The relationship between isolated dizziness/vertigo and the risk factors of ischemic stroke: a case control study
Chang, C.-C.; Chang, W.-N.; Huang, C.-R.; Liou, C.-W.; Lin, T.-K.; Lu, C.-H.
Acta Neurologica Taiwanica 20(2): 101-106
2011
ISSN/ISBN: 1028-768X PMID: 21739387 Document Number: 655878
The prevalence of dementia is approximately 1.7 - 4.3% among aged people in Taiwan, and Alzheimer disease (AD) is the most common cause of dementia. Although three cholinesterase inhibitors and one glutamate NMDA receptor antagonist are available in Taiwan to treat dementia, their insurance reimbursement is strictly regulated and only a small proportion of patients with AD receive medical treatment. A local consensus of and guideline for treatment of dementia is needed in Taiwan. Therefore, the Guideline Subcommittee of the Taiwan Dementia Society summarized the data of cholinesterase inhibitors and glutamate NMDA receptor antagonist for treatment of the patients with AD according to the principles of evidence- based medicine. We have assessed the qualities of studies, levels of evidence, and referred to other guidelines proposed by Western countries. After several panel discussions, we merged opinions from the subcommittee members and proposed a Taiwan consensus. Dizziness/vertigo are important public heath care issues especially in elderly patients. Isolated dizziness/vertigo without neurological deficits has seldom been considered a symptom/sign due to vascular origin. Recently, some studies have suggested that vascular origin should be considered in cases of positional vertigo and isolated vertigo or dizziness when the etiology remains unclear. In this study, we tried to delineate the correlation of dizziness/vertigo and risk factors of stroke. We collected adult subjects receiving health screening of the brain at their own expense. All subjects had undergone brain magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and carotid duplex. The chief complaints, body height, body weight, waist circumference and blood pressure of all subjects were recorded. Most received blood tests including fasting sugar, total cholesterol, low density lipoprotein, high density lipoprotein (HDL), triglycerides, and uric acid (UA). The relationships between dizziness/vertigo and blood test data, blood pressure, body mass index (BMI), waist circumference, metabolic syndrome, carotid duplex, silent brain infarction, leukoaraiosis and MRA were analyzed. After exclusion, a total of 170 out of 210 subjects were collected. The analysis revealed that dizziness/ vertigo had a significant correlation to age, UA , BMI, male HDL and female waist circumference. Among them, female waist circumference had the highest statistical significance (P = 0.001). Leukoaraiosis on brain MRI also had a close relationship with dizziness/vertigo. After careful examination and approach, a vascular origin should be considered in dizzy patients of unknown etiology.