Vertigo in a district NHS hospital

Thirteen general ENT clinics are held for a population of 600,000 people. The present study comprises an individual experience in managing patients with dizziness seen in three general ENT clinics. Eighty-six patients with a complaint of dizziness were seen over a period of 10 years from 1974 to 1984. Postural vertigo in elderly patients was the commonest cause of vertigo (50 per cent) in the present study. Most of these patients suffered from momentary dizzy spells with excessive neck movements. Symptomatic relief was achieved with reassurance and advice to avoid precipitating neck movements in most of the cases. Menière's disease was the second commonest cause of dizziness, which was seen in 15.1 per cent of the patients. Most of the cases were managed successfully with firm reassurance and a short course of treatment with either Betahistine or Cinnarizine. Only two patients showed a very moderate deterioration in hearing and only one patient needed saccus decompression surgery for uncontrolled vertiginous spells. Three patients with congenital unilateral total deafness showed a characteristic picture of secondary hydrops. One needed chemical destruction of the labyrinth to control the dizziness. Two cases (2.4 per cent) had posterior fossa lesions, one with an acoustic neuroma and the other with a large subarachnoid cyst. Both these cases were successfully managed by surgery.