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Published in: Journal of Neurology 9/2015

01-09-2015 | Original Communication

Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study

Authors: Mark Obermann, Eva Bock, Nikolay Sabev, Nils Lehmann, Ralph Weber, Marcus Gerwig, Markus Frings, Diana Arweiler-Harbeck, Stephan Lang, Hans-Christoph Diener

Published in: Journal of Neurology | Issue 9/2015

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Abstract

To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23 %), benign peripheral paroxysmal vertigo (14.4 %), unilateral vestibulopathy (10.5 %), central vestibular disorders (8 %), Menière’s disease (9.8 %), vestibular migraine (6.9 %), bilateral vestibulopathy (5.5 %), and vestibular paroxysmia (3.1 %). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1 % of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably.
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Literature
1.
go back to reference Hannaford PC, Simpson JA, Bisset AF, Davis A, McKerrow W, Mills R (2005) The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Fam Pract 22(3):227–233CrossRefPubMed Hannaford PC, Simpson JA, Bisset AF, Davis A, McKerrow W, Mills R (2005) The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland. Fam Pract 22(3):227–233CrossRefPubMed
2.
go back to reference Yardley L, Owen N, Nazareth I, Luxon L (1998) Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract J R Coll Gen Pract 48(429):1131–1135 Yardley L, Owen N, Nazareth I, Luxon L (1998) Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract J R Coll Gen Pract 48(429):1131–1135
3.
go back to reference Kroenke K, Price RK (1993) Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med 153(21):2474–2480CrossRefPubMed Kroenke K, Price RK (1993) Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Arch Intern Med 153(21):2474–2480CrossRefPubMed
4.
go back to reference Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T et al (2005) Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology 65(6):898–904CrossRefPubMed Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T et al (2005) Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology 65(6):898–904CrossRefPubMed
5.
go back to reference Sloane PD (1989) Dizziness in primary care. Results from the national ambulatory medical care survey. J Fam Pract 29(1):33–38PubMed Sloane PD (1989) Dizziness in primary care. Results from the national ambulatory medical care survey. J Fam Pract 29(1):33–38PubMed
6.
go back to reference Best C, Eckhardt-Henn A, Diener G, Bense S, Breuer P, Dieterich M (2006) Interaction of somatoform and vestibular disorders. J Neurol Neurosurg Psychiatry 77(5):658–664PubMedCentralCrossRefPubMed Best C, Eckhardt-Henn A, Diener G, Bense S, Breuer P, Dieterich M (2006) Interaction of somatoform and vestibular disorders. J Neurol Neurosurg Psychiatry 77(5):658–664PubMedCentralCrossRefPubMed
7.
go back to reference Jacobson GP, Newman CW (1990) The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 116(4):424–427CrossRefPubMed Jacobson GP, Newman CW (1990) The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 116(4):424–427CrossRefPubMed
8.
go back to reference Equilibrium CoHa (1995) Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière’s disease. Am Acad Otolaryngol Head Neck Found Inc Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg 113(3):181–185CrossRef Equilibrium CoHa (1995) Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière’s disease. Am Acad Otolaryngol Head Neck Found Inc Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg 113(3):181–185CrossRef
9.
go back to reference Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J et al (2012) Vestibular migraine: diagnostic criteria. J Vestib Res Equilib Orientat 22(4):167–172 Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J et al (2012) Vestibular migraine: diagnostic criteria. J Vestib Res Equilib Orientat 22(4):167–172
10.
go back to reference Brandt T, Huppert D, Dieterich M (1994) Phobic postural vertigo: a first follow-up. J Neurol 241(4):191–195CrossRefPubMed Brandt T, Huppert D, Dieterich M (1994) Phobic postural vertigo: a first follow-up. J Neurol 241(4):191–195CrossRefPubMed
