Vol.100 No.1 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 1 January 2007
Clinical Statistics of Patients with Dizziness
Consulting the Emergency Outpatient Clinic
Yasuo Ogawa, Akira Hagiwara, Naoharu Kitajima,
Taro Inagaki, Masaaki Shimizu, Hiroko Furuse,
Ujimoto Konomi, Kumiko Yukawa and Mamoru Suzuki
(Tokyo Medical University)
Between May 2004 and April 2006, 468 emergency patients with vertigo or dizziness consulted the otorhinolarygological emergency room of Tokyo Medical University. Patients with vertigo or dizziness comprised about 9％ of the whole otorhinolaryngological emergency patients. The number of female patients was larger than that of male patients. About half of the patients were brought to our hospital by ambulance. Nystagmus was observed in 219 patients (46.8％). Incidence of nystagmus was highest on positional nystagmus test. Brain CT was obtained in 185 patients (39.5％), but there were no abnormal findings in any patients. The most frequent diagnosis was inner ear disorder (22％), followed by Meniere's disease (7％), vestibular neuritis (6％), BPPV (6％). Cerebral infarction was observed in 1.9％.
Eighty-four patients were admitted. Major diseases requiring admission were vestibular neuritis and inner ear disorder.
In patients with cerebral infarction, brain CT was normal. These patients were all elderly males over 60 years old. Their nystagmus in the emergency room did not suggest central disorder, or they did not have other neurological findings. Neurological signs and symptoms appeared thereafter.
In the emergency room, establishing a diagnosis by limited examination is difficult. Careful examination is necessary, since vertigo or dizzy patient with a central disorder can show sudden change.
Key words : emergency, vertigo, otorhinolarygology, cerebral infarction