Post-Traumatic Dizziness

Abstract

Purpose of Review

Traumatic brain injury (TBI) is a significant cause of morbidity and to a lesser extent mortality yearly. Dizziness remains a common complaint, presenting in up to 80% of patients post-head injury. This has obvious physical and psychological consequences not only to the individual but also a significant economic impact on society as a whole. Despite much being written in the field of TBI including concussion and sports-related head injury, the effects of trauma on the vestibular system have had relatively little study. Large-scale population studies addressing dizziness in the context of head injury do not exist in the literature. This article aims to provide an overview of dizziness post-TBI. The results from a large prospective database from the University Health Network (UHN) Workplace Insurance and Safety Board (WSIB) Neurotology are presented.

Recent Findings

The results of the UHN WSIB Neurotology database (n = 3438 head-injured workers) from the Canadian province of Ontario (1998–2014) either suggested or diagnosed BPPV in 23% post-head injured workers. One hundred and forty-nine workers (4.3%) were diagnosed with other distinct forms of peripheral vestibular dysfunction; the most common episodic type (35% of 149 workers) being a recurrent vestibulopathy (RV). The study did not find a causative link in the TBI patients studied to support a diagnosis for post-traumatic Meniere's as the incidence of the disease in this cohort was equal to that in the general population.

Summary

This article is intended to provide an overview of post-traumatic dizziness following TBI, to discuss generally recognized inner ear disorders post-head injury, the results from the UHN WSIB Neurotology database and to address some of the controversies in the field.

http://ift.tt/2pGzm1M