目的:评估儿科和成人患者的诊断趋势,这些患者进行跨寿命的头晕和失衡的多学科亚专科评估。
方法:回顾性图表回顾。
方法:单儿科和单成人学术三级护理医院。
方法:回顾性回顾2017年至2020年到成人或儿科多学科前庭诊所就诊的患者的电子健康记录,包括临床数据,物理治疗评估,和前庭听力测试。
结果:共评估了1934名1至95岁的患者。大多数患者是女性(n=1188,61%);最大的队列是在生命的第五个十年(n=321,17%)。76%的患者(n=1470)被指定为病理诊断。头晕的主要原因在儿童和年轻人中最常见,占1至30岁所有诊断的38%至54%。周围性前庭疾病的比例随着年龄的增长而增加,在61至70岁的年龄段达到32%的峰值。前庭性偏头痛是6至20岁(n=110,39%)和31和50岁(n=69,17%)的最常见病理诊断,但在女性中更为普遍(21%vs14%;P<0.0001)。良性阵发性位置性眩晕(BPPV)的患病率在整个生命周期中增加,在71至80岁时达到顶峰。梅尼埃病(MD)在生命的第一个十年内没有发生,但此后增加,在51到60岁之间达到顶峰。
结论:多学科前庭评估导致大多数患者的诊断。前庭诊断随寿命而变化,然而在大多数年龄组中,中枢紊乱,包括偏头痛,多于外周前庭病变。外周前庭疾病如BPPV和MD的患病率随年龄增加而增加。
方法:四级。
OBJECTIVE: To evaluate diagnostic trends in pediatric and adult patients presenting for multidisciplinary subspecialty evaluation of dizziness and imbalance across the lifespan.
METHODS: Retrospective chart review.
METHODS: Single pediatric and single adult academic tertiary care hospital.
METHODS: Retrospective review of electronic health record for patients presenting to an adult or pediatric multidisciplinary vestibular clinic from 2017 to 2020, including clinical data, physical therapy evaluation, and audiovestibular testing.
RESULTS: A total of 1934 patients aged 1 to 95 were evaluated. Most patients were female (n = 1188, 61%); the largest cohort was in the fifth decade of life (n = 321, 17%). Seventy-six percent of patients (n = 1470) were assigned a pathologic diagnosis. Central causes of dizziness were most common in children and young adults, comprising 38% to 54% of all diagnoses in ages 1 to 30. The proportion of peripheral
vestibular disorders increased with age, peaking at 32% in ages 61 to 70.
Vestibular migraine was the most common pathologic diagnosis in ages 6 to 20 (n = 110, 39%) and 31 and 50 (n = 69, 17%) regardless of gender, but was more prevalent in females (21% vs 14%; P < .0001). The prevalence of benign paroxysmal positional vertigo (BPPV) increased throughout the lifespan, peaking at age 71 to 80. Meniere\'s disease (MD) did not occur within the first decade of life, but increased thereafter, peaking at ages 51 to 60.
CONCLUSIONS: Multidisciplinary
vestibular evaluation resulted in a diagnosis for the majority of patients.
Vestibular diagnoses vary across the lifespan however among most age groups, central disorders, including migraine disorders, outnumber peripheral vestibulopathies. The prevalence of peripheral
vestibular disorders such as BPPV and MD increased with age.
METHODS: Level IV.