Clinical and functional characteristics of patients with chronic dizziness

N. V. Halinouskaya, O. V. Nak, A. V. Skachkou
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Abstract

   Objective. To form a clinical and functional characterization of patients with chronic dizziness.   Materials and methods. A single one-stage cohort study of 32 patients with chronic dizziness (CD), among them 26 women and 6 men, mean age - 49 [36.5; 51.5] years, was conducted. Patients were examined by objective neurologic examination, laboratory (general and biochemical blood tests) and instrumental (radiography, magnetic resonance imaging (MRI), ultrasound) methods were used during the study. Barany’s test was also performed, and neuropsychological testing was performed. The data were processed using descriptive statistical methods of the application package “Statistica”, 10.0.   Results. During the examination, patients complained of dizziness (100 %) and shakiness when walking (84 %), provoked mainly by intermittent visual stimuli (31 % each). Subjective neurological deficit in patients with CD was caused by kinesthetic sensations of instability (34 %), accompanied by decreased attention and memory (28 %). Objectively, the phase of optokinetic nystagmus in Barany’s test lengthened in the studied group - 190 [170; 225] s and the time of balance retention in Romberg’s pose decreased - 3 [2; 5] s. CD patients were characterized by high personality anxiety - 53 [44; 53] points and autonomic imbalance according to the questionnaire of A.M. Vein - 42 [40; 44] points. We did not reveal a connection of CD with structural anomalies, pathology of brachiocephalic vessels.   Conclusion. The clinical and functional status of CD patients was characterized by the absence of focal lesions of the nervous system and a small number of concomitant diseases causing vertigo. At the same time, the patients’ subjective sensations underlying the perception of non-existent stimuli led to impaired maintenance of vertical body position and, in turn, formed an anxiety disorder.
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慢性头晕患者的临床和功能特征
目的对慢性头晕患者的临床和功能特征进行分析。 材料和方法。对 32 名慢性头晕(CD)患者(其中 26 名女性和 6 名男性,平均年龄 49 [36.5; 51.5]岁)进行了单阶段队列研究。研究期间对患者进行了客观的神经系统检查,并使用了实验室(一般和生化血液测试)和仪器(射线照相术、磁共振成像(MRI)、超声波)方法。此外,还进行了巴拉尼测试和神经心理学测试。数据使用 "Statistica "10.0 应用软件包的描述性统计方法进行处理。 结果在检查过程中,患者主诉头晕(100%)和走路颤抖(84%),主要由间歇性视觉刺激引起(各占 31%)。CD 患者的主观神经功能缺陷是由不稳定的运动感觉引起的(34%),同时伴有注意力和记忆力下降(28%)。客观上,在研究组中,巴拉尼试验的视运动眼震阶段延长了 190 [170; 225] 秒,罗姆伯格姿势的平衡保持时间缩短了 3 [2; 5] 秒。根据 A.M. Vein 的问卷调查,CD 患者的性格焦虑程度高 - 53 [44; 53] 分,自律神经失衡 - 42 [40; 44] 分。我们没有发现 CD 与肱动脉血管的结构异常和病变有关。 结论CD 患者的临床和功能状态的特点是神经系统无局灶性病变,引起眩晕的并发症较少。同时,患者对不存在的刺激的主观感觉导致身体垂直位置的维持能力受损,进而形成焦虑症。
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