Clinical efficacy of vestibular assessment and rehabilitation training in peripheral vestibular vertigo.

Objective: To evaluate the clinical efficacy of vestibular assessment and rehabilitation training in patients with peripheral vestibular vertigo. Method: This was a retrospective study. A total of 169 patients diagnosed with peripheral vestibular vertigo, admitted to Cangzhou People's Hospital between January 2020 and January 2023 were divided into control group (83 cases) and observation group (86 cases). The control group received medication-based treatment, while the observation group was provided with combined treatment of medication and vestibular rehabilitation training. Assessment of recovery included the Dizziness Handicap Inventory (DHI), Vestibular Symptom Index (VSI), and Activities-specific Balance Confidence (ABC) scale before and at two, four, and eight weeks post-treatment. Psychological status, sleep quality, and life quality were evaluated. Both groups underwent the Fukuda stepping test and timed balance test. Result: At two, four, and eight weeks post-treatment, both groups exhibited significantly lower DHI-P, DHI-F, DHI-E, VSI, and ABC scores compared to pre-treatment (p<0.05). The observation group showed significantly lower DHI-P, DHI-F, DHI-E, VSI, and ABC scores than the control group at two and four weeks post-treatment (p<0.05). After treatment, both groups demonstrated reduced body deviation angles and increased time without falling in the Fukuda stepping test (p<0.05). Notably, the observation group had significantly better outcomes (p<0.05). Conclusion: In comparison to medication-based treatment alone, a combined approach involving medication treatment and vestibular rehabilitation training may demonstrate early improvements in vertigo symptoms, enhance balance capabilities, and ameliorate psychological well-being, sleep quality, and overall quality of life for patients.

Age dependent vestibulo-ocular reflex gain in video head impulse test among normal Indians.

Determination of the normative data of Vestibulo-Ocular Reflex gain using VHIT of all three semicircular canals (anterior, posterior, horizontal) on both sides in different age groups is of interest. This is an observational study comprised of 10 healthy individuals in each decade from less than 10 years to 80 years of both sexes making a total of 80. The study was done using the equipment SYNAPSYS VHIT ULMER with Software EVOLUTION 3.0. Mean VOR gain of each decade for all the semicircular canals is calculated and they are compared using ANOVA (Analysis of variance). In our study, percentage of patients with overt saccades is nil. Hence, in our study, the occurrence of covert saccades was insignificant as compared to the above studies. Age dependent VOR gain in normal individuals did not have any significance in our study of 80 patients performed by video head impulse test. VOR gain in our study is not affected by age. Normative data for different age groups obtained compared among different age groups showing no significant difference in Mean VOR gain. The normative values of VOR gain can be compared to patients with dizziness thus helping in determining any vestibular loss.

[The VeSFADS structural classification of vestibular disorders].

The issuing of International Classification of Vestibular Disorders（ICVD） by Brny society（2015） greatly facilitates the progress of vestibular medicine. The syndromic classification of vestibular disorders by ICVD enable the physician to narrow the spectrum of differential diagnosis for the vestibular disorder in clinical practice. However, the division of vestibular pathway, especially the central vestibular system, has not be classified yet in the ICVD（2015）. Central vertigo, being a group of heterogeneous disorders, may present diverse clinical spectrums. The misdiagnosis of central vestibular as well as peripheral vestibular disorders have been reported in the clinic practice. Therefore, the author by review study proposes a structural classification of vestibular disorders combined the Vestibular System Functional Anatomy Division with Syndromes（VeSFADS）. The VeSFADS classification of vestibular disorders could help the physician in clinical practice to narrow the spectrum of vestibular disorders, in addition to the syndromic classification, by the clinical feature of vestibular disorders from different division of vestibular system. And the VeSFADS classification of vestibular disorders may facilitate to clarify the clinical features of vestibular disorders at different Division of vestibular pathway.

The First 100 Children Treated in a Newly Established Pediatric Vertigo Center.

