Vertigo and dizziness profile in the primary health care institution patients
Abstract
Vertigo is one of the most frequent clinical syndromes. According literature about 65 percent of patients in Western Europe coming to the primary health care physician complain on vertigo. The aim of our study was to evaluate the profile of vertigo and dizziness in patients of one Lithuanian regional primary health care institution. Specially designed questionnaire for the patients has been used to evaluate vertigo profile together with visual analogue scale (VAS) for the evaluation of everyday life impairment of the vertigo sufferer.
36 patients who underwent treatment at their general practitioner for the complain of vertigo or dizziness have been interviewed. The major group were women (77.8%). In 80% of cases there was no evidence of provoking event (trauma, surgery etc.). Clear sensation of vertigo was described in 52.8% of cases, feeling of fainting – in 19.4 % of cases, disequilibrium- 33.3% of cases, psychogenic vertigo could be suspected in 5.6% of cases. Provoking head movement was noted in 44.4% of cases, duration seconds- till minute- in 41.7% of cases. Similar number of 44.4% of cases mentioned that vertigo stops in itself. 66.7% had nausea during attack, 50% experienced feeling of fear. No complains of accompanying signs of vertigo attack as hearing loss or tinnitus was in 97.2% of cases. Physicians had prescribed various medications- vasodilatators, improving of blood circulation in brain, vitamins of B group, sedative. No effect of treatment was noted in 50% of cases. According VAS measures, vertigo interfered very much everyday life in 52.8%, moderately- 34.1% of cases.
None of the patients was referred to the ENT or neurologists for the suspicion of BPPV, which might have been suspected in nearly half of the cases, no provoking manoeuvres were performed. We speculate that the knowledge of vertigo symptom in primary health care institution is not sufficient and in most of the cases the transient vertebrobasilary insufficiency was over diagnosed.
