Do the diagnoses behind dizziness differ between men and women and across ages?

Details

Dizziness is more common in females, and the researchers suggested that clinical diagnostic frameworks might therefore be biased towards females. The study aimed to examine how diagnoses in neuro-otology clinics were distributed by sex and age.

This retrospective cohort study reviewed case notes using electronic healthcare records for 474 adults aged ≥18 years. These patients were referred with a primary complaint of dizziness, vertigo, or unsteadiness to outpatient neurological clinics at University College London Hospitals, UK, from January 2023 to September 2024.

Among all 474 patients, the most common diagnosis for dizziness was persistent postural perceptual dizziness (PPPD), at 24.3%, followed by vestibular migraine (VM), at 22.4%. In women, VM was the most common diagnosis (31.9%); in men, PPPD was the most common (21.7%).

Among patients under 65 years old, the leading diagnosis was VM (28.9%), followed by PPPD (28.6%) and “other central causes” (12.19%). Among patients over 65 years old, the leading diagnoses were benign paroxysmal positional vertigo (BPPV) (18.4%) and “other central causes” (18.4%).

PPPD (28.3%) and VM (21.4%) were the most common causes of chronic vertigo. In the acute phase, the most common causes were VM (26%), vascular causes (14%), and BPPV (14%).

The researchers concluded that PPPD was the most common cause of dizziness in males overall, while vascular vertigo was the most common cause of acute dizziness in males, regardless of age. They suggested that considering age and sex together may help neurologists, otorhinolaryngologists, and other clinicians seeing patients with dizziness formulate diagnostic possibilities before further assessment.