BACKGROUND: Correctly diagnosing dizziness in children is essential for appropriate management; nevertheless, healthcare professionals face challenges due to children's limited ability to describe their symptoms and their cooperation during physical examination. The objective of this study is to describe the first 100 patients seen at a newly established pediatric vertigo center. METHODS: This is a retrospective review of a consecutive series of 100 patients seen at our pediatric vertigo clinic in a tertiary referral center from August 2019 until June 2022. Comprehensive clinical data were collected. The diagnoses were established by 2 pediatric otolaryngologists based on validated diagnostic criteria. Trends in diagnosis, investigation, and treatment of these patients were analyzed. RESULTS: A total of 100 children were included in the study. Vestibular migraine was the most common diagnosis (20%) followed by benign paroxysmal vertigo of childhood (14%). Eleven patients had combined pathologies. Fifteen out of 70 children (21%) had abnormal audiograms, 30 out of 48 children (62.5%) had abnormal vestibular testing, and 6 out of 31 (19%) patients had abnormal imaging. Fifty-one children received medical treatment, 23 received vestibular physiotherapy, and 9 patients had particle repositioning maneuvers; moreover, 17 of these patients received multimodal treatment. CONCLUSIONS: Our analysis suggests that imaging and audiology testing have relatively low yield in the assessment of pediatric vertigo. On the other hand, vestibular testing detected a high proportion of abnormalities, such as saccadic pursuit, vertical nystagmus, central positional nystagmus, and abnormal directional preponderance, particularly associated with vestibular migraine. Given the complexity of diagnosing vertigo in children, it is critical to establish multidisciplinary specialized centers capable of providing accurate diagnosis and treatment for these children.

[Application of the holism of body-qi-spirit in needle knife treatment for cervical vertigo].

This paper introduces Professor WANG Haidong's approach to treat cervical vertigo with needle knife based on the holism of body-qi-spirit. Professor WANG Haidong, considering the etiology and pathogenesis of cervical vertigo, starting from the holism of body-qi-spirit, based on the anatomical structure, employs the "seven-neck points" technique to improve local blood supply and address the physical issue; guided by the Jingjin theory, he utilizes the "knot releasing technique" to disperse knots and relax sinews, thereby regulating qi. In addition, he uses the "bone puncturing technique at governor vessel" to uplift yang-qi and nourish the brain, thereby nurturing the spirit.

Feasibility of gamified visual desensitisation for visually-induced dizziness.

Visually-induced dizziness (visual vertigo) is a core symptom of Persistent Perceptual Postural Dizziness (PPPD) and occurs in other conditions and general populations. It is difficult to treat and lacks new treatments and research. We incorporated the existing rehabilitation approach of visual desensitisation into an online game environment to enhance control over visual motion and complexity. We report a mixed-methods feasibility trial assessing: Usage and adherence; rehabilitation potential; system usability and enjoyment; relationship with daily dizziness. Participants played online with (intervention, N = 37) or without (control, N = 39) the visual desensitisation component for up to 5-10 min, twice daily for 6 weeks. Dropout was 45%. In the intervention group, N = 17 played for the recommended time while N = 20 played less. Decreases in visual vertigo symptoms, anxiety and depression correlated with playtime for the intervention but not control. System usability was high. Daily symptoms predicted playtime. Qualitative responses broadly supported the gamified approach. The data suggest gamified visual desensitisation is accessible, acceptable and, if adherence challenges can be overcome, could become a useful addition to rehabilitation schedules for visually-induced dizziness and associated anxiety. Further trials are needed.

[Curative effect analysis of anterior cervical discectomy and fusion in patients with cervical spondylosis of vertebral artery type].

OBJECTIVE: To investigate the clinical effect of anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylosis of vertebral artery type(CSA). METHODS: The clinical data of 42 patients with CSA from January 2020 to January 2022 were retrospectively analyzed. There were 25 males and 17 females, aged from 30 to 74 years old with an average of (53.9±11.0) years old. There were 18 cases with single-segment lesions, 17 cases with two-segment lesions, and 7 cases with three-segment lesions. The American Academy of Otolaryngology-Head and Neck Surgery's Hearing and Balance Committee score (CHE), the Neck Disability Index (NDI) and the cervical curvature Cobb angle were recorded before surgery and after surgery at 6 months. RESULTS: All 42 ACDF patients were followed up for 6 to 30 months with an average of (14.0±5.2) months. The operative time ranged from 95 to 220 min with an average of (160.38±36.77) min, the intraoperative blood loss ranged from 30 to 85 ml with an average of (53.60±18.98) ml. Tow patients had mild postoperative dysphagia, which improved with symptomatic treatment such as nebulized inhalation. CHE score decreased from (4.05±0.96) preoperatively to (2.40±0.70) at 6 months postoperatively (t=12.97, P<0.05). The number of improved vertigo at 6 months postoperatively was 38, with an improvement rate of 90.5%. NDI score was reduced from (34.43±8.04) preoperatively to (20.76±3.91) at 6 months postoperatively (t=11.83, P<0.05). The cervical curvature Cobb angle improved from (8.04±6.70)° preoperatively to (12.42±5.23)° at 6 months postoperatively (t=-15.96, P<0.05). CONCLUSION: The ACDF procedure has outstanding clinical efficacy in treating CSA. The operation can rapidly relieve patients' episodic vertigo symptoms by relieving bony compression and reconstructing cervical curvature. However, it is necessary to strictly grasp the indications for surgery and clarify the causes of vertigo in patients, and ACDF surgery is recommended for CSA patients for whom conservative treatment is ineffective.

