Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic.

• Material Type: 博士論文
• Title: Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic.
• Author/Editor: Nishikawa, Daisuke; Wada, Yoshiro; Shiozaki, Tomoyuki; Shugyo, Masayuki; Ito, Taeko; Ota, Ichiro; Kitahara, Tadashi
• Author Heading: Nishikawa, Daisuke; Wada, Yoshiro; Shiozaki, Tomoyuki; Shugyo, Masayuki; Ito, Taeko; Ota, Ichiro; Kitahara, Tadashi
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2021-06
• Publication Date (W3CDTF): 2021-06
• Alternative Title: 地域の一般耳鼻咽喉科医よって外来経過観察された原因不明のめまい患者の内訳
• Periodical title: Auris Nasus Larynx
• No. or year of volume/issue: 48 3
• Volume: 48
• Issue: 3
• Pages: 400-407
• ISSN (Periodical Title): ISSN : 0385-8146
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2022-03-15
• Dissertation Number: 乙第1523号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Outpatient town clinic; Unknown origin; Motion-evoked floating sensation; No obvious nystagmus; Benign paroxysmal positional vertigo; Orthostatic dysregulation
• Target Audience: 一般
• Note (General): type:Thesis; Objectives: The purpose of this study was to access the contribution of vertigo/dizziness-related patients' interview and examinations during short-term hospitalization in determining the accurate final diagnosis of vertigo/dizziness of unknown origin. Methods: We reviewed 1905 successive vertigo/dizziness patients at the Vertigo/Dizziness Center of Nara Medical University, who were introduced from general otolaryngologists at outpatient town clinic from May 2014 to April 2020. However, 244 patients were diagnosed with vertigo/dizziness of unknown origin (244/1905; 12.8%). Of these patients, 240 were hospitalized and underwent various examinations, including caloric test (C-test), video head impulse test (vHIT), vestibular evoked cervical myogenic potentials (cVEMP), subjective visual vertical (SVV), inner ear magnetic resonance imaging (ieMRI), Schellong test (S-test), and self-rating questionnaires of depression score (SDS). Results: According to the examination data, together with interviewed vertigo/dizziness characteristics and daily changeable nystagmus findings, the final diagnoses were as follows: benign paroxysmal positional vertigo (BPPV: 107/240; 44.6%), orthostatic dysregulation (OD: 56/240; 23.3%), vestibular peripheral disease (VPD: 25/240; 10.4%), vestibular migraine (VM: 14/240; 5.8%), Meniere's disease (MD: 12/240; 5.0%), gravity perception disturbance (GPD: 10/240; 4.2%), psychogenic vertigo (Psycho: 10/240; 4.2%), and unknown (Unknown: 6/240; 2.5%). Supporting factors of final diagnosis was seen in gender, evoked dizziness, and positional nystagmus as BPPV; in evoked dizziness, S-test, and hypertension as OD; in evoked dizziness, head shaking after nystagmus, C-test, and vHIT as VPD; in gender, headache, and S-test as VM; in ear fullness and ieMRI as MD; in gender, evoked dizziness, and SVV as GPD; and in SDS as Psycho. To sum up, the ratios of Unknown were significantly reduced by this short-term hospitalization (244/1905→6/240). Conclusions: The answer lists for vertigo/dizziness of unknown origin obtained in the present study may be helpful for future general otolaryngologists at outpatient town clinic to better attain an accurate final iagnosis.; 博士（医学）・乙第1523号・令和4年3月15日; © 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V. All rights reserved.; identifier:Auris Nasus Larynx Vol.48 No.3 p.400-407 (2021 Jun); identifier:03858146; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4028; identifier:Auris Nasus Larynx, 48(3): 400-407
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.anl.2020.09.012
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4028/1/01%e4%b9%991523%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4028/2/02%e4%b9%991523%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

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