Clinico-Aetiological Profile of Patients with Vertigo: A Cross-sectional Observational Study

Abstract

Introduction: Nearly 5-10 percent of patients seen in general OPD, and between 10-20 percent of patients seen by ENT specialists and neurologists are those with complaints pertaining to vertigo and dis-equilibrium. The standard definition of vertigo states it to be an illusion of motion particularly rotatory sensation. Overlapping symptoms and terms such as dizziness, light headedness, giddiness and pre-syncope make it challenging to achieve a proper diagnosis. Aim: To study the clinical profile and revisit the various aetiological factors for vertigo in patients with actual sensation of rotatory motion seen in contemporary Otolaryngology practice. Materials and Methods: The present study was a cross-sectional observational study carried out over a period of 12 months in the Department of Otorhinolaryngology at a tertiary care centre. One-hundred and ten cases complaining of the sense of rotation of either head or their surroundings with at least a single episode in preceding one month were included. Comprehensive otological and vestibular evaluation was done. Each patient was subjected to thorough clinical vestibular and laboratory tests. Subjects with known cervical spine disease, neurological disorders and cardiac ailments were excluded. Statistical analysis was done and Chi-square test was applied. Results: The mean age of patients in the study was 49.75 years with a male to female ratio of 1:1. Majority of the patients (90%) presented with acute onset of vertigo. The total duration of symptoms most commonly observed ranged between one week to one month. Nearly, all patients had intermittent character of vertigo. The duration of each episode in most of the patients ranged between 1 minute to 10 minutes. Maximum patients (90.9%) were observed with intensity of vertigo as mild and moderate type (Level II and III SVVSLCRE). Positional variation was observed in 64.5% of the patients. The most common aetiological diagnosis deduced from the study was benign paroxysmal positional vertigo (30.4%) followed by orthostatic hypotension (17.9%) and Meniere’s disease (13.4%). Conclusion: The most common aetiological factor of vertigo was found to be benign paroxysmal positional vertigo, which can be effectively treated by performing Epley’s maneuver. Orthostatic hypotension has been observed as an important cause liable to be missed by otologists. The management of vertigo must be directed by a meticulous work up of aetiologies and should not be treated under a blanket regimen.