2025 Volume 118 Issue 12 Pages 867-872
The incidence rate of patients with life-threatening dizziness seen at vertigo/dizziness outpatient clinics has been reported to be approximately 1%. Of the remaining cases, in 70%–80%, the dizziness is considered as being of inner ear origin. We, as neuro-otologists, have an important role in making the appropriate diagnosis in each case of peripheral vestibular disease. Especially in city hospitals and town outpatient clinics with insufficient equipment for examining equilibrium, neuro-otologists need to adopt rational history-taking techniques for diagnosing the cause of vertigo/dizziness.
In this study, we reviewed the data of 464 patients with vertigo/dizziness in whom a definitive diagnosis had been made at the vertigo/dizziness outpatient clinic between April 2023 and March 2024. We hypothesized that if a patient’s dizziness was motion-evoked, they would have difficulty in answering questions about the frequency and duration of their symptoms. To assess this hypothesis, we analyzed the relationship between the patients’ responses regarding the duration and frequency of vertigo episodes and the final confirmed diagnosis.
The results showed a significant correlation, indicating that patients who could provide information about the monthly frequency and duration of their vertigo episodes were more likely to have diseases causing spontaneous vertigo, whereas those who could not were more likely to have diseases causing motion-evoked dizziness. Through structured medical interviews based on this approach, clinicians should first roughly list several possible causes of vertigo and then select specific examinations to establish a definitive diagnosis.