[Cochleovestibular manifestations in coronavirus infection]. / Kokhleovestibulyarnye proyavleniya pri koronavirusnoi infektsii.

One of the main causes of the of the inner ear pathology is a viral infection including SARS-CoV-2 virus. On the other hand the psycho-emotional state of patients also affects patients with hearing loss, tinnitus and dizziness, and an increase in depression and anxiety was revealed during the period of self-isolation. Goal of our study was to analyze cochleovestibular pathology in patients with COVID-19. The study involved 84 patients and the leading complaint was hearing loss - in 70 patients, tinnitus - in 54 patients, dizziness - in 50 patients. In addition, an increased anxiety background was found in patients, as well as signs of depression. Thus, the 2020 pandemic period was a high risk period for patients with inner ear pathology, which may be associated not only with the actual pathological effect of the virus on the auditory and vestibular system, but also with changes in the psycho-emotional status of patients.

A Month of Vestibular Migraine: Symptom Characterization Using Ecological Momentary Assessment.

OBJECTIVE(S): This study investigated the frequency and intensity of vestibular migraine (VM) symptoms using Ecological Momentary Assessment (EMA). This approach was intended to provide insights into the day-to-day experiences of individuals with VM, contributing to a more comprehensive understanding of this condition. METHODS: Participants reported symptoms to an automated text system, rating their dizziness over the prior 24 h as none, mild, moderate, or severe. Definitive Dizzy Days (DDDs) were defined as days with moderate or severe dizziness. A student's independent group t-test was used to compare the number of DDDs between VM and probable VM subjects. RESULTS: Sixty-six subjects were included, with an average of 29 days of pre-intervention data (SD = 1.4). The average number of days with no dizziness was 3.5 (SD = 6.5), mild dizziness was 9.1 (SD = 6.7), moderate dizziness was 11 (SD = 6.1), and severe dizziness was 5.4 (SD = 6.3). Out of the 66 patients, 52 were classified as VM and 14 as pVM. The average number of DDDs was not significantly different between VM (17.0, SD = 8.3) and pVM (15.3, SD = 10.0) patients, with a two-tailed p-value of 0.44. CONCLUSION: With EMA, we found that the average subject with VM had some degree of dizziness almost every day, and more than 15 DDDs per month. LEVEL OF EVIDENCE: III Laryngoscope, 2024.

Partial Treatment During BPPV Diagnostic Maneuvers.

This study examines a case of lateral canal benign paroxysmal positional vertigo (BPPV) where the sequence of diagnostic positional maneuvers may have influenced the release of some canaliths into the utricle. Partial treatment during BPPV diagnostic maneuvers may complicate side identification during supine roll test, especially in canalolithiasis cases.

A Systematic Review on Hearing and Balance in Patients with Chronic Kidney Disease with and Without Hemodialysis.

Objective: Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Methods: Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Results: Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. Conclusion: CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population.

Impact of Epley's Manoeuvre on Quality of Life in Patients with Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: A Pre- and Post-Treatment Analysis.

Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder, predominantly affecting the posterior semicircular canal (PSC), and significantly impacts the quality of life (QoL) of patients. This study assesses the effectiveness of Epley's manoeuvre in improving QoL in patients with PSC-BPPV. This prospective analytical study, conducted at a tertiary care centre from January 2021 to December 2022, included 93 adult patients diagnosed with PSC-BPPV via the Dix-Hallpike test. Participants were evaluated using the dizziness handicap inventory (DHI) and visual vertigo analogue score (VAS) at baseline and on days 3, 10, and 30 post-treatments with Epley's manoeuvre. Data analysis focused on changes in DHI and VAS scores to assess the impact of treatment. The cohort comprised 58.1% males and 41.9% females, with a significant majority over 50 years of age. Notably, 90% of patients reported improvement by the first follow-up. Both DHI and VAS scores showed a statistically significant decrease over the follow-up period (p < 0.05), indicating a reduction in perceived dizziness and visual vertigo symptoms post-treatment. Epley's manoeuvre effectively improves the QoL in patients with PSC-BPPV, as evidenced by significant reductions in DHI and VAS scores. This study contributes to the evidence supporting Epley's manoeuvre as a key intervention in PSC-BPPV treatment, emphasizing its role in enhancing patient outcomes in clinical practice.

Diagnosis of Benign Paroxysmal Positional Vertigo Using a Questionnaire in a Hospital Based Rural Setting in India.

To develop and validate a simple questionnaire for the diagnosis of Benign Paroxysmal Positional Vertigo (BPPV) and also to accurately predict the involved side in BPPV. Patients (N = 148) who presented with dizziness to the ENT department were asked to fill out a questionnaire which was formulated to diagnose BPPV and the affected side. Five questions were part of the questionnaire. The fifth question was set to ascertain the affected side in BPPV. All the patients underwent a detailed neuro-otological examination and the findings were noted. The findings of the examination were correlated with the questionnaire findings. The mean age of the patient group was 54.72 years of age. The sensitivity of the questionnaire in detecting BPPV was 94.5%, though in 12.79% (n = 11) the side was not predicted correctly. The specificity of the questionnaire was 91.22%. The positive predictive value of the questionnaire in detecting BPPV was assessed at 94.5%.The questionnaire can be effectively used in predicting BPPV amongst patients presenting with dizziness and thus helps in avoiding unnecessary imaging and referrals to higher centres in view of suspicion of central causes of dizziness.

Enhancing BPPV Treatment Outcomes: A Comparative Study of the Epley Maneuver with and without the Dizzy-Fix Training Device.

INTRODUCTION: This study evaluates the effectiveness of combining the Epley Maneuver with the Dizzy-Fix Training Device in treating Benign Paroxysmal Positional Vertigo (BPPV), aiming to enhance treatment outcomes and patient satisfaction. METHODS: In this randomized controlled trial, 50 patients diagnosed with posterior canal BPPV were allocated into two groups: one receiving the traditional Epley Maneuver and the other undergoing the Epley Maneuver supplemented with the Dizzy-Fix Training Device. Key measures included the proportion of symptom-free patients at one month, changes in the Visual Analogue Scale (VAS) and Dizziness Handicap Inventory (DHI) scores, the recurrence rate within one month, and patient satisfaction. RESULTS: The Dizzy-Fix group achieved a significantly higher symptom resolution rate by day 7 (90% vs. 60%) and reported greater patient satisfaction (4.5/5 vs. 3.8/5) compared to the Epley Maneuver alone group. Additionally, this group exhibited a more substantial decrease in DHI scores (from an average of 30 to 5) and a lower recurrence rate (10% vs. 40%) within the first month post-treatment. CONCLUSION: Incorporating the Dizzy-Fix Training Device with the Epley Maneuver significantly improves the management of BPPV, evidenced by faster symptom resolution, enhanced patient satisfaction, and reduced symptom recurrence. These findings underscore the value of integrating real-time visual feedback technologies in vestibular rehabilitation, promising better patient outcomes, and advancing the quality of care in BPPV treatment.

A Study of Quality of Life Improvement in Videonystagmography Guided Epley's Manoeuvre in Posterior Canal Benign Paroxysmal Positional Vertigo.

