Frequency, aetiology, and impact of vestibular symptoms in the emergency department: a neglected red flag.

Göldlin, Martina; Gaschen, Janika; Kammer, Christoph; Comolli, Lukas; Bernasconi, Corrado Angelo; Spiegel, Rainer; Bassetti, Claudio; Exadaktylos, Aristomenis K.; Lehmann, Beat; Mantokoudis, Georgios; Kalla, Roger; Fischer, Urs (2019). Frequency, aetiology, and impact of vestibular symptoms in the emergency department: a neglected red flag. Journal of neurology, 266(12), pp. 3076-3086. Springer-Medizin-Verlag 10.1007/s00415-019-09525-4

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OBJECTIVE We aimed to determine the incidence of all vestibular symptoms in a large interdisciplinary tertiary emergency department (ED) and to assess stroke prevalence, and frequency of other life-threatening aetiologies. METHODS In this 1-year retrospective study, we manually screened all medical records of 23,608 ED visits for descriptions of vestibular symptoms. Symptoms were classified according to the International Classification of Vestibular Disorders of the Bárány Society. We evaluated all patients older than 16 years in whom vestibular symptoms were the main or accompanying complaint. We extracted clinical, radiological, and laboratory findings as well as aetiologies from medical records. RESULTS We identified a total of 2596 visits by 2464 patients (11% of ED visits) who reported at least one vestibular symptom. In 1677/2596 visits (64.6%), vestibular symptoms were the main reason for the ED consultation. Vestibular symptoms were classified as dizziness (43.8%), vertigo (33.9%), postural symptoms (6.5%), or more than one symptom (15.8%). In 324/2596 visits (12.5%), cerebrovascular events were the aetiology of vestibular symptoms, and in 355/2596 visits (13.7%), no diagnosis could be established. In 23.8% of visits with vestibular symptoms as the main complaint, the underlying condition was life-threatening. CONCLUSION Frequency and impact of vestibular symptoms in patients visiting the ED were higher than previously reported, and life-threatening aetiologies such as strokes are common. Therefore, awareness among physicians regarding the importance of vestibular symptoms has to be improved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Göldlin, Martina Béatrice; Bernasconi, Corrado Angelo; Bassetti, Claudio; Exadaktylos, Aristomenis; Lehmann, Beat; Mantokoudis, Georgios; Kalla, Roger and Fischer, Urs

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-5354

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

11 Nov 2019 14:30

Last Modified:

14 Nov 2019 01:33

Publisher DOI:

10.1007/s00415-019-09525-4

PubMed ID:

31531764

Uncontrolled Keywords:

Aetiology Emergency department Frequency Impact Stroke Vestibular symptoms

BORIS DOI:

10.7892/boris.134849

URI:

https://boris.unibe.ch/id/eprint/134849

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