Richard T Zhu1, Vincent Van Rompaey2,3, Bryan K Ward4, Raymond Van de Berg5, Paul Van de Heyning2,3, Jeffrey D Sharon1. 1. 1 Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA. 2. 2 Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. 3. 3 Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium. 4. 4 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 5. 5 Department of Otorhinolaryngology and Head & Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Abstract
BACKGROUND: According to population-based studies that estimate disease prevalence, the majority of patients evaluated at dizziness clinics receive a single vestibular diagnosis. However, accumulating literature supports the notion that different vestibular disorders are interrelated and often underdiagnosed. OBJECTIVE: Given the complexity and richness of these interrelations, we propose that a more inclusive conceptual framework to vestibular diagnostics that explicitly acknowledges this web of association will better inform vestibular differential diagnosis. METHODS: A narrative review was performed using PubMed database. Articles were included if they defined a cohort of patients, who were given specific vestibular diagnosis. The interrelations among vestibular disorders were analyzed and placed within a conceptual framework. RESULTS: The frequency of patients currently receiving multiple vestibular diagnoses in dizziness clinic is approximately 3.7% (1263/33 968 patients). The most common vestibular diagnoses encountered in the dizziness clinic include benign paroxysmal positional vertigo (BPPV), vestibular migraine, vestibular neuritis, and Ménière's disease. CONCLUSIONS: A review of the literature demonstrates an intricate web of interconnections among different vestibular disorders such as BPPV, vestibular migraine, Ménière's disease, vestibular neuritis, bilateral vestibulopathy, superior canal dehiscence syndrome, persistent postural perceptual dizziness, anxiety, head trauma, and aging, among others.
BACKGROUND: According to population-based studies that estimate disease prevalence, the majority of patients evaluated at dizziness clinics receive a single vestibular diagnosis. However, accumulating literature supports the notion that different vestibular disorders are interrelated and often underdiagnosed. OBJECTIVE: Given the complexity and richness of these interrelations, we propose that a more inclusive conceptual framework to vestibular diagnostics that explicitly acknowledges this web of association will better inform vestibular differential diagnosis. METHODS: A narrative review was performed using PubMed database. Articles were included if they defined a cohort of patients, who were given specific vestibular diagnosis. The interrelations among vestibular disorders were analyzed and placed within a conceptual framework. RESULTS: The frequency of patients currently receiving multiple vestibular diagnoses in dizziness clinic is approximately 3.7% (1263/33 968 patients). The most common vestibular diagnoses encountered in the dizziness clinic include benign paroxysmal positional vertigo (BPPV), vestibular migraine, vestibular neuritis, and Ménière's disease. CONCLUSIONS: A review of the literature demonstrates an intricate web of interconnections among different vestibular disorders such as BPPV, vestibular migraine, Ménière's disease, vestibular neuritis, bilateral vestibulopathy, superior canal dehiscence syndrome, persistent postural perceptual dizziness, anxiety, head trauma, and aging, among others.
Authors: Doris-Eva Bamiou; Dimitris Kikidis; Thanos Bibas; Nehzat Koohi; Nora Macdonald; Christoph Maurer; Floris L Wuyts; Berina Ihtijarevic; Laura Celis; Viviana Mucci; Leen Maes; Vincent Van Rompaey; Paul Van de Heyning; Irwin Nazareth; Themis P Exarchos; Dimitrios Fotiadis; Dimitrios Koutsouris; Linda M Luxon Journal: J Neurol Date: 2021-10-20 Impact factor: 6.682