Evaluation of the dizzy patient: experience from a multidisciplinary neurotology clinic

Heaton, Judith M.; Barton, Jason J.S.; Ranalli, Paul J.; Tyndel, Felix; Mai, Ryan

doi:10.1017/s0022215100143063

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…Vertigo mostly affected patients aged between 43 and 49 years and more often in woman (male:female ratio 1:1.7-2.6), Table 1. Age at presentation in the present series are similar to those reported from Canada (50 years) [1,7] but younger than Spain (57.6 years) [8].…”

Section: Resultssupporting

confidence: 86%

“…Hearing and vestibular impairment are the main sequelae in patients with S. suis meningitis [10]. The number of patients with psychogenic vertigo in this study and the other studies in Thailand were substantially lower (0.1-2.6%) than previously reported (5.1-11.5%) [1,7,8]. Psychiatric disorder was reported, either as a primary or a contributing factor in 40% of cases with persistent dizziness, but was considered primary in only 16% [11].…”

Section: Discussioncontrasting

confidence: 61%

“…In the ENT clinic, peripheral vestibular disorder is the main diagnostic category (72.9%), as seen in other studies in Thailand (60.4-82.2%) and in Europe and North America (57.5-65.5%) [1,7,8] The percentage of patients with a definitive diagnosis being ascertained in this study was 73.9% (404 of 547 cases), similar to a study by Katsarkas in Montreal, Canada (79.4%) [9]. Some studies reported 94.9-99% of cases diagnosed with definitive etiology of vertigo, which included motion sickness, glaucoma, renal insufficiency, diabetes, fibromyalgias, orthostatic syncope, presyncope, unspecified cardiovascular, or Costen's syndrome [8].…”

Section: Discussionmentioning

confidence: 56%

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Causes and time-course of vertigo in an ear, nose, and throat clinic

Isaradisaikul

Navacharoen

Hanprasertpong

et al. 2010

Eur Arch Otorhinolaryngol

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The purpose of this study is to review etiologies and identify the time-course of vertigo presenting in an ear, nose, and throat clinic, and serve as a reference guide for other clinics. The study includes retrospective chart review in a tertiary care, university hospital. The patient data with reported ICD-10 codes as causes of vertigo between April 2005 and December 2007 were extracted from the database. At each visit, the main diagnosis as to etiology, characteristics of the vertigo, its time-course, and patient demographic data were recorded. Of 547 cases, 17 diagnoses were made in 73.9%. Diagnostic categories included peripheral vertigo 72.9%, central vertigo 0.8%, psychogenic cause 0.2%, and unknown 26.1%. Common causes of vertigo were benign paroxysmal positional vertigo (BPPV) 52.5%, Meniere's disease 14.6%, and sudden idiopathic hearing loss 2.9%. Less common diagnoses were benign paroxysmal vertigo of childhood 0.7%, labyrinthitis 0.7%, and vestibular schwannoma 0.3%. Rare conditions were delayed endolymphatic hydrops, Ramsey Hunt syndrome, otosyphilis, vestibular neuritis, temporal bone fracture, post-concussion syndrome, cerebellar infarction, epilepsy, cervical vertigo, Streptococcus suis meningitis, and psychogenic vertigo. Ninety-nine cases who reported remission of vertigo during the study period had median onset of the remission at 4 weeks. In the ear, nose, and throat clinic at Chiang Mai University, a tertiary university hospital, peripheral vestibular disorders were the main etiology of vertigo. The three most common causes were BPPV, Meniere's disease, and sudden idiopathic hearing loss. Half of the cases who returned for follow up had remitted symptoms within 4 weeks.

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Section: Resultssupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 56%

See 1 more Smart Citation

Causes and time-course of vertigo in an ear, nose, and throat clinic

Isaradisaikul

Navacharoen

Hanprasertpong

et al. 2010

Eur Arch Otorhinolaryngol

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“…On the other hand, we could not come to a diagnosis in 11% of the cases - this is in line with publications from other tertiary dizziness centres [3,4,5]. Furthermore, it should be noted that a majority of patients did not come to our centre for reassurance, but for a new or clearer diagnosis - again, this is in contrast to the results from the survey among consultants mentioned above.…”

Section: Discussionsupporting

confidence: 86%

Referrals to a Specialised Dizziness Clinic often Result in Revised Diagnoses and New Therapeutic Advice

Leeuwen

Zaag-Loonen²

2014

Eur Neurol

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Background: Patients with dizziness are frequently referred to specialised centres for a second opinion. The incremental diagnostic and therapeutic yield of this approach has rarely been studied. Aim of the Study: How often is a new diagnosis or treatment advice given to patients with dizziness who are referred for a second opinion to a tertiary multi-disciplinary expertise centre? Methods: In a prospective observational study, the following data were collected: reason for referral, diagnosis and treatment made by ENT surgeon and a neurologist in consensus. Results: In the complete group of patients (n = 327), a new (or amended) diagnosis was made in 54% and 62% of the patients received a new treatment advice. Conclusion: Referral of selected dizzy patients to a multidisciplinary centre provides a revised diagnosis or treatment recommendation for a majority of patients. i 2014 S. Karger AG, Basel

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“…Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness, accounting for 22-32% of peripheral vestibular pathologies presenting to dizziness clinics [1,2]. Patients with BPPV complain of brief recurrent episodes of vertigo triggered by head movement [3].…”

Section: Introductionmentioning

confidence: 99%

Benign paroxysmal positional vertigo nurse-led follow-up clinic

Reddy

Sargent

Prior

2010

Eur Arch Otorhinolaryngol

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Patients with benign paroxysmal positional vertigo (BPPV) often require multiple appointments for treatment with Epley manoeuvres. Waiting times for medical follow up can be very long. To reduce waiting times and increase availability of ENT outpatients' appointments, a nurse-led dizziness clinic (NLDC) to follow up BPPV patients was established. Prospective audit of 99 consecutive patients attending the NLDC, at which patients are assessed and treated, was conducted. Non-responders are redirected for further medical review. 99 patients were seen in 200 appointments in the NLDC from July 2007 to May 2009. The mean time to NLDC was 16 days. 67 patients were discharged from the NLDC free of symptoms. Cost analysis revealed savings of £3,800. A survey of NLDC attendees revealed that the care they received was rated as excellent, very good or good by 92% of patients. In conclusion, the NLDC is an innovation which increases availability of ENT outpatient appointments. This is acceptable to patients and is a natural extension of the roles of ENT nurse practitioners which could be implemented in other ENT departments.

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Evaluation of the dizzy patient: experience from a multidisciplinary neurotology clinic

Cited by 11 publications

References 12 publications

Causes and time-course of vertigo in an ear, nose, and throat clinic

Causes and time-course of vertigo in an ear, nose, and throat clinic

Referrals to a Specialised Dizziness Clinic often Result in Revised Diagnoses and New Therapeutic Advice

Benign paroxysmal positional vertigo nurse-led follow-up clinic

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