Abstract
Semicircular canal and otolith functions came to be evaluated recently, but comprehensive and comparative analysis of canal and otolith dysfunction in common vestibular disorders is lacking. We aimed to analyze the abnormal rates of canal and otolith function in common vestibular disorders. We enrolled 302 patients who were managed for 2 months in a dizziness clinic. Results of caloric, video head impulse test (vHIT), and cervical and ocular vestibular evoked myogenic potential (cVEMP and oVEMP) tests were analyzed and compared among various diagnoses. Vestibular disorders diagnosed included recurrent vestibulopathy (RV, 27%), vestibular migraine (VM, 21%), benign paroxysmal positional vertigo (BPPV, 17%), Meniere's disease (MD, 11%), vestibular neuritis (VN, 10%), orthostatic dizziness (7%), and central lesions (3%). Lateral canal dysfunction was found most in VN (100%) and less commonly in definite MD (75%), RV (46%) and definite VM (29%). Abnormal caloric results were more common than abnormal vHIT in all disorders. Otolith dysfunction was found more frequently than lateral canal dysfunction in most vestibular disorders except VN. An abnormal cVEMP was more frequent in definite MD than the other disorders. Isolated otolith dysfunction without lateral canal dysfunction was the most found in BPPV, followed by definite VM, RV, and definite MD in decreasing order. Various patterns of involvement in canal and otoliths were revealed in vestibular disorders, suggesting different pathogenesis.
Highlights
Based on a report from a national survey in the United States, vestibular dysfunction is a common condition with a 4-year prevalence of 35.4% in adults aged 40 years and older [1]
We investigated the epidemiological features of patients with dizziness in an outpatient clinic and compared the results of vestibular function tests (VFTs) to investigate how differently the vestibular organs are involved in various vestibular disorders
The most common final diagnoses assigned to this population of patients were recurrent vestibulopathy (26.5%), followed by vestibular migraine (20.5%), benign paroxysmal positional vertigo (BPPV) (17.2%), Meniere’s disease (10.6%), vestibular neuritis (10.3%), orthostatic dizziness (7.0%), central lesions (3.3%), and trauma-related dizziness (3.0%)
Summary
Based on a report from a national survey in the United States, vestibular dysfunction is a common condition with a 4-year prevalence of 35.4% in adults aged 40 years and older [1]. Dizziness is one of the most common complaints in an outpatient neurotologic clinic and the epidemiology of vestibular disorders is of interest when evaluating these cases [2,3,4]. It can be easier for a physician to think of the most common diseases as a cause of dizziness but a definitive diagnosis of dizziness. There have been some studies that have analyzed the epidemiology of vestibular disorders, but few reports to date have comprehensively compared the results of vestibular function tests in patients in a dizziness clinic [2,3,4]. We speculated that a comparison of the results of each test in patients with different vestibular disorders might improve our understanding of the involvement patterns of vestibular organs in those different conditions
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