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Post-concussive Dizziness: A Review and Clinical Approach to the Patient.
1The Ear and Balance Institute, Covington, LA, United States.
Frontiers in Neurology
|January 21, 2022
Summary
Dizziness after mild traumatic brain injury (mTBI), known as post-concussive dizziness (PCD), often stems from peripheral vestibular issues. Early identification and treatment of these peripheral causes can significantly improve patient outcomes.
Area of Science:
- Neurology
- Otolaryngology
- Vestibular Science
Background:
- Dizziness is a common symptom following mild traumatic brain injury (mTBI), second only to headache.
- Post-concussive dizziness (PCD) diagnosis includes non-vestibular, central vestibular, and peripheral vestibular causes.
- Increasingly, patients present with combined central and peripheral vestibular findings.
Purpose of the Study:
- To review the literature and outline a general approach to diagnosing PCD.
- To detail diagnostic categories for PCD, including central and peripheral vestibular disorders.
- To emphasize the importance of identifying treatable peripheral vestibular components in PCD.
Main Methods:
- Literature review of post-concussive dizziness.
- Discussion of diagnostic categories for PCD.
- General approach to patient evaluation for PCD.
Main Results:
- PCD frequently involves peripheral vestibular dysfunction, sometimes mimicking central causes.
- Improved vestibular testing identifies previously unnoticed peripheral disorders.
- Common PCD diagnoses include BPPV, labyrinthine concussion, and perilymph fistula.
Conclusions:
- Peripheral vestibular disorders are a significant and often treatable cause of PCD.
- Many patients with PCD are not adequately evaluated for vestibular issues.
- Prompt diagnosis and management of peripheral vestibular components are crucial for PCD patients.
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