10 yrs of Vertigo Clinic at National Hospital In Nigeria: what have we learned?

Discussion in 'Your Living Room' started by Vicki, Mar 13, 2016.

  1. Vicki

    Vicki Guest

    I wish they would state what medication they used to get such good results.

    http://www.ncbi.nlm.nih.gov/pubmed/26961517
    Eur Arch Otorhinolaryngol. 2016 Mar 9. [Epub ahead of print]

    10 years of Vertigo Clinic at National Hospital Abuja, Nigeria: what have we learned?

    Olusesi AD1,2, Abubakar J3,4.



    Author information

    1Department of Ear, Nose and Throat, National Hospital Abuja, Plot 132, Central area, Garki (Phase II), Abuja, Nigeria. [email protected].
    2CSR Otologics Specialist Clinics, Abuja, Nigeria. [email protected].
    3Department of Ear, Nose and Throat, National Hospital Abuja, Plot 132, Central area, Garki (Phase II), Abuja, Nigeria.
    4CSR Otologics Specialist Clinics, Abuja, Nigeria.

    Abstract

    The clinician's major role in management of the dizzy patient involves determining what dizziness is vertigo, and what vertigo is of central or peripheral origin. These demand attention to details of history, otolaryngological workup including vestibular assessment, and often use of diagnostic and management algorithms. There is paucity of published reports of the management outcomes of peripheral vestibular diseases from Africa. Two tertiary care otologist-led dedicated vertigo clinics are located in Abuja, Nigeria. A prospective, non-randomized study of patients presenting with features of peripheral vestibular diseases attending the National Hospital Abuja Nigeria (between May 2005 and April 2014) and CSR Otologics Specialist Clinics (May 2010 to April 2014) was carried out.

    Both institutions adopted the same diagnostic and management protocols. Data extracted from anonymized databases created for this study include age, sex, vertigo duration (acute <12 weeks, chronic >12 weeks), dizziness handicap inventory score at presentation and at subsequent visits, otological and vestibular findings, ice-water caloric testing results, other investigation outcomes, treatments offered and outcomes. 561/575 (97.5 %) of the cases recorded had peripheral vestibular disease. The male-to-female ratio was 290:271. The mean age of the subjects was 44.7 years. Duration of vertigo at presentation was acute in 278 subjects and chronic in 283 subjects.

    Identifiable clinical diagnostic groups include BPPV (n = 200), Meniere's disease (n = 189), cervicogenic vertigo (n = 35), labyrinthitis (n = 32), Migraine-associated vertigo (MAV) (n = 32), cholesteatoma/perilymph Fistula (n = 10), climacteric vertigo (n = 8) and unclassified vertigo (n = 55). Migraine-associated vertigo recorded the highest DHI score (95 % CI 75 ± 4.3), followed by cholesteatoma/perilymph fistula (95 % CI 72 ± 6.1) and labyrinthitis (95 % CI 62 ± 1.9). Pure tone audiometry (95 % CI 67.3 ± 3.43), followed by thyroid function tests (95 % CI 66.7 ± 23.55) and ice-water caloric testing (95 % CI 59.7 ± 2.69) were investigations with the highest yields. 86.5 % of cases were treated by either vestibular suppressant medications alone (n = 285) and/or particle repositioning maneuver (n = 200) with improvement in vertigo control (95 % CI 63.63 to 74.37 % and 62.59 to 75.41 %, respectively).

    Peripheral vestibular diseases constitute majority of cases of self-reported vertigo seen in our setting. Migraine-associated vertigo seen in our setting all have peripheral vestibular signs. Dedicated vertigo clinics could significantly improve the diagnostic and treatment yield in a resource-constrained setting like ours. Most cases can be managed using non-operative measures.
     
  2. scott tom

    scott tom Active Member

    1,158
    5
    38
    May 14, 2015
    It's Nigeria. The only country less reliable than China when it comes to "science".
     

Share This Page