Etiology of dizziness among patients referring to an Iranian ear, nose and throat clinic

Abstract

Background and Aim: Dizziness is one the most common complaints of patients in the emergency rooms. It has various etiologies and can lead to falling and other life-threatening injuries, especially in the elderly. Dizziness aff­ects the quality of life and results in negative emotional reactions. This research studied the etiology of dizziness in a three-year study.

Methods: This study was conducted on 650 patients with the complaint of dizziness, whose specialists suspected them of having possible vestibular involvement, referred to a tertiary audiology clinic from 2015 to 2018. Videonys­tagmography, electrocochleography and cervical vestibular evoked myogenic potentials were administered. Other medical tests including neu­rologic examinations, blood analysis, and brain imaging were performed based on patients’ complaints.

^* Corresponding author: Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Piche-Shemiran, Enghelab Ave., Tehran, 1148965141, Iran. Tel: 009821-77530636,
E-mail: audiology_zamiri@yahoo.com

Results: This was a descriptive study of dizzi­ness prevalence with different etiologies. Patie­nts’ age range was 18-85 years with mean (SD) age: 42.34 (13.12), including 377 (58%) females and 273 (42%) males. Patients’ chief complaints included vertigo in 64.8%, dizziness in 20.2% and imbalance in 15.1%. Vestibular disorders were identified in 49.2% of the referred patients. The patients’ final diagnosis in order of preva­lence were as follows: systemic involvement (292 cases), benign paroxysmal positional ver­tigo (187 cases), unilateral vestibular weakness (63 cases), endolymphatic hydrops (51 cases), bilateral vestibular weakness (37 cases), central involvement (20 cases), cervical (10 cases) and migraine-associated vertigo (8 cases).

Conclusion: About 49.2% of the patients refe­rred to the ENT clinic had actual vestibular involvement. Careful history taking, teamwork, and comprehensive evaluations are necessary to differentiate underlying cause and selecting app­ropriate treatment.