AI Article Synopsis
- Vertigo and dizziness are common issues in emergency departments and outpatient centers, prompting consultations with specialists like neurologists and ENT physicians for better patient care.
- An online survey of 111 specialists in Switzerland revealed that both neurologists and ENT doctors often use specific tests for diagnosing common conditions like BPPV, but there are notable differences in their approaches, particularly in the use of brain MRIs and referrals for physical therapy.
- The findings emphasize the need for standardized guidelines for diagnosing and treating dizziness across specialties, alongside the importance of training neurologists in specific repositioning techniques for better patient management.
Article Abstract
Background: Vertigo and dizziness are frequent presenting symptoms in the emergency department and in outpatient centers. While the majority of dizzy patients are evaluated by primary care physicians, specialists are often involved in the diagnostic workup. We aimed to gain more insights into the role of specialists in the care of dizzy patients.
Materials And Methods: Board-certified neurologists and ear-nose-throat (ENT) physicians working in Switzerland were invited to participate in an online survey. Descriptive statistical analyses were performed, and prospectively defined hypotheses were assessed using correlation analyses.
Results: All 111 participating specialists (neurologists = 62; ENT specialists = 49) were familiar with testing for posterior canal benign paroxysmal positional vertigo (BPPV), and 66% regularly applied provocation maneuvers for suspected lateral canal BPPV. Reposition maneuvers for posterior (99%) and lateral (68%) canals were frequently performed. ENT physicians were familiar with lateral canal BPPV repositioning maneuvers significantly more often than neurologists (84 vs. 56%, ≤ 0.012). Specialists strongly agreed that performing the head impulse test (86%) and looking for deficient eccentric gaze holding (82%) are important. Compared to neurologists, significantly fewer ENT physicians indicated ordering brain MRI in acutely dizzy patients (OR = 0.33 [0.16-0.067], = 0.002) and physical therapy in patients with acute (50 vs. 20%, = 0.005) or episodic/chronic dizziness (78 vs. 50%, = 0.003).
Conclusion: We found substantial differences in the care of dizzy patients by neurologists and ENT physicians. This underlines the need for a standardized, guideline-oriented diagnostic workup and treatment across specialties. Dedicated training for performing lateral canal BPPV repositioning maneuvers should be prioritized for neurologists. Similarly, physical therapy should be considered more often by ENT physicians.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733682 | PMC |
| http://dx.doi.org/10.3389/fneur.2023.1322330 | DOI Listing |
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