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International Journal of Environmental... Feb 2021(1) Objectives: The evaluation of dizzy patients is difficult due to nonspecific symptoms that require a multi-specialist approach. The Dizziness Handicap Inventory... (Observational Study)
Observational Study
(1) Objectives: The evaluation of dizzy patients is difficult due to nonspecific symptoms that require a multi-specialist approach. The Dizziness Handicap Inventory (DHI) is widely used in the assessment of dizziness-related disability, but its clinical efficacy needs further expansion. The aim of this study was to identify the subscales of DHI that may correlate with some vestibular or nonvestibular dysfunctions. (2) Material and methods: This observational study included 343 dizzy patients with one of the following clinical conditions: Vestibular impairment noncompensated or compensated, central or bilateral, benign paroxysmal positional vertigo (BPPV), migraine and psychogenic dizziness. Principal component analysis was used to examine the factorial structure of the questionnaire. (3) Results: The DHI questionnaire total scoring and its vestibular subscale distinguished between patients with compensated and uncompensated vestibular dysfunction with positive predictive values of 76% and 79%, respectively. The DHI items composing the F3 (positional) subscale revealed the highest scoring in the BPPV group with 75% sensitivity and 92% negative predictive value (NPV) in reference to Dix-Hallpike tests. The DHI total score and the subscales scores correlated with anxiety-depression, and the highest correlation coefficients were calculated for vestibular (F2 0.56) and anxiety (F5 0.51) subscales. (4) Conclusions: Our analysis revealed that the DHI vestibular subscale distinguishes between patients with compensated and uncompensated vestibular dysfunction. The positional subscale showed the highest scoring in the BPPV group with high sensitivity and low specificity of the test. The DHI is highly correlated with patients' psychological status.
Topics: Benign Paroxysmal Positional Vertigo; Disability Evaluation; Disabled Persons; Dizziness; Humans; Migraine Disorders; Surveys and Questionnaires
PubMed: 33668099
DOI: 10.3390/ijerph18052210 -
The Medical Clinics of North America May 2014Dizziness is a common presenting concern in primary care practice. The most useful diagnostic approach in distinguishing different types of dizziness is a thorough... (Review)
Review
Dizziness is a common presenting concern in primary care practice. The most useful diagnostic approach in distinguishing different types of dizziness is a thorough history and physical examination; additional tests are rarely necessary. Effective treatments exist for many causes of dizziness, and these treatments are often accomplished in the clinic or at home without the need for medication.
Topics: Diagnosis, Differential; Disease Management; Dizziness; Humans; Primary Health Care; Vertigo
PubMed: 24758962
DOI: 10.1016/j.mcna.2014.01.014 -
Disability and Rehabilitation Jan 2023The aim of this study was to examine the association between the Dizziness Handicap Inventory (DHI) and sickness absence from work in patients with dizziness.
PURPOSE
The aim of this study was to examine the association between the Dizziness Handicap Inventory (DHI) and sickness absence from work in patients with dizziness.
MATERIAL AND METHODS
This was a cross-sectional study conducted at an otolaryngology clinic with 238 patients referred for a suspected vestibular disorder during a 1-year period. The association between sickness absence over the last 30 days and DHI was examined with binary and ordinal logistic regression. The Hospital Anxiety and Depression scale (HADS), health-related quality of life (RAND-12), duration of dizziness, diagnosis, age and gender were used as adjustments variables.
RESULTS
The adjusted analysis showed that a 10-point increase on DHI was associated with an increased risk of sickness absence (yes/no) (OR: 1.50, 95% CI: 1.25-1.90, < 0.001). In addition, a 10-point increase in DHI-score was associated with a higher degree of sickness absence (OR: 1.50, 95% CI: 1.25-1.80, < 0.001).
CONCLUSION
A higher DHI-score was associated with sickness absence in addition to the duration of absence the previous month. These results indicate the relevance and clinical usefulness of the DHI as a possible indicator of sickness absence from work in patients with dizziness regardless of diagnosis.IMPLICATIONS FOR REHABILITATIONApproximately half of patients referred to a dizziness clinic have sickness absence.A higher score on The Dizziness Handicap Inventory is associated with longer duration of sickness absence.A vestibular diagnosis was not associated with sickness absence.The results indicate that the Dizziness Handicap Inventory may be a clinically useful tool for identifying patients with a high risk of sickness absence.
