Balance Disorders: A Review of Patients at a Specialized Vestibular Clinic

Abstract

Introduction: With recent advancements in vestibular assessments, new ancillary tests can assist clinicians to better understand underlying cause of a balance problem. The recently established specialized vestibular clinic in Sultan Ahmad Shah Medical Centre @IIUM is equipped with these tests. This study aimed to determine the prevalence of the different diagnoses of balance disorders in a specialized vestibular clinic in Kuantan, Malaysia. Materials and Methods: This is a retrospective review of 121 walk-in patients over an 18-month period at a specialized Vestibular Clinic in Sultan Ahmad Shah Medical Centre @IIUM. The variables analysed in this review include the age, gender, ethnicity, diagnoses, and total number of visits before diagnoses were achieved. Results: Meticulous history taking, focused otorhinolaryngological examination and detailed vestibular assessment through the specialized vestibular clinic helped us in reaching a conclusive diagnosis. The most common cause of balance disorders in our review was Benign Paroxysmal Positional Vertigo (BPPV), constituting 41.3% of the cases. Among the canals, the posterior canal is the most affected (70%) and is usually treated with Epley manoeuvre. Other common diagnoses include Vestibular Migraine, Meniere’s Disease and Vestibular Neuritis. Conclusion: Vestibular clinics play a vital role in helping to pinpoint the accurate diagnosis of patients with balance disorders.

Effects of Betahistine on Vestibulo-Ocular Reflex in Normal Healthy Adults: A Randomized Double-Blind, Placebo-Controlled Trial

“…A study in a specialized otology clinic in Malaysia in 2013 revealed that the prevalence of vestibular disorder is 32.2%, where the majority of patients were of Malay ethnicity [ 2 ]. According to Wong et al (2022), the most common cause of vestibular disorder is benign paroxysmal positional vertigo (BPPV), which accounts for approximately 41%, followed by vestibular migraine (20.7%), Ménière's disease (5.8%), vestibular neuritis (3.3%), labyrinthitis (1.7%), and chronic vestibulopathy (0.8%) [ 3 ]. Antiemetics, histamine analogs, antihistamines, diuretics, steroids, antivirals, antimicrobials, calcium channel blockers, antidepressants, anticonvulsants, and aminopyridines are common drugs used to treat vertigo [ 4 ].…”