Evaluation of giddiness: a peripheral hospital experience


  • George Thomas Department of ENT, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
  • Grace Mary John Department of clinical Pharmacology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
  • Anulekha Mary John Department of Endocrinology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India




Giddiness, Peripheral vertigo, BPPV


Background: Giddiness remains one of the most common reasons to consult an ENT specialist. There are multiple causes for giddiness, both peripheral and central. It takes a careful, dedicated and committed history taking as well as examination to establish the cause for giddiness. Vascular effects of metabolic diseases can prepone the onset of vestibular symptoms. This study was undertaken to see the proportions of different types of giddiness among patients who presented with dizziness.

Methods: A descriptive study was done in the ENT Outpatient settings for all the patients who presented with dizziness and/or vertigo. Careful history elicitation and examination was done to establish the cause.  

Results: There was a female preponderance with female to male ratio 13:7. Giddiness due to non-peripheral causes were seen in 150 (69%) and peripheral and migrainous vertigo accounted for dizziness in 33 (15.2%) and 34 (15.7%) patients. Diabetes mellitus was seen in 143 (65.8%) patients.

Conclusions: Comprehensive examination and assessment of patients is required for reasonable evaluation of vertigo. Though vestibular causes are important, it is essential to have a broad understanding of the various causes of vertigo so that serious and life threatening non peripheral causes is not missed out. Growing geriatric population, increasing lifestyle diseases and iatrogenic causes should be kept in mind while evaluation protocols of vertigo are standardized through the country.

Author Biography

George Thomas, Department of ENT, Believers Church Medical College Hospital, Thiruvalla, Kerala, India

assistant professor


Colledge NR, Wilson JA, Macintyre CCA, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age Aging. 1994;23:117-20.

Neuhauser HK, von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T. Epidemiology of vestibular vertigo A neurotologic survey of the general population. Neurology Sep. 2005;65(6):898-9.

Bird JC, Beynon GJ, Prevost AT, Baguley DM. An analysis of referral patterns for dizziness in the primary care setting. Br J Gen Pract. 1998;48(437):1828-32.

Hoffman RM, Einstadter D, Kroenke K. Evaluating dizziness. Am J Med. 1999;107:468-78.

Cass SP, Furman JM, Ankerstjerne K, Balaban C, Yetiser S, Aydogan B. Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol. 1997;106:182-9.

Kentala E, Rauch SD. A practical assessment algorithm for diagnosis of dizziness. Otolaryngol Head Neck Surg. 2003;128:54-9.

Hanley K, O’Dowd T. Symptoms of vertigo in general practice: a prospective study of diagnosis. Br J Gen Pract. 2002;52:809-12.

Herr RD, Zun L, Mathews JJ. A directed approach to the dizzy patient. Ann Emerg Med. 1989;18:664-72.

Sloane PD, Baloh RW. Persistent dizziness in geriatric patients. J Am Geriatr Soc. 1989;37(11):1031-8.

Greenman RL, Panasyuk S, Wang X, Lyons TE, Dinh T, Longoria L, et al. Early changes in the skin microcirculation and muscle metabolism of the diabetic foot. Lancet. 2005;366(9498):1711-7.

Masaoki W, Hideaki N, Koji T, Hashimoto SI, Ito A, Okamoto M. Arteriosclerotic Changes as Background Factors in Patients with Peripheral Vestibular Disorders. Int Tinnitus J. 2008;14(2):131–4.






Original Research Articles