To assess Quality of life improvement in Videonystagmography guided Epley's Manoeuvre in posterior canal benign paroxysmal positional vertigo. The design of present study is cross-sectional analytical study. The study is conducted in the Department of Otorhinolaryngology, Sri Aurobindo Medical College and Post Graduate Institute, Indore in association with Sri Aurobindo Institute of speech and hearing, Indore. Current study done to assess the effectiveness of canalolith repositioning procedures (Epley's maneuver) with and without drug therapy in posterior canal benign paroxsymal positional vertigo and to assess the patients based on Dizziness Handicap Inventory. All Patients who come to ENT OPD at Sri Aurobindo Medical College and Post Graduate Institute, Indore in the specified duration and according to the inclusion criteria were chosen in the study. Majority of the patients were in the age group of 18-58 years with the median age of 32 and subjective symptomatic relief on Epley's manoeuvre and DHI on day 15, 46 out of 60 subjects reported symptomatic relief with a percentage of 76.6%. This group of 46 subjects with symptomatic relief was labeled as resolved group. The age range in resolved group was between 18 and 58 years. Remaining 14 subjects, labelled as relapsed group were prescribed beta-histine and repeat Epley's maneuver was performed to assess the effectiveness of adjunct therapy. We conclude that a single Videonystagmography guided Epley's maneuver is an excellent tool for effective rehabilitation of majority of posterior canal BPPV alone and combined with adjunct betahistine therapy can even cure refractory cases providing them with better quality of life.

Corrigendum: Residual dizziness after BPPV management: exploring pathophysiology and treatment beyond canalith repositioning maneuvers.

[This corrects the article DOI: 10.3389/fneur.2024.1382196.].

Incidence of Subsequent Injuries Associated with a New Diagnosis of Benign Paroxysmal Positional Vertigo and Effects of Treatment: A Nationwide Cohort Study.

Background/Objectives: Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo and the most common peripheral vestibular disorder. It is characterized by intense vertigo triggered by head and position changes. This study investigates the risk of subsequent injury in BPPV patients and the effects of treatment. Methods: A population-based retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2005 in Taiwan. Patients with and without BPPV were identified between 2000 and 2017. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method determined the cumulative incidence rates of injury in both cohorts, and a log-rank test analyzed the differences. Cox proportional hazard models calculated each cohort's 18-year hazard ratios (HRs). Results: We enrolled 50,675 patients with newly diagnosed BPPV and 202,700 matched individuals without BPPV. During follow-up, 47,636 patients were diagnosed with injuries (13,215 from the BPPV cohort and 34,421 from the non-BPPV cohort). The adjusted HR for injury in BPPV patients was 2.63 (95% CI, 2.49-2.88). Subgroup analysis showed an increased incidence of unintentional and intentional injuries in BPPV patients (aHR 2.86; 95% CI, 2.70-3.13 and 1.10; 95% CI, 1.04-1.21, respectively). A positive dose-response relationship was observed with increasing BPPV diagnoses. Treatment with canalith repositioning therapy (CRT) or medications reduced the risk of injury slightly but not significantly (aHR, 0.78; 95% CI, 0.37-1.29, 0.88; 95% CI, 0.40-1.40, respectively). Conclusions: BPPV is independently associated with an increased risk of injuries. CRT or medications have limited effects on mitigating this risk. Physicians should advise BPPV patients to take precautions to prevent injuries even after treatment.

Comparative effectiveness of non- pharmacological treatments in patients with persistent postural-perceptual dizziness: a systematic review and effect sizes analyses.

Introduction: The patho-psychological mechanisms of persistent postural-perceptual dizziness (PPPD) appear to be very complex, and a multimodal, multidisciplinary approach is suggested for treating patients with PPPD. The aim of this review was to provide a comprehensive overview of non-pharmacological treatments and their comparative effectiveness in patients with PPPD. Methods: Scopus, Web of Science, PsycINFO, Medline, Embase, CINAHL, Cochrane Library and ClinicalTrials.gov were searched in April 2022 with a search update in August 2023. Only randomized controlled trials (RCTs) were included. There was no restrictions regarding publication date. Two reviewers independently identified eligible trials, extracted data, double-checked all extracted information from the included articles and assessed the risk of bias using the Cochrane risk of bias tool. A qualitative synthesis was performed, considering methodological heterogeneity between trials. Finally, an effect size analysis was performed for each treatment comparison. The standardized mean differences (SMD) and their corresponding 95% confidence intervals (95%CI) were calculated for each trial using Review Manager 5.4. Results: Thirteen RCTs (618 patients with moderate or mild dizziness) out of 1,362 references describing seven different non-pharmacological comparisons were selected. Nine trials included patients with PPPD, and four trials included patients with functional dizziness. The trials used different interventions that were classified as: (1) psychotherapeutic interventions (cognitive behavioral therapy, patient education), (2) physiotherapeutic interventions/training (vestibular rehabilitation, optokinetic stimulation), (3) stimulation procedures (vagus nerve stimulation, transcranial direct current stimulation) and (4) device application (visual desensitization using personalized glasses). However, most of the trials investigated the effects of single interventions, rather than multimodal interdisciplinary treatment of patients with PPPD. The SMD for dizziness handicap and severity was between 0.04 and 0.52 in most trials. In one trial using visual desensitization, the SMD was 1.09 (strong effect on the severity of dizziness) and 1.05 (strong effect on dizziness handicap). Discussion: Several individual interventions have shown benefits in the treatment of patients with PPPD with small to moderate effects. However, the multimodal treatment or a combination of vestibular rehabilitation with visual desensitization, cognitive behavioral therapy including patient education, and medication support should be further investigated. Future trials should include a large sample size with severe dizziness, and provide a longer follow-up period. Clinical trial registration: PROSPERO CRD42022320344.

