Acute vertigo in the ENT emergency

Česká verzia

Authors: V. Albrecht ¹ ; Lukáš Školoudík ^1,2 ; P. Sila ^1,2 ; Jan Mejzlík ^1,2 ; Janouch M. ¹; Viktor Chrobok ^1,2
Authors place of work: Klinika otorinolaryngologie a chirurgie hlavy a krku, FN Hradec Králové ¹; Lékařská fakulta UK v Hradci Králové ²
Published in the journal: Otorinolaryngol Foniatr, 70, 2021, No. 3, pp. 146-155.
Category: Original Article
doi: https://doi.org/10.48095/ccorl2021146

Summary

Introduction: Acute vertigo ranks among the common reasons for visiting the emergency department. The aim of this study was to evaluate the rate of peripheral vestibular syndrome (PVS) in patients with acute vertigo examined at the ENT emergency department and to compare the agreement of physical ENT examination with video-assisted vestibular testing. Methods: Patients eamined at the ENT emergency department from January to December 2019 were evaluated retrospectively. The patients who underwent basic ENT examination without video-assisted vestibular testing form group A. The patients who underwent basic ENT examination which was followed by video head impulse test (vHIT) and videonystagmography in the next four days form group B. Results: A total of 117 patients with acute vertigo were included in group A, PVS was found in 31 patients (27%). In total, 50 patients were included in group B; PVS was found in 15 patients (30%), vestibular neuronitis was diagnosed most often (10 patients). The difference in the diagnosis of PVS by basic ENT examination (27 patients, 54%) and by video-assisted vestibular testing (15 patients, 30%) was statistically significant (P = 0.0030). The gain of the lateral (P = 0.0101) and superior (P = 0.0043) semicircular canal proved to be statistically significant, while vHIT was lower in PVS in comparison to other causes of vertigo. Conclusion: After basic ENT examination, PVS as a cause of acute vertigo was diagnosed in 27%. Video-assisted vestibular testing proved a statistically significant lower incidence of PVS in comparison to basic ENT examination. Accessibility of video-assisted vestibular testing in the emergency department might allow for higher accuracy in the diagnosis of acute vertigo.

Keywords:

acute vertigo – vestibular function tests – Video Head Impulse Test – videonystagmography

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