Journal
EUROPEAN NEUROLOGY
Volume 79, Issue 1-2, Pages 5-12Publisher
KARGER
DOI: 10.1159/000481982
Keywords
Dizziness; Vertigo; Epidemiology; Emergency medicine; Acute vestibular syndrome; Cerebrovascular disease (stroke, TIA)
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Funding
- Swedish Stroke Association
- Northern Swedish Stroke Fund
- Swedish Society of Medicine
- Department of Pharmacology and Neuroscience, Section of Neurology at Umea University
- Umea University
- Vasterbotten County Council
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Background: Dizziness is a common occurrence witnessed at emergency departments (EDs). This study aims to describe the epidemiology and management of dizzy patients with and without an acute vestibular syndrome (AVS) in the ED at Umea University Hospital. Methods: A total of n = 2,126 ED dizziness visits during 3 years were identified. Data were obtained through retrospective review of medical records. Cases were stratified based on presentation, including AVS and neurological deficits. The outcomes analyzed included cerebrovascular causes of dizziness. A Poisson distribution was assumed when calculating incidence CIs. Results: Dizziness accounted for 2.1% of all ED visits, incidence 477/100,000 inhabitants (95% CI 457-498). Among dizzy patients, 19.2% had an AVS, incidence 92/100,000 inhabitants (95% CI 74-113). Top medical diagnostic groups were otovestibular (15.1%), cardiovascular (8.7%) and neurological diseases (7.7%), including stroke and transitory ischemic attack (4.8%). Cerebrovascular causes of dizziness were more common among those with an AVS (10.0%) vs. those without (3.6%), p < 0.01. Conclusion: The risk for cerebrovascular causes of dizziness, although low in an unselected cohort, increases with the presence of neurological signs and an AVS. These population-based data may be useful when planning and implementing dizziness and AVS management algorithms at EDs. (C) 2017 S. Karger AG, Basel
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