Neuhauser Hannelore K, Radtke Andrea, von Brevern Michael, Lezius Franziska, Feldmann Maria, Lempert Thomas
Department of Epidemiology, Robert Koch Institute, Berlin, Germany.
Arch Intern Med. 2008 Oct 27;168(19):2118-24. doi: 10.1001/archinte.168.19.2118.
Dizziness and vertigo are common, however, the cause often remains unexplained. The percentage of vertigo of vestibular origin in individuals with unselected dizziness has not been well examined, and its underestimation may lead to diagnostic bias in primary care. The purpose of this study was to reassess the burden of dizziness in the community and to quantify the contribution of vertigo of vestibular origin.
A nationally representative sample of 4869 adults living in Germany was screened for moderate or severe dizziness, and 1003 individuals with dizziness underwent validated neurotologic interviews to differentiate vestibular vertigo from nonvestibular dizziness according to explicit diagnostic criteria.
Dizziness/vertigo had a prevalence of 22.9% in the last 12 months and an incidence (first episode of dizziness/vertigo) of 3.1%. For vestibular vertigo, the prevalence was 4.9% [corrected] and the incidence was 1.4%. We also found that 1.8% of unselected adults consulted a physician in the last 12 months for [corrected] dizziness/vertigo (0.9% for vestibular vertigo). Compared with nonvestibular dizziness, vestibular vertigo was more frequently followed by medical consultation (70% vs 54%; P < .001), sick leave (41% vs 15%; P < .001), interruption of daily activities (40% vs 12%; P < .001), and avoidance of leaving the house (19% vs 10%; P = .001). However, more than half of the participants with vestibular vertigo reported nonvestibular diagnoses. Age- and sex-adjusted health-related quality of life was lower in individuals with dizziness and vertigo compared with dizziness-free control subjects.
The occurrence of dizziness and vertigo is frequent and associated with a considerable personal and health care burden. Vestibular vertigo accounts for a considerable percentage of this burden, which suggests that diagnosis and treatment of frequent vestibular conditions are important issues in primary care.
头晕和眩晕很常见，但其病因往往不明。在未经筛选的头晕患者中，前庭性眩晕的比例尚未得到充分研究，对其估计不足可能导致初级保健中的诊断偏差。本研究的目的是重新评估社区中头晕的负担，并量化前庭性眩晕的作用。
对德国4869名成年人进行全国代表性抽样，筛查中度或重度头晕，1003名头晕患者接受了经验证的神经耳科学访谈，根据明确的诊断标准区分前庭性眩晕和非前庭性头晕。
在过去12个月中，头晕/眩晕的患病率为22.9%，发病率（头晕/眩晕首发）为3.1%。前庭性眩晕的患病率为4.9%[校正后]，发病率为1.4%。我们还发现，在过去12个月中，1.8%未经筛选的成年人因头晕/眩晕（前庭性眩晕为0.9%）咨询过医生。与非前庭性头晕相比，前庭性眩晕后更常进行医疗咨询（70%对54%；P<.001）、病假（41%对15%；P<.001）、日常活动中断（40%对12%；P<.001）和避免出门（19%对10%；P=.001）。然而，超过一半的前庭性眩晕参与者报告有非前庭性诊断。与无头晕的对照受试者相比，头晕和眩晕患者经年龄和性别调整的健康相关生活质量较低。
头晕和眩晕的发生很频繁，且与相当大的个人和医疗负担相关。前庭性眩晕占这一负担的相当大比例，这表明常见前庭疾病的诊断和治疗是初级保健中的重要问题。
