OBJECTIVE: Chronic subjective dizziness (CSD) is a form of chronic
dizziness. Many patients report fewer symptoms when they get up with an
aggravation over of the day. Therefore, the change in the severity of the
symptoms during daytime was evaluated and compared with other chronic
vestibular diseases: bilateral vestibulopathy (BVP) and downbeat nystagmus (DBN).
DESIGN/METHODS: In a prospective study 131 patients with CSD, 108
patients with BVP, and 38 patients with DBN filled out a questionnaire
asking about the symptom intensity (0 = no symptoms, 1 = light, 2 = moderate,
3 = strong) at 6 time-points. The influences of duration of the disease and
physical activity on the change of symptoms were also investigated.
RESULTS: The symptom intensity score in CSD was lower after getting
up in comparison to later time points. In BVP a strong sensation of
dizziness after getting up with worsening in the evening was observed. In
DBN symptoms significantly improved during daytime. In BVP, the symptom
intensity scores were significantly higher in patients with symptoms more
than six month as less than six month. In the other groups, no association
between duration of illness and intensity of perceived dizziness could be seen.
CONCLUSION: There are considerable differences in the change in
symptoms between the three diseases. Taking the patient history simply
asking how the symptoms are when the patient gets up in the morning and how
they change during daytime can be helpful in the differential diagnosis.
Having less or no symptoms after getting up may be a diagnostic criterion
for CSD.
