Mareo y/o vértigo como motivo de consulta en la policlínica neurológica: Estudio descriptivo

Lorena Castro; Patricia Braga

Authors

Lorena Castro Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Instituto de Neurología. Ex Asistente de Neurología
Patricia Braga Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Instituto de Neurología. Profesora Adjunta de Neurología

Keywords:

DIZZINESS, VERTIGO, PROSPECTIVE STUDIES

Abstract

Introduction: dizziness and vertigo are one of the main causes of consultation in medicine. Patients suffering from these symptoms repeatedly consult due to the impairments caused by them, and in many cases the etiological diagnosis is not clear. It is a costly condition both for health services and patients.
Objectives: 1. To learn about the clinical features of the population that consulted for dizziness and/or vertigo in the neurology polyclinic of the University Hospital. 2. To evaluate the kinds of vertigo and their etiology.
Method: we conducted a prospective study during six months in a cohort of patients over 15 years old, who consulted for dizziness and /or vertigo.
Results: 64 patients were included in the referred period of time (84% women, 16% men); average age was 55.2 years old. Seventy eight per cent of patients had already consulted previously, for these same symptoms. The specialists most frequently consulted were general practitioners (28%). Seventy two per cent of patients suffered from real vertigo and they had been experiencing the symptom for over a year in 52% of cases. Upon physical examination, the most widely used clinical signs to assess the vestibular system (Romberg, Barany y Unterberger) were found to have high specificity, although their sensitivity is low. The most frequent etiology diagnosis was benign paroxysmal positional vertigo (BPPV), in 39% of patients.
Conclusions: dizziness and vertigo are frequent reasons for consultation, and usually patients consult repeatedly. We need to make our best to achieve the right etiologic diagnosis and appropriate treatment.

References

(1) Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al. Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology 2005; 65(6):898-904.
(2) Gaensler E. Neurorradiología fundamental. Madrid: Marban Libros, 1998.
(3) López-Gentili LI, Kremenchutzky M, Salgado P. Análisis estadístico de 1.300 pacientes con mareo y vértigo: causas más frecuentes. Rev Neurol 2003; 36(5):417-20.
(4) Pérez Garrigues H, Andrés C, Pérez A. Aspectos epidemiológicos del vértigo en la población general. Acta Otolaryngol 2008; 128(1):43-7.
(5) Narita S, Kurose M, Kobayashi K, Himi T. Study on 242 inpatients reporting vertigo and dizziness. Nihon Jibiinkoka Gakkai Kaiho 2003; 106(1):21-7.
(6) Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T. Burden of dizziness and vertigo in the community. Arch Intern Med 2008; 168(19):2118-24.
(7) Bartual J, Pérez N, Barona R, Fernández S, Guirado CR, Guirado FR. El sistema vestibular y sus alteraciones: fundamentos y semiología. Barcelona: Masson, 1998.
(8) Olvera Martínez MT, Martínez Rodríguez HR. Mareo y vértigo. Med Univ 2002; 4(17):222-9.
(9) Philip R, Prepageran N. Dizziness, a review of walk-in patients at a specialised neurotology clinic. Med J Malaysia 2009; 64(1):56-8.
(10) Tata LJ, Lewis SA, McKeever TM, Smith CJ, Doyle P, Smeeth L, et al. Effect of maternal asthma, exacerbations and asthma medication use on congenital malformations in offspring: a UK population-based study. Thorax 2008; 63(11):981-7.
(11) Hanley K, O’Dowd T, Considine N. A systematic review of vertigo in primary care. Br J Gen Pract 2001; 51(469):666-71.
(12) Branch WT, Barton J. Approach to the patient with dizziness. Literature review current through: May 2013. This topic last updated: abr 24, 2012. UptoDate 2013. Disponible en: http://www.uptodate.com/contents/approach-to-the-patient-with-dizziness. Consulta: 10 setiembre 2012.