Topics: Humans; Dizziness; Cross-Sectional Studies; Quality of Life; Vertigo; Vestibular Diseases
PubMed: 34978234
DOI: 10.1080/09638288.2021.2022786 -
Laryngo- Rhino- Otologie May 2024Vertigo and dizziness comprise a multisensory and multidisciplinary syndrome of different etiologies. The term "cerebellar vertigo and dizziness" comprises a... (Review)
Review
Vertigo and dizziness comprise a multisensory and multidisciplinary syndrome of different etiologies. The term "cerebellar vertigo and dizziness" comprises a heterogenous group of disorders with clinical signs of cerebellar dysfunction and is caused by vestibulo-cerebellar, vestibulo-spinal or cerebellar systems. About 10 % of patients in an outpatient clinic for vertigo and balance disorders suffer from cerebellar vertigo and dizziness. According to the course of the symptoms, one can considers 3 types: permanent complaints, recurrent episodes of vertigo and balance disorders, or an acute onset of complaints. The most common diagnoses in patients with cerebellar vertigo and dizziness were as follows: degenerative disease, hereditary forms and acquired forms. In a subgroup of patients with cerebellar vertigo, central cerebellar oculomotor dysfunction is indeed the only clinical correlate of the described symptoms. 81 % of patients with cerebellar vertigo suffer from permanent, persistent vertigo and dizziness, 31 % from vertigo attacks, and 21 % from both. Typical clinical cerebellar signs, including gait and limb ataxia or dysarthria, were found less frequently. Key to diagnosis is a focused history as well as a thorough clinical examination with particular attention to oculomotor function. Regarding oculomotor examination, the most common findings were saccadic smooth pursuit, gaze-evoked nystagmus, provocation nystagmus, rebound nystagmus, central fixation nystagmus, most commonly downbeat nystagmus, and disturbances of saccades. Thus, oculomotor examination is very sensitive in diagnosing cerebellar vertigo and dizziness, but not specific in distinguishing different etiologies. Laboratory examinations using posturography and a standardized gait analysis can support the diagnosis, but also help to estimate the risk of falls and to quantify the course and possible symptomatic treatment effects. Patients with cerebellar vertigo and dizziness should receive multimodal treatment.
Topics: Humans; Dizziness; Vertigo; Cerebellar Diseases; Diagnosis, Differential
PubMed: 37989215
DOI: 10.1055/a-2192-7278 -
Otolaryngologia Polska = the Polish... 2010The complaint of dizziness is one of the most common reasons that older adults feel constrained to visit the doctor's office. Because of a growing number of older people...
The complaint of dizziness is one of the most common reasons that older adults feel constrained to visit the doctor's office. Because of a growing number of older people in the industrial society the problem grows. Therapeutic process of elderly people with vertigo and dizziness needs more than vestibular diagnostics. In addition to sufficient anamnesis, presence of visual deficits, extrasensory changes and even psychological circumstances are necessary. Frequently the indication and the encouragement of vestibular rehabilitation have significant value. The initiation of fall prevention may also be essential.
Topics: Accidental Falls; Activities of Daily Living; Aged; Dizziness; Exercise; Humans; Patient Education as Topic; Quality of Life; Tai Ji; Vertigo; Walking
PubMed: 21299055
DOI: 10.1016/S0030-6657(10)70586-2 -
Neurologic Clinics Feb 2012The cause of dizziness in patients seen in the emergency room can usually be determined by a focused evaluation that consists of identifying three key features in the... (Review)
Review
The cause of dizziness in patients seen in the emergency room can usually be determined by a focused evaluation that consists of identifying three key features in the history and five key elements of the clinical examination. This article discusses the most common causes of dizziness, how to use this approach, and management of these cases in the emergency room.
Topics: Dizziness; Emergencies; Humans; Physical Examination; Vertigo
PubMed: 22284055
DOI: 10.1016/j.ncl.2011.09.006 -
Journal of Vestibular Research :... 2013A review of the Dizziness Handicap Inventory (DHI). NUMBER OF STUDIES: Seventy-four studies. (Review)
Review
PURPOSE
A review of the Dizziness Handicap Inventory (DHI). NUMBER OF STUDIES: Seventy-four studies.
MATERIALS/METHODS
Articles published between January 1990 and May 2012 were identified by searches in PubMed electronic database. Of the 227 articles meeting the inclusion criteria 74 were reviewed. These articles are discussed under nine topics; Reliability, validity and internal consistency of the original version of DHI, relationship between vestibular/balance tests and DHI, association between DHI and the other scales related to balance impairments, exploratory factor analysis of the DHI, screening version of DHI, translations of DHI into other languages, the role of DHI to assess the success of the treatment of balance disorder, DHI results in various vestibular disorders, general characteristics of DHI in patients with balance impairment.
CONCLUSIONS
Self reported measures represent unique pieces of the information important for the management of dizzy patients. DHI is the most widely used self reported measurement of patients with dizziness. It has been translated into fourteen languages, so it is widely accepted.