Visual scale to document acute dizziness in the hospital.

BACKGROUND: Managing acute vertigo/dizziness for inpatients requires valid communication between the various healthcare professionals that triage such life-threatening presentations, yet there are no current scaling methods for managing such acute vertigo symptoms for inpatients. OBJECTIVE: To describe the development and validation of the Krems Acute Vertigo/Dizziness Scale (KAVEDIS), a new instrument for tracking subjective symptoms (vertigo, dizziness) and gait impairment across four unique vestibular diagnoses (Menière's disease, benign paroxysmal positional vertigo, peripheral vestibular hypofunction, and vestibular migraine) over a one-year period after inpatient hospital admission. METHODS: Retrospective data collection study from KAVEDIS scale and chart documentation. RESULTS: The KAVEDIS scale can significantly distinguish scores from admission to discharge in three of four vestibular diagnoses. The documented course of subjective vestibular symptoms and gait disturbances were correlated in all four groups. CONCLUSION: We suggest that KAVEDIS documentation among inpatients admitted with acute vertigo/dizziness may improve communication between the various intervening clinicians and help to raise concern in cases of symptomprogression.

Healthcare Costs due to Dizziness/Vertigo in Korea: Analyses Using the Public Data of Health Insurance Review & Assessment Service.

BACKGROUND: Dizziness/vertigo is one of the most common symptoms for which people seek healthcare. However, the healthcare expenditure attributable to dizziness/vertigo in South Korea remains poorly understood. We investigated the healthcare costs due to six major disorders causing dizziness/vertigo using claims data. METHODS: The healthcare costs were evaluated using all the claims data submitted to the Health Insurance Review and Assessment Service from January 1 to December 31, 2022. The six major vestibular disorders included for analysis were benign paroxysmal positional vertigo (BPPV), psychogenic/persistent postural perceptual dizziness (PPPD), vascular vertigo/dizziness (VVD), vestibular migraine (VM), Meniere's disease (MD), and vestibular neuritis (VN). RESULTS: During the 1-year study period, 4.1% of adults aged 20 or older visited hospitals due to dizziness/vertigo in South Korea. Compared to the general population, the patients with dizziness/vertigo were more often elderly, female, and residents of small towns. The total healthcare cost for the six major vestibular disorders was ₩547.8 billion (approximately $406.5 million). BPPV incurred the highest annual healthcare cost (₩183.5 billion, 33.5%), followed by VVD (₩158.8 billion, 29.0%), MD (₩82.2 billion, 15.0%), psychogenic/PPPD (₩60.3 billion, 11.0%), VN (₩32.9 billion, 6.0%), and VM (₩30.1 billion, 5.5%). The mean healthcare cost per hospital visit due to dizziness/vertigo was ₩96,524 (95% confidence interval, ₩96,194-₩96,855), 30% higher than the average (₩73,948) of the overall healthcare cost per hospital visit over the same period. CONCLUSION: Owing to higher healthcare costs for dizziness/vertigo and increased prevalence of dizziness/vertigo in the aged population, healthcare costs due to dizziness/vertigo will increase rapidly in South Korea. Thus, a guideline for cost-effective management of dizziness/vertigo should be established to reduce the healthcare costs due to these common symptoms.