期刊论文详细信息
Journal of Otolaryngology-Head & Neck Surgery
Neurotology symptoms at referral to vestibular evaluation
Fátima Gómez-Alvarez1  Verónica Ramos-Toledo2  Leticia Viveros-Rentería2  Aralia Gutierrez-Marquez2  Kathrine Jáuregui-Renaud1 
[1] Unidad de Investigación Médica en Otoneurología, Planta baja del Edificio C-Salud en el Trabajo Centro Médico Nacional siglo XXI, IMSS, Av. Cuauhtémoc 330, Colonia Doctores, CP 06720, México, DF, México;Departamento de Audiología y Otoneurología, HG CMN La Raza, Instituto Mexicano del Seguro Social, México DF, México
关键词: Dizziness;    Vertigo;    Vestibular;   
Others  :  861546
DOI  :  10.1186/1916-0216-42-55
 received in 2013-07-31, accepted in 2013-11-23,  发布年份 2013
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【 摘 要 】

Background

Dizziness-vertigo is common in adults, but clinical providers may rarely diagnose vestibular impairment and referral could be delayed. To assess neurotology symptoms (including triggers) reported by patients with peripheral vestibular disease, during the year just before their referral to vestibular evaluation.

Methods

282 patients with peripheral vestibular disease and 282 control subjects accepted to participate. They had no middle ear, retinal, neurological, psychiatric, autoimmune or autonomic disorders. They reported their symptoms by a standardized questionnaire along with their anxiety/depression symptoms.

Results

Patients were referred after months or years from the onset of their symptoms, 24% of them reported frequent falls with a long clinical evolution; 10% of them reported no vertigo but instability related to specific triggers; 86% patients and 12% control subjects reported instability when moving the head rapidly and 79% patients and 6% control subjects reported instability when changing posture. Seven out of the 9 symptoms explored by the questionnaire allowed the correct classification of circa 95% of the participants (Discriminant function analysis, p < 0.001). High blood pressure, dyslipidemia and anxiety/depression symptoms showed a mild correlation with the total score of symptoms (multiple R2 =0.18, p < 0.001).

Conclusions

Late referral to vestibular evaluation may underlie a history of frequent falls; some patients may not report vertigo, but instability related to specific triggers, which could be useful to prompt vestibular evaluation. High blood pressure, dyslipidemia and anxiety/depression symptoms may have a mild influence on the report of symptoms of vestibular disease in both, patients and control subjects.

【 授权许可】

   
2013 Jáuregui-Renaud et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Hanley K, O’ Dowd T, Considine N: A systematic review of vertigo in primary care. Br J Gen Pract 2001, 51:666-671.
  • [2]Burt CW, Schappert SM: Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1999–2000. Vital Health Stat 2004, 13:1-70.
  • [3]Kerber KA, Meurer WJ, West BT, Fendrick M: Dizziness presentations in U.S. emergency departments, 1995–2004. Acad Emerg Med 2008, 15:744-750.
  • [4]Kroenke K, Hoffman RM, Einstadter D: How common are various causes of dizziness? A critical review. South Med J 2000, 93:160-167.
  • [5]Polensek SH, Tusa RJ, Sterk CE: The challenges of managing vestibular disorders: a qualitative study of clinicians’ experiences associated with low referral rates for vestibular rehabilitation. Int J Clin Pract 2009, 63:1604-1612.
  • [6]Wilhelmsen K, Ljunggren AE, Goplen F, Eide GE, Nordahl SH: Long-term symptoms in dizzy patients examined in a university clinic. BMC Ear Nose Throat Disord 2009, 9:2.
  • [7]Gutierrez MA, Jáuregui-Renaud K, Viveros RL, Villanueva PL: Discapacidad por enfermedad auditiva y vestibular en un centro de atención especializada. Gac Med Mex 2005, 141:105-110.
  • [8]Rascol O, Montastruc JL: Drug therapy of vértigo. Rev Prat 1994, 44:354-360.
  • [9]Phillips JS, FitzGerald JE, Bath AP: The role of the vestibular assessment. J Laryngol Otol 2009, 123:1212-1215.
  • [10]Bayer O, Warninghoff JC, Straube A: Diagnostic indices for vertiginous diseases. BMC Neurol 2010, 10:98.
  • [11]Yardley L, Masson E, Verschuur C, Luxon L, Haacke NP: Symptoms, anxiety and handicap in dizzy patients:development of the vertigo symptom scale. J Psychosom Res 1992, 36:731-741.
  • [12]Eagger S, Luxon L, Davies RA, Cohelo A, Ron MA: Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical neurotological study. J Neurol Neurosurg Psychiatry 1992, 55:383-387.
  • [13]Jáuregui-Renaud K, Gutierrez A, Viveros L, Villanueva L: Síntomas de inestabilidad corporal y enfermedad vestibular. Rev Med Inst Mex Seg Social 2003, 41:373-378.
  • [14]Goldberg D, Williams P: A users Guide to the General Health Questionnaire. London: nferNelson; 1988.
  • [15]Calderón NG: Cuestionario clínico para el diagnóstico de los cuadros de depresión. Rev Med Inst Mex Seg Social 1992, 30:377-380.
  • [16]Bamiou DE, Davies RA, McKee M, Luxon LM: Symptoms, disability and handicap in unilateral peripheral vestibular disorders. Effects of early presentation and initiation of balance exercises. Scand Audiol 2000, 29:238-244.
  • [17]Pothula VB, Chew F, Lesser TH, Sharma AK: Falls and vestibular impairment. Otolaryngol Allied Sci 2004, 29:179-182.
  • [18]Kristinsdottir EK, Nordell E, Jarnlo GB, Tjäder A, Thorngren KG, Magnusson M: Observation of vestibular asymmetry in a majority of patients over 50 years with fall-related wrist fractures. Acta Otolaryngol 2001, 121:481-485.
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