Institution where work was performed, Department of Otolaryngology, Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, CA, USA.
Current location, Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ann Otol Rhinol Laryngol. 2022 Apr;131(4):403-411. doi: 10.1177/00034894211025416. Epub 2021 Jun 13.
To elucidate differences in demographic and clinical characteristics between patients with episodic and chronic dizziness.
A cross-sectional, observational study of 217 adults referred for dizziness at 1 tertiary center was undertaken. Subjects were split into a chronic dizziness group (>15 dizzy days per month) and an episodic dizziness group (<15 dizzy days per month).
217 adults (average age, 53.7 years; 56.7% female) participated. One-third (n = 74) met criteria for chronic dizziness. Dizziness handicap inventory (DHI) scores were significantly higher in those with chronic dizziness compared to those with episodic dizziness (53.9 vs 40.7; < .001). Comorbid depression and anxiety were more prevalent in those with chronic dizziness (44.6% and 47.3% vs 37.8% and 35.7%, respectively; > .05). Abnormal vestibular testing and abnormal imaging studies did not differ significantly between the 2 groups. Ménière's disease and BPPV were significantly more common among those with episodic dizziness, while the prevalence of vestibular migraine did not differ according to chronicity of symptoms. A multivariate regression that included age, sex, DHI, history of anxiety and/or depression, associated symptoms, and dizziness triggers was able to account for 15% of the variance in the chronicity of dizziness (pseudo- = 0.15; < .001).
Those who suffer from chronic dizziness have significantly higher DHI and high comorbid rates of depression and anxiety than those with episodic dizziness. Our findings show that factors other than diagnosis alone are important in the chronification of dizziness, an observation that could help improve on multimodal treatment options for this group of patients.
阐明发作性和慢性头晕患者在人口统计学和临床特征方面的差异。
在 1 家三级中心对 217 名因头晕就诊的成年人进行了横断面、观察性研究。受试者分为慢性头晕组（每月头晕天数>15 天）和发作性头晕组（每月头晕天数<15 天）。
共有 217 名成年人（平均年龄 53.7 岁；56.7%为女性）参与了研究。三分之一（n=74）符合慢性头晕的标准。与发作性头晕相比，慢性头晕患者的头晕残疾量表（DHI）评分明显更高（53.9 分比 40.7 分； < .001）。慢性头晕患者更常见共病抑郁和焦虑（分别为 44.6%和 47.3%比 37.8%和 35.7%； > .05）。两组之间异常前庭测试和异常影像学研究无显著差异。发作性头晕患者中梅尼埃病和良性阵发性位置性眩晕明显更为常见，而前庭性偏头痛的患病率则与症状的慢性程度无关。包括年龄、性别、DHI、焦虑和/或抑郁史、相关症状和头晕诱因在内的多元回归可以解释头晕慢性程度的 15%的变异性（伪 = 0.15； < .001）。
与发作性头晕患者相比，慢性头晕患者的 DHI 明显更高，且抑郁和焦虑的共病率更高。我们的发现表明，除了诊断之外，其他因素在头晕的慢性化中也很重要，这一观察结果可能有助于改善这组患者的多模式治疗选择。
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