Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study

Colledge, N.R.; Barr-Hamilton, R. M.; Lewis, Susan J.; Sellar, Robin; Wilson, Janet A

doi:10.1136/bmj.313.7060.788

Cited by 177 publications

(173 citation statements)

References 29 publications

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“…28 The proportion of subjects with vertigo (41%) was slightly higher than in previous studies. [3][4][5][6][7] In the present study, as well as in previous studies, dizziness/vertigo was more common for women than for men in all age groups. 7,[9][10][11][12][13][14]29 However, women also have higher rates of sickness absence in general, 19,30,31 often explained by occupational differences.…”

Section: Comparison With Existing Literaturesupporting

confidence: 57%

“…Treatment in primary care typically consists of reassurance and medication to relieve symptoms, 3,5,6,35 even though medication is not recommended beyond the acute stage. 3,5,36 Referral to vestibular rehabilitation [37][38][39][40] is uncommon in primary care. 17,36,41 Lack of guidelines may lead to persistent complaints with disability pension as the endpoint.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

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Occupational disability caused by dizziness and vertigo: a register-based prospective study

Skøien¹,

Wilhemsen²,

Gjesdal³

2008

Br J Gen Pract

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Section: Comparison With Existing Literaturesupporting

confidence: 57%

Section: Comparison With Existing Literaturementioning

confidence: 99%

Occupational disability caused by dizziness and vertigo: a register-based prospective study

Skøien¹,

Wilhemsen²,

Gjesdal³

2008

Br J Gen Pract

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“…As doenças vestibulares periféricas são identificadas como causa primária ou fator contribuinte entre 4 a 64% dos pacientes [15][16][17] . Da mesma forma, alterações vasculares são identificadas em até 70%, doenças psiquiátri-cas em até 40%, doenças cervicais, especialmente a espondiloartrose, em 0% a 66% 16,18,19 . A freqüência de casos em que a etiologia não pode ser identificada varia de 8 a 22%, enquanto múltiplos diagnósticos são feitos em até 85% dos casos.…”

Section: Discussionunclassified

Perfil diagnóstico do idoso portador de desequilíbrio corporal: resultados preliminares

Simoceli

Bittar

Bottino

et al. 2003

Rev. Bras. Otorrinolaringol.

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FORMA DE ESTUDO: Estudo de corte transversal. MATERIAL E MÉTODOS: Os autores avaliaram 55 pacientes que procuraram o Ambulatório de Otoneurologia Geriátrica do Hospital das Clínicas do HCFMUSP com queixa de desequilíbrio e/ou tontura entre agosto de 2001 e março de 2003, caracterizando o perfil dessa população de idosos quanto a idade, sexo, fatores etiológicos relacionados à alteração do equilíbrio, conduta terapêutica adotada e resultados parciais de tratamentos propostos. RESULTADOS: O paciente idoso com alteração do equilíbrio corporal apresentou mais de uma etiologia relacionada ao seu problema em 51% dos casos, sendo as patologias mais freqüentes: Insuficiência Vértebro-Basilar - IVB (40%), Alteração Metabólica relacionada a metabolismo de açúcar e colesterol (40%), Síndrome do Desequilíbrio de Idoso - SDI (30%), Vertigem Posicional Paroxística Benigna - VPPB (14,5%), Vestibulopatia Cervical (7,2%) e Alterações Hormonais (5,4%), entre outras. CONCLUSÃO: Estes achados corroboram dados prévios da literatura e chamam a atenção para a necessidade de uma abordagem multidisciplinar para a compreensão do desequilíbrio e seu adequado tratamento na população idosa.

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“…The occurrence of vertigo is frequent in real-world settings and is associated with a substantial individual and healthcare burden. 1,18,19 Vertigo due to vestibular origin accounts for a large percentage of this burden, which necessitates optimum treatment. This large-scale pan-India registry helped to generate data regarding the entire spectrum of clinical presentation of vertigo, emphasizing importance of detailed history taking of vertigo attacks -duration and frequency of episodes at baseline and also for evaluating the effectiveness of antivertigo treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinicoetiological pattern and pharmacotherapy practices in patients with new onset vertigo: findings from a prospective multicenter registry in India

Kameswaran

Pujari²,

Singh³

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: The objective was to evaluate the clinicoetiological pattern and pharmacotherapy practices of new onset vertigo in India. Methods: This multicentre, prospective, registry was conducted in adult patients across 37 centres. Enrolled patients were followed at week 1, month 1 and 3 to assess clinicoetiological characteristics, prescribed pharmacotherapy, safety and effectiveness of treatment. Results: Of the 1520 patients enrolled, 1428 (93.95%) completed the study. The mean (SD) age was 50.2 (±15.37) years and 53.2% were women. Of 202 patients reporting co-morbidities, 55.4% had cardiovascular disease and 38.6% had diabetes mellitus. Peripheral causes were predominant in majority (74.3%); benign paroxysmal positional vertigo (BPPV) being the most frequent (67.58%). Migraine affected 68.9% (80/116) patients, .as the central cause. Betahistine (74.6%) and prochlorperazine (21.75%) were the top two drugs of choice irrespective of origin, preferred by all treating specialists. Both the drugs significantly prevented recurrence by week 1 (prochlorperazine: 76.6%; betahistine: 64.2%) (p<0.001) and over 3 months. A lower daily dose of betahistine (15.6±5.26 mg) was preferred. Almost half complained of nausea and vomiting; prochlorperazine significantly reduced recurrence of both within a week (p<0.001). The treatments were well-tolerated with no reported adverse drug reactions. Conclusions: The study demonstrates vestibular vertigo, BPPV to be the dominant type in Indian patients with new onset vertigo. Betahistine and prochlorperazine top the physicians’ preference list, with equal benefits in preventing recurrence. Prochlorperazine has an additional antinausea and antiemetic property, thereby may improve patient satisfaction. Prescription of a lower dose of betahistine calls for the need to sensitize physicians.

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Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study

Abstract: Expensive investigations are rarely helpful in dizzy elderly people. The cause of the dizziness can be diagnosed in most cases on the basis of a thorough clinical examination without recourse to hospital referral.

Cited by 177 publications

References 29 publications

Occupational disability caused by dizziness and vertigo: a register-based prospective study

Occupational disability caused by dizziness and vertigo: a register-based prospective study

Perfil diagnóstico do idoso portador de desequilíbrio corporal: resultados preliminares

Clinicoetiological pattern and pharmacotherapy practices in patients with new onset vertigo: findings from a prospective multicenter registry in India

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