11.
go back to reference Prokopakis E, Vlastos IM, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G (2013) Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurootol 18(2):83–88CrossRefPubMed Prokopakis E, Vlastos IM, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G (2013) Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurootol 18(2):83–88CrossRefPubMed
12.
go back to reference Prokopakis EP, Chimona T, Tsagournisakis M, Christodoulou P, Hirsch BE, Lachanas VA et al (2005) Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure. Laryngoscope 115(9):1667–1671CrossRefPubMed Prokopakis EP, Chimona T, Tsagournisakis M, Christodoulou P, Hirsch BE, Lachanas VA et al (2005) Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure. Laryngoscope 115(9):1667–1671CrossRefPubMed
13.
go back to reference Sekine K, Imai T, Sato G, Ito M, Takeda N (2006) Natural history of benign paroxysmal positional vertigo and efficacy of Epley and Lempert maneuvers. Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg 135(4):529–533CrossRef Sekine K, Imai T, Sato G, Ito M, Takeda N (2006) Natural history of benign paroxysmal positional vertigo and efficacy of Epley and Lempert maneuvers. Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg 135(4):529–533CrossRef
14.
go back to reference von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T et al (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78(7):710–715CrossRef von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T et al (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78(7):710–715CrossRef
15.
go back to reference Sato G, Sekine K, Matsuda K, Takeda N (2013) Risk factors for poor outcome of a single Epley maneuver and residual positional vertigo in patients with benign paroxysmal positional vertigo. Acta Otolaryngol 133(11):1124–1127CrossRefPubMed Sato G, Sekine K, Matsuda K, Takeda N (2013) Risk factors for poor outcome of a single Epley maneuver and residual positional vertigo in patients with benign paroxysmal positional vertigo. Acta Otolaryngol 133(11):1124–1127CrossRefPubMed
16.
go back to reference Tschan R, Best C, Wiltink J, Beutel ME, Dieterich M, Eckhardt-Henn A (2013) Persistence of symptoms in primary somatoform vertigo and dizziness: a disorder “lost” in health care? J Nerv Ment Dis 201(4):328–333CrossRefPubMed Tschan R, Best C, Wiltink J, Beutel ME, Dieterich M, Eckhardt-Henn A (2013) Persistence of symptoms in primary somatoform vertigo and dizziness: a disorder “lost” in health care? J Nerv Ment Dis 201(4):328–333CrossRefPubMed
17.
go back to reference Holmberg J, Karlberg M, Harlacher U, Magnusson M (2007) One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. J Neurol 254(9):1189–1192CrossRefPubMed Holmberg J, Karlberg M, Harlacher U, Magnusson M (2007) One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. J Neurol 254(9):1189–1192CrossRefPubMed
18.
go back to reference Ruckenstein MJ, Staab JP (2009) Chronic subjective dizziness. Otolaryngol Clin N Am 42(1):71–77 (ix) CrossRef Ruckenstein MJ, Staab JP (2009) Chronic subjective dizziness. Otolaryngol Clin N Am 42(1):71–77 (ix) CrossRef
19.
go back to reference Kaderli R, Seelandt J, Umer M, Tschan F, Businger A (2013) Reasons for the persistence of adverse events in the era of safer surgery—a qualitative approach. Swiss Med Wkly 143:w13882PubMed Kaderli R, Seelandt J, Umer M, Tschan F, Businger A (2013) Reasons for the persistence of adverse events in the era of safer surgery—a qualitative approach. Swiss Med Wkly 143:w13882PubMed
20.
go back to reference Strupp M, Hupert D, Frenzel C, Wagner J, Hahn A, Jahn K et al (2008) Long-term prophylactic treatment of attacks of vertigo in Menière’s disease—comparison of a high with a low dosage of betahistine in an open trial. Acta Otolaryngol 128(5):520–524CrossRefPubMed Strupp M, Hupert D, Frenzel C, Wagner J, Hahn A, Jahn K et al (2008) Long-term prophylactic treatment of attacks of vertigo in Menière’s disease—comparison of a high with a low dosage of betahistine in an open trial. Acta Otolaryngol 128(5):520–524CrossRefPubMed
21.
