Introduction:
The term ”dizziness” refers to an unpleasant disturbance of spatial orientation while vertigo refers to an erroneous perception of movement which involves movement either of one’s own body, such as swaying or rotation, or of the environment, or both. Vertigo and dizziness are one of the common symptoms presented to physicians. Their lifetime prevalence is approximately 20% to 30% [14, 20]. Its prevalence rises with age and is about two to three times higher in women than in men [14]. It is usually benign and self-limiting. Vertigo / dizziness is associated with many causes- hypotension, dehydration, Meniere’s disease; to more serious brain tumor, stroke, myocardial infarction, etc.
International Classification of Vestibular Disorders I (ICVD-I) by the Committee for the Classification of Vestibular Disorders of the Barany Society classified vertigo and dizziness based on the description as (i) Vertigo (ii) Dizziness (iii) Vestibulo-visual symptoms (iv) Postural symptoms [2]. Because vertigo and dizziness are often triggered symptoms and many vestibular disorders are identified by the presence (or absence) of particular triggers; it further classified vertigo and dizziness as ‘Triggered’ and “Spontaneous’ [2].
Targeted history taking, clinical bedside examinations, functional testing of the vestibular system, and imaging are instrumental for correct diagnosis and therapy management [24]. Wuyts, Floris L et al developed a ‘SO STONED’ questionnaire tool for dizziness/vertigo assessment and differential diagnosis; based on their experience and literature [24]. It encompasses set of eight independent but closely related dimensions necessary to discriminate between several diagnoses. The acronym ‘SO STONED’ stands for, S: symptoms, O: often, S: since, T: trigger, O: otology, N: neurology, E:evolution, D:duration. Trigger is an important aspect for differential diagnosis. ‘Trigger’ refers to a specific act or situation that provokes or aggravates the symptoms and are important for the differential diagnosis for vertigo / dizziness. Vestibular problems due to BPPV should cause vertigo upon lying down, and also during the upright movement; but if the problem occur only during the upright movement, then the probable underlying cause could be of cardiac origin such as orthostatic hypotension [24].
Although dizziness is a non-specific symptom, it affects patient’s quality of life (QOL). Bronstein, Adolfo M et al evaluated QOL and social impact of dizziness in the cities, and its findings highlighted the high social and economic impact of dizziness [3]. Subjectivity of the dizziness makes it difficult for the clinicians to quantify it. The Dizziness Handicap Inventory (DHI) is one of the most popular questionnaires for assessment and grading of the dizziness [11]. It was developed by Jacobson GP and Newman CW. The DHI is a self-reported questionnaire designed to determine dizziness-dependent changes grouped into three domains: Functional (36 points), emotional (36 points), and physical (28 points) (Total score range 100-0). Higher the score more the perceived handicap because of the vertigo / dizziness [6]. It is used to assess QOL. We have used DHI score for the evaluation of the treatment as well as QOL impact in our study.
The present study was conducted to review the common disorders related to dizziness, its impact on QOL and management.