Epidemiological data of this condition in the general population are lacking. Assignment of prevalence, determinants, and compensation of vHI was performed in a cross-sectional epidemiological study of 3,517 individuals representing the German population. Life-time prevalence of vHI is 28 % (females 32 %). A higher prevalence is associated independently with a family history of vHI, anxiety disorders, migraine, or motion sickness susceptibility. Women aged 50–59 have a higher prevalence than younger women or men of all ages. Initial attacks occur most often (30 %) in the second decade; however, attacks can manifest throughout life. The main symptoms are fearfulness, inner agitation, a queasy-stomach feeling, subjective postural instability with to-and-fro vertigo, and weakness in the knees. Climbing a tower is the first most common precipitating stimulus; the spectrum of such
Electronic supplementary material The online version of this article (doi:10.1007/s00415-012-6685-1) contains supplementary material, which is available to authorized users. D. Huppert T. Brandt (&) Institute for Clinical Neurosciences and German Dizziness Center, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany e-mail: [email protected] D. Huppert e-mail: [email protected] E. Grill Institute for Medical Information Processing, Biometrics and Epidemiology (IBE) and German Dizziness Center, Ludwig-Maximilians University, Munich, Germany e-mail: [email protected]
stimuli widens with time in more than 50 % of afflicted individuals. The most frequent reaction to vHI is to avoid the triggering stimuli ([50 %); 11 % of susceptible individuals consult a doctor, most often a general practitioner, neurologist, ENT doctor, or psychiatrist. In brief, visual height intolerance affects one-third of the general population, considerably restricting the majority of these individuals in their daily activities. The data show that the two terms do not indicate a categorical distinction but rather a continuum from slight forms of visual height intolerance to the specific phobia of fear of heights. Keywords Visual height intolerance Fear of heights Acrophobia Height vertigo Epidemiology
Introduction Visual height intolerance (vHI) is a distressing phenomenon. It occurs when a visual stimulus causes apprehension of losing one’s balance (control of stance and gait) and falling from some height. The apprehensive individual may, as a result, avoid such trigger situations, and consequently more and more limit his/her daily life, soc
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