Topics: Aged; Disability Evaluation; Dizziness; Female; Humans; Male; Middle Aged; Vertigo; Vestibular Diseases; Vestibular Function Tests
PubMed: 24447966
DOI: 10.3233/VES-130488 -
BMC Geriatrics Feb 2022The prevalence of dizziness increases with age. We aimed to determine the point prevalence of dizziness and, in particular, of benign paroxysmal positional vertigo...
BACKGROUND
The prevalence of dizziness increases with age. We aimed to determine the point prevalence of dizziness and, in particular, of benign paroxysmal positional vertigo (BPPV) among retirement home residents. Furthermore, we aimed to evaluate the efficacy of a 2-axis turntable based BPPV treatment.
METHODS
We contacted all large retirement homes in or around the city of Zurich (Switzerland). 10 retirement homes (with a total of 536 residents) agreed to participate in this study. 83 rejected inquiries by residents led to a potential study population of 453 residents. After a structured interview evaluating the presence and characteristics of dizziness, all willing patients were tested for positional vertigo and nystagmus on a portable and manually operated 2-axis turntable that was transported to the retirement home. Testing consisted of the Dix-Hallpike and supine roll maneuvers to both sides. Participants were immediately treated with the appropriate liberation maneuver whenever BPPV was diagnosed. Otherwise, taking the resident's medical history, a neuro-otological bedside examination, and a review of the available medical documentation was used to identify other causes of dizziness.
RESULTS
Out of the 453 residents, 75 (16.6%; average age: 87.0 years; 68% female) were suffering from dizziness presently or in the recent past and gave their consent to participate in this study. Among the participants tested on the turntable (n = 71), BPPV was present in 11.3% (point prevalence). Time-related properties, triggering factors and qualitative attributes of vertigo or dizziness were not significantly different between the dizzy participants with and those without BPPV. In all BPPV patients, appropriate liberation maneuvers were successful.
CONCLUSIONS
BPPV could be demonstrated in about one tenth of retirement home residents with dizziness or recent dizziness. Such point prevalence of BPPV translates to a much higher yearly prevalence if one assumes that BPPV is not present on every day. Our finding suggests that retirement home residents suffering from dizziness should be regularly tested for BPPV and treated with appropriate liberation maneuvers, ideally on turntable to reduce strain.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier NCT03643354 .
Topics: Aged, 80 and over; Benign Paroxysmal Positional Vertigo; Cross-Sectional Studies; Dizziness; Female; Humans; Male; Prevalence; Retirement
PubMed: 35151262
DOI: 10.1186/s12877-022-02818-w -
Journal of Vestibular Research :... 2022This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society...
This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). It contains a literature update while the original criteria from 2012 were left unchanged. The classification defines vestibular migraine and probable vestibular migraine. Vestibular migraine was included in the appendix of the third edition of the International Classification of Headache Disorders (ICHD-3, 2013 and 2018) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included in a later version of the ICHD, when further evidence has accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms. Symptoms that qualify for a diagnosis of vestibular migraine include various types of vertigo as well as head motion-induced dizziness with nausea. Symptoms must be of moderate or severe intensity. Duration of acute episodes is limited to a window of between 5 minutes and 72 hours.
Topics: Dizziness; Humans; Migraine Disorders; Vertigo; Vestibular Diseases; Vestibule, Labyrinth
PubMed: 34719447
DOI: 10.3233/VES-201644 -
Sensors (Basel, Switzerland) Nov 2021Vertigo is a sensation of movement that results from disorders of the inner ear balance organs and their central connections, with aetiologies that are often benign and... (Review)
Review
Vertigo is a sensation of movement that results from disorders of the inner ear balance organs and their central connections, with aetiologies that are often benign and sometimes serious. An individual who develops vertigo can be effectively treated only after a correct diagnosis of the underlying vestibular disorder is reached. Recent advances in artificial intelligence promise novel strategies for the diagnosis and treatment of patients with this common symptom. Human analysts may experience difficulties manually extracting patterns from large clinical datasets. Machine learning techniques can be used to visualize, understand, and classify clinical data to create a computerized, faster, and more accurate evaluation of vertiginous disorders. Practitioners can also use them as a teaching tool to gain knowledge and valuable insights from medical data. This paper provides a review of the literatures from 1999 to 2021 using various feature extraction and machine learning techniques to diagnose vertigo disorders. This paper aims to provide a better understanding of the work done thus far and to provide future directions for research into the use of machine learning in vertigo diagnosis.
Topics: Artificial Intelligence; Diagnosis, Differential; Dizziness; Humans; Machine Learning; Vertigo
PubMed: 34833641
DOI: 10.3390/s21227565