Vertigo:an etiological analysis of 200 patients in department of neurology of polyclinic / 中华神经科杂志

ABSTRACT

Objective To discuss the causes of diseases presenting vertigo as a chief complaint in patients in department of neurology of polyclinic and to compare the clinical features of these disease in order to draw the attention of the physicians to benign paroxysmal positional vertigo(BPPV)and posterior circulation ischenmia(PCI).Methods Prospective clinical study was carried out.Followed up outpatients (135)and inpatients(65)with a chief complaint of vertigo were followed up in the department of neurology, the second affiliated hospital of Harbin Medical University.Thorough history, especially the timing and duration of vertigo, provoking and aggravating factors, symptoms associated and risk factors for cerebrovascular were obtained.Physical examinations with special attention to neurologic systems and Dix- Hallpike maneuver were performed.Based on the history, the physical examination, Dix-Hallpike maneuver and special techniques, the diagnoses of 200 patients with vertigo was made.Two weeks after each patient' s first consultation, a follow-up was made.Results The main diagnoses for these 200 patients were BPPV (56.0%), PCI(21.5%), neurosis(13.0%), M?ni?re' s disease(2.5%), multiple sclerosis (1.0%), probably cervical disease(1.0%), acoustic neuroma(1.0%), labyrinthine apoplexy(1.0%), brainstem hemorrhage(0.5%), vestibular neuronitis(0.5%), cerebellum cyst(0.5%), unknown causes (1.5%).Such clinical features of the diseases with vertigo, as age, vertigo duration, and provoking factors, associated symptoms, risk factors, the physical examinations, the treatment and so on were summed up.Conclusions Presentations of vertigo can be clinically diagnosed in most cases, with a larger number of patients suffering from BPPV.Combination of these prominent clinical features may guide the general physicians to the likely causes of vertigo.