go back to reference Ramsey RR, Ryan JL, Hershey AD, Powers SW, Aylward BS, Hommel KA (2014) Treatment adherence in patients with headache: a systematic review. Headache 54(5):795–816CrossRefPubMed Ramsey RR, Ryan JL, Hershey AD, Powers SW, Aylward BS, Hommel KA (2014) Treatment adherence in patients with headache: a systematic review. Headache 54(5):795–816CrossRefPubMed
22.
go back to reference Lempert T, Neuhauser H (2009) Epidemiology of vertigo, migraine and vestibular migraine. J Neurol 256(3):333–338CrossRefPubMed Lempert T, Neuhauser H (2009) Epidemiology of vertigo, migraine and vestibular migraine. J Neurol 256(3):333–338CrossRefPubMed
23.
go back to reference Best C, Eckhardt-Henn A, Tschan R, Dieterich M (2009) Psychiatric morbidity and comorbidity in different vestibular vertigo syndromes. Results of a prospective longitudinal study over one year. J Neurol 256(1):58–65CrossRefPubMed Best C, Eckhardt-Henn A, Tschan R, Dieterich M (2009) Psychiatric morbidity and comorbidity in different vestibular vertigo syndromes. Results of a prospective longitudinal study over one year. J Neurol 256(1):58–65CrossRefPubMed
24.
go back to reference Yoon MS, Manack A, Schramm S, Fritsche G, Obermann M, Diener HC et al (2013) Chronic migraine and chronic tension-type headache are associated with concomitant low back pain: results of the German Headache Consortium study. Pain 154(3):484–492CrossRefPubMed Yoon MS, Manack A, Schramm S, Fritsche G, Obermann M, Diener HC et al (2013) Chronic migraine and chronic tension-type headache are associated with concomitant low back pain: results of the German Headache Consortium study. Pain 154(3):484–492CrossRefPubMed
25.
go back to reference Karatas M (2008) Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurol 14(6):355–364CrossRef Karatas M (2008) Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurol 14(6):355–364CrossRef
26.
go back to reference Brown KE, Whitney SL, Marchetti GF, Wrisley DM, Furman JM (2006) Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil 87(1):76–81CrossRefPubMed Brown KE, Whitney SL, Marchetti GF, Wrisley DM, Furman JM (2006) Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil 87(1):76–81CrossRefPubMed
27.
go back to reference Hillier SL, McDonnell M (2011) Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev (2):CD005397 Hillier SL, McDonnell M (2011) Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev (2):CD005397
28.
go back to reference Zingler VC, Weintz E, Jahn K, Mike A, Huppert D, Rettinger N et al (2008) Follow-up of vestibular function in bilateral vestibulopathy. J Neurol Neurosurg Psychiatry 79(3):284–288CrossRefPubMed Zingler VC, Weintz E, Jahn K, Mike A, Huppert D, Rettinger N et al (2008) Follow-up of vestibular function in bilateral vestibulopathy. J Neurol Neurosurg Psychiatry 79(3):284–288CrossRefPubMed
29.
go back to reference Gillespie MB, Minor LB (1999) Prognosis in bilateral vestibular hypofunction. Laryngoscope 109(1):35–41CrossRefPubMed Gillespie MB, Minor LB (1999) Prognosis in bilateral vestibular hypofunction. Laryngoscope 109(1):35–41CrossRefPubMed
30.
go back to reference Krebs DE, Gill-Body KM, Parker SW, Ramirez JV, Wernick-Robinson M (2003) Vestibular rehabilitation: useful but not universally so. Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg 128(2):240–250CrossRef Krebs DE, Gill-Body KM, Parker SW, Ramirez JV, Wernick-Robinson M (2003) Vestibular rehabilitation: useful but not universally so. Otolaryngol Head Neck Surg Off J Am Acad Otolaryngol Head Neck Surg 128(2):240–250CrossRef
31.
go back to reference Eleftheriadou A, Skalidi N, Velegrakis GA (2012) Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Oto Rhino Laryngol Off J Eur Fed Oto Rhino Laryngol Soc 269(11):2309–2316CrossRef Eleftheriadou A, Skalidi N, Velegrakis GA (2012) Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Oto Rhino Laryngol Off J Eur Fed Oto Rhino Laryngol Soc 269(11):2309–2316CrossRef
Metadata
Title
Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study
Authors
Mark Obermann
Eva Bock
Nikolay Sabev
Nils Lehmann
Ralph Weber
Marcus Gerwig
Markus Frings
Diana Arweiler-Harbeck
Stephan Lang
Hans-Christoph Diener
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 9/2015
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-015-7803-7

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