Central Vestibular Dysfunction in an Otorhinolaryngological Vestibular Unit: Incidence and Diagnostic Strategy
Int. arch. otorhinolaryngol. (Impr.)
;
18(3): 235-238, Jul-Sep/2014.
Artigo
em Inglês
| LILACS
| ID: lil-720857
ABSTRACT
Introduction:
Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis.Objective:
The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit.Methods:
This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required.Results:
There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years). Provisional videonystagmography (VNG) results were 40% benign paroxysmal positional vertigo (BPPV), 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41) had magnetic resonance imaging (MRI) and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23%) were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus).Conclusions:
Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions...
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Doenças Vestibulares
Tipo de estudo:
Estudo diagnóstico
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Pesquisa qualitativa
/
Fatores de risco
Limite:
Adulto
/
Idoso
/
Humanos
Idioma:
Inglês
Revista:
Int. arch. otorhinolaryngol. (Impr.)
Assunto da revista:
Otorrinolaringologia
Ano de publicação:
2014
Tipo de documento:
Artigo
País de afiliação:
Egito
Instituição/País de afiliação:
Ain-Shams University/EG
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