Causes of persistent dizziness: A prospective study of 100 patients in ambulatory care

Kurt Kroenke, Christine A. Lucas, Michael L. Rosenberg, Barbara Scherokman, Jerome E. Herbers, Paul A. Wehrle, Joseph O. Boggi

Research output: Contribution to journalArticle

212 Citations (Scopus)

Abstract

Objective: To determine the causes of persistent dizziness in outpatients. Design: Consecutive adult outpatients presenting with a chief complaint of dizziness. Setting: Four clinics (internal medicine, walk-in, emergency room, and neurology) in a teaching hospital. Patients: Of 185 patients presenting during the 10-month study period, 51 (28%) had minimal or no dizziness at 2-week follow-up. Of the remaining 134 patients, 100 completed the study protocol (mean age, 62 years; range, 20 to 85 years). Measurements: Evaluation included a detailed study questionnaire, standardized physical examination, vestibular testing by a neuro-ophthalmologist, laboratory tests, audiometry, and a structured psychiatric interview. Data were abstracted onto a standard form and reviewed by three raters. Raters independently assigned diagnoses using explicit criteria, with the final cause determined by consensus. Results: Primary causes of dizziness included vestibular disorders (54 patients), psychiatric disorders (16 patients), presyncope (6 patients), dysequilibrium (2 patients), and hyperventilation (1 patient); dizziness was multicausal in 13 patients and of unknown cause in 8 patients. Many of those with a single primary cause, however, had at least one other condition contributing to their dizziness; only 52% of patients had a single "pure" cause. Thirty patients had a potentially treatable primary cause, the most common being benign positional vertigo (BPV) (16%) and psychiatric disorders (6%). Central vestibulopathies detected in 10 patients were presumably vascular or idiopathic in origin. No brain tumors or cardiac arrhythmias were found. Conclusions: Vestibular disease and psychiatric disorders are the most common causes of persistent dizziness in outpatients. In about 50% of patients with dizziness, more than one factor causes or aggravates symptoms. Life-threatening causes were rare, even in our elderly population.

Original languageEnglish (US)
Pages (from-to)898-904
Number of pages7
JournalAnnals of Internal Medicine
Volume117
Issue number11
StatePublished - Dec 1992
Externally publishedYes

Fingerprint

Dizziness
Ambulatory Care
Prospective Studies
Psychiatry
Outpatients
Vestibular Diseases
Audiometry
Hyperventilation
Vertigo
Syncope
Neurology
Internal Medicine
Brain Neoplasms
Teaching Hospitals
Physical Examination
Blood Vessels
Hospital Emergency Service
Cardiac Arrhythmias

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kroenke, K., Lucas, C. A., Rosenberg, M. L., Scherokman, B., Herbers, J. E., Wehrle, P. A., & Boggi, J. O. (1992). Causes of persistent dizziness: A prospective study of 100 patients in ambulatory care. Annals of Internal Medicine, 117(11), 898-904.

Causes of persistent dizziness : A prospective study of 100 patients in ambulatory care. / Kroenke, Kurt; Lucas, Christine A.; Rosenberg, Michael L.; Scherokman, Barbara; Herbers, Jerome E.; Wehrle, Paul A.; Boggi, Joseph O.

In: Annals of Internal Medicine, Vol. 117, No. 11, 12.1992, p. 898-904.

Research output: Contribution to journalArticle

Kroenke, K, Lucas, CA, Rosenberg, ML, Scherokman, B, Herbers, JE, Wehrle, PA & Boggi, JO 1992, 'Causes of persistent dizziness: A prospective study of 100 patients in ambulatory care', Annals of Internal Medicine, vol. 117, no. 11, pp. 898-904.
Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA et al. Causes of persistent dizziness: A prospective study of 100 patients in ambulatory care. Annals of Internal Medicine. 1992 Dec;117(11):898-904.
Kroenke, Kurt ; Lucas, Christine A. ; Rosenberg, Michael L. ; Scherokman, Barbara ; Herbers, Jerome E. ; Wehrle, Paul A. ; Boggi, Joseph O. / Causes of persistent dizziness : A prospective study of 100 patients in ambulatory care. In: Annals of Internal Medicine. 1992 ; Vol. 117, No. 11. pp. 898-904.
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