Tontura em idosos: diagnóstico otoneurológico e interferência na qualidade de vida

Sabrina Scherer, H. Lisboa, A. Pasqualotti
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引用次数: 15

Abstract

PURPOSE: To verify the otoneurologic diagnosis of elderly individuals with dizziness and the interference of this symptom in their quality of life. METHODS: Cross-sectional study, conducted with 56 elderly individuals with dizziness. Subjects' mean age was 71.2 years, and they were submitted to otoneurologic assessment, which involved: pure-tone, speech and impedance audiometry, balance assessment, testing for positional and positioning vertigo and nystagmus, and vectoelectronystagmography. A specific questionnaire for dizziness was used to assess the quality of life, the Dizziness Handicap Inventory (DHI), which verifies the handicap effects provoked by this symptom. RESULTS: Rotatory dizziness was reported by 29 patients (51.8%), 75% presented some hearing complaint, and 69.6% had altered results in audiometry. Patients with vestibular complaints of positional dizziness presented significant difference for the physical aspect of the DHI. Patients with vestibular complaints of imbalance showed significant difference for the functional and emotional aspects. The computerized vectoelectronystagmography was altered in 47 patients (83.9%), indicating peripheral vestibular disorder in all cases. In the post-caloric assessment, hyperreflexia was the most prevalent alteration, and the most frequent diagnosis was Deficient Peripheral Vestibular Syndrome to the Left. Regarding quality of life, the functional aspect had the highest average score among the three aspects evaluated, and there was a significant difference between the functional and emotional aspects. CONCLUSION: Most elderly patients with dizziness present alterations in audiometry and vectoelectronystagmography, which indicate a disorder in the vestibulocochlear system; they also present impaired quality of life.
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老年人头晕:耳神经学诊断及对生活质量的干扰
目的:验证老年眩晕患者的耳神经学诊断及其对生活质量的干扰。方法:对56例老年头晕患者进行横断面研究。受试者平均年龄为71.2岁,接受耳神经系统评估,包括纯音、语音和阻抗听力学、平衡评估、体位性眩晕和眼震测试以及矢量眼震电图。眩晕障碍量表(DHI)用于评估眩晕患者的生活质量,该问卷验证了眩晕症状引起的障碍效应。结果:29例(51.8%)患者报告有旋转性头晕,75%的患者有一定的听力疾患,69.6%的患者听力测量结果有改变。前庭主诉体位性头晕的患者在DHI的生理方面存在显著差异。前庭失衡主诉患者在功能和情绪方面存在显著差异。47例(83.9%)患者的计算机矢量眼震图改变,提示所有病例均有外周前庭功能障碍。在热量评估后,反射亢进是最普遍的改变,最常见的诊断是左侧外周前庭综合征缺陷。在生活质量方面,功能方面在三个评估方面的平均得分最高,功能方面与情感方面之间存在显著差异。结论:大多数老年头晕患者的听力学和矢状电心动图改变,提示前庭耳蜗系统病变;他们还表现出生活质量受损。
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