title: Neurotology symptoms at referral to vestibular evaluation.
abstract: BACKGROUND
  Dizziness-vertigo is common in adults, but clinical providers may rarely diagnose vestibular impairment and referral could be delayed. To assess neurotology symptoms (including triggers) reported by patients with peripheral vestibular disease, during the year just before their referral to vestibular evaluation.
  
  
  METHODS
  282 patients with peripheral vestibular disease and 282 control subjects accepted to participate. They had no middle ear, retinal, neurological, psychiatric, autoimmune or autonomic disorders. They reported their symptoms by a standardized questionnaire along with their anxiety/depression symptoms.
  
  
  RESULTS
  Patients were referred after months or years from the onset of their symptoms, 24% of them reported frequent falls with a long clinical evolution; 10% of them reported no vertigo but instability related to specific triggers; 86% patients and 12% control subjects reported instability when moving the head rapidly and 79% patients and 6% control subjects reported instability when changing posture. Seven out of the 9 symptoms explored by the questionnaire allowed the correct classification of circa 95% of the participants (Discriminant function analysis, p < 0.001). High blood pressure, dyslipidemia and anxiety/depression symptoms showed a mild correlation with the total score of symptoms (multiple R2 =0.18, p < 0.001).
  
  
  CONCLUSIONS
  Late referral to vestibular evaluation may underlie a history of frequent falls; some patients may not report vertigo, but instability related to specific triggers, which could be useful to prompt vestibular evaluation. High blood pressure, dyslipidemia and anxiety/depression symptoms may have a mild influence on the report of symptoms of vestibular disease in both, patients and control subjects.
authors.affiliation: Unidad de Investigación Médica en Otoneurología, Planta baja del Edificio C-Salud en el Trabajo Centro Médico Nacional siglo XXI, IMSS, Av, Cuauhtémoc 330, Colonia Doctores, CP 06720, México, DF, México. kathrine.jauregui@imss.gob.mx.
authors.forename: Kathrine
authors.initials: K
authors.lastname: Jáuregui-Renaud
authors.forename: Aralia
authors.initials: A
authors.lastname: Gutierrez-Marquez
authors.forename: Leticia
authors.initials: L
authors.lastname: Viveros-Rentería
authors.forename: Verónica
authors.initials: V
authors.lastname: Ramos-Toledo
authors.forename: Fátima
authors.initials: F
authors.lastname: Gómez-Alvarez
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065635:Benign Paroxysmal Positional Vertigo; D004244:Dizziness / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis; D008875:Middle Aged; D015999:Multivariate Analysis; D012017:Referral and Consultation; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology; D015837:Vestibular Diseases / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult