Outcome of symptoms of dizziness in a general practice community sample.

Abstract

Background. Dizziness is commonly experienced in the community, but little is known about the long-term progression of the condition. Objective.We aimed to assess over 18 months the outcome of symptoms of dizziness in a sample of patients identified from London general practices. Method.We followed up at 18 months a cohort of patients who reported symptoms of dizziness with or without anxiety, panic reactions or avoidance of situations that provoked the symptoms. The subjects completed a structured questionnaire both at baseline and at 18 months. Results. At 18 months, 24% (95% CI = 23.5–34.8%) were more handicapped and 20% (95% CI = 15.2–25.2%) had recurrent dizziness, while 20% (95% CI = 14.9–24.8%) had improved. Patients with significant dizziness were more likely to consult their GP (OR = 14.4, 95% CI = 7.0–29.1) and were more likely to receive treatment (OR = 7.8, 95% CI = 3.2–22.4) or be referred to hospital (OR = 8.4, 95% CI = 3.2–22.4). The independent predictors of handicapping dizziness at 18 months were a history of fainting (OR = 2.4, 95% CI = 1.2–4.7), vertigo (OR = 2.6, 95% CI = 1.3–5.0) and avoidance of a situation that provoke dizziness (OR = 4.8, 95% CI = 2.5–9.0). Conclusion.Four per cent of all patients registered with a GP suffer persistent symptoms of dizziness and at least 3% are severely incapacitated by their symptoms. The presence of vertigo, fainting and avoidance in a person with dizziness is predictive of chronic handicapping dizziness. Further research is required on the progressions of symptoms of dizziness in a sample of GP attenders and those in the community.