Retrospective evaluation of demographic and etiologic features of patients presenting with dizziness

Dizziness is one of the most common presenting symptom of patients in emergency services and outpatient clinics. Because dizziness is a frequent symptom that affects a wide proportion of the population and sometimes represents life threating conditions, etiological studies of vertigo is very important. In this study, our objective was determining the etiological and symptomatological properties and subgroups of patients with dizziness, for improving our knowledge in the management of these cases. In this study, the data of total number of 794 patients (n=491, 61.8% women and n=303, 38.2% men) who presented with dizziness to Department of Neurology, Baskent University Ankara Hospital between August 2012 and August 2013, were retrospectively analyzed. Patients with dizziness were grouped based on the symptoms and final diagnosis. Our results revealed that mean age of the patients was 59,9 ± 18,2. Based on the diagnosis peripheric, central, psychogenic and systemic groups were consisted of 408 (51,4%), 129 (16,2%), 37 (4,7%) and 55 (6,9%) patients, respectively. Subgroups regarding main symptom of vertigo, imbalance, presyncope and nonspesific dizziness, were consisted of 481 (60,6%), 157 (19,8%), 21 (2,6%) and 135 (17%) patients, respectively. Female gender was more than male gender in all diagnosis groups and was also statistical significantly higher in psychogenic group. In all symtom groups, female gender was higher than male gender except for imbalance group in which male gender was found to be higher. Mean age was significantly lower in psychogenic group. In imbalance group, mean age was significantly higher than vertigo and nonspecific dizziness groups. With regard to main symptom, vertigo was the most common symptom in peripheric group (93,9%), imbalance (46,5%) and vertigo (43,3) were the most common symptoms in central group, nonspecific dizziness was the most common symptom in psychogenic and systemic groups (48,6%, 52,7%, respectively), nonspecific dizziness (41,8%) and imbalance (40,6%) were the most common symptoms in non-diagnostic group. Nausea and vomiting and ear complaints were more common in peripheric group. Headache and additional central symptom and ataxia were found to be higher in central group however psychogenic symptoms was more frequent in psychogenic group. The most common conditions were hypertension (HT) in systemic group, previous stroke in central and systemic groups, coronary arter disease in central, systemic and non-diagnostic groups and dyslipidemia in non-diagnostic and psychogenic groups. The most common causes of dizziness in central group were ischemic stroke (38%), parkinson (13,2%), migrenous vertigo (13,2%), transient ischemic attack (7%). Benign paroxismal positional vertigo (BPPV) (34,3%), vestibular neuritis (4,9%) and Ménière disease were the most common reasons in peripheric group. Orthostotic hypotension (27,3%), fluctuations in blood pressure (25,5%), vasovagal presyncope (9,1%) and adverse effect of a drug (9,1%) were the most frequent causes in systemic group. In all patients of the study, the most common specific causes of dizziness were BPPV, ischemic stroke, psychogenic factors, vestibular neuiritis and migrenous vertigo, respectively. In conclusion, although peripheric causes are the most common underlying factor, other causes must be kept in mind in the evaluation of patients presenting with a complaint of dizziness.