title: Experience from a multidisciplinary "dizzy" clinic.
abstract: OBJECTIVE
  To describe the experience of a combined otolaryngology and neurology multidisciplinary clinic in the evaluation, investigation, and management of patients with dizziness.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Patients were seen in a tertiary referral, multidisciplinary clinic at The Toronto Hospital, University of Toronto, Ontario, Canada.
  
  
  METHODS
  A thorough history, formal otoneurologic examination, and appropriate laboratory investigations were performed. After their assessment, the patient's diagnoses were classified as peripheral, central, psychogenic, or undiagnosed and were then subdivided into specific clinical diagnoses.
  
  
  RESULTS
  The first 812 consecutive patients seen in the multidisciplinary clinic from January 1, 1993 to December 31, 1998 are reported. Five hundred twenty-five (64.7%) patients were found to have a peripheral vestibular cause for their dizziness, 66 (8.1%) had a central cause, 108 (13.3%) had a diagnosis unknown, and 73 (9.0%) were thought to be psychogenic. In 40 (4.9%) patients, a peripheral and central cause were found. More than one type of peripheral disorder was noted in 17.9% of patients with a peripheral vestibular cause for their dizziness, and 12.3% of patients with a central cause for their dizziness had more than one specific type of central nervous system disorder.
  
  
  CONCLUSIONS
  Most patients that were seen in a multidisciplinary clinic had a peripheral vestibular disorder. Central causes of dizziness were relatively uncommon. Serious diseases such as tumor, multiple sclerosis, and encephalitis were rare and unlikely to present with dizziness only. It is important to realize that a patient may have more than one type of disorder accounting for the symptoms, which may represent a spectrum of disease affecting the inner ear.
authors.affiliation: Department of Otolaryngology, The Toronto Hospital, University of Toronto, Ontario, Canada.
authors.forename: A P
authors.initials: AP
authors.lastname: Bath
authors.forename: R M
authors.initials: RM
authors.lastname: Walsh
authors.forename: P
authors.initials: P
authors.lastname: Ranalli
authors.forename: F
authors.initials: F
authors.lastname: Tyndel
authors.forename: M L
authors.initials: ML
authors.lastname: Bance
authors.forename: R
authors.initials: R
authors.lastname: Mai
authors.forename: J A
authors.initials: JA
authors.lastname: Rutka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D004244:Dizziness / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010044:Outpatient Clinics, Hospital; D010348:Patient Care Team; D011446:Prospective Studies