Stephanie Maihoub1, András Molnár1, András Csikós2, Péter Kanizsai2, László Tamás1, Ágnes Szirmai1
1: Semmelweis University ENT and Head and Neck Surgery Department
2: Semmelweis University Emergency Department
Dizziness is a common multisensory syndrome. 3% of all ED patients have a vertigo or dizziness complaint. Aetiologies could be extravestibular, and central or peripheral vestibular origin. Peripheral lesions are mostly benign, and self-limiting, thus the treatment is not urgent. Central lesions cases might be more serious, eg. stroke, and urgent treatment is necessary. Although most of the peripheral lesion patients are emitted within 24 hours, the detailed examination of these patients is missing.
Aim of our study is to clarify what diagnosis is given to patients after leaving the emergency department and the follow-up of this dizzy population.
In the last 2 year period 626 patients were examined at the Semmelweis University Emergency Department with vertigo and dizziness (H81, R42H0). We send a questionnaire to these patients about the symptoms, final diagnosis and time elapse between first diagnosis and endmost one. We had got 66 completed paper back (10.5%).
There were 40 women and 26 men. Mean age was 61.8 years (27-92). Most cases of dizziness in the emergency department were nominated as central dysfunction or BPPV. Majority of the vertigo was few days long. Accompanied symptoms in most were nausea, and then headache. Based on the patient information they received, higher was BPPV and cerebrovascular etiology. Follow up was mostly in the family doctor, who may have send them in other specializations such us neurology and ENT. Only one third of the patients with vertigo referred to detailed neurotological examination. Eventually their final diagnosis in most of these patients took several days and 41% remained undiagnosed.
After the patients’ emission from the emergency department, the complete evaluation of the vertigo is often missing. Emphasizing the importance of the neurotological examination in every patients, who had vertigo complaints.
Otoneurology, vestibular disorders