CHRONIC DIZZINESS POST TRAUMATIC BRAIN INJURY: A CROSS-SECTIONAL STUDY. Issue 12 (15th November 2016)

• Record Type: Journal Article
• Authors: Ahmad, Hena; Arshad, Qadeer; Roberts, Richard; Patel, Mitesh; Ham, Timothy; Sharp, David; Seemungal, Barry
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 87:Issue 12(2016)
• Page Start: e1
• Page End: e1
• Publication Date: 2016-11-15
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2016-315106.172
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Traumatic brain injury is the commonest cause of disability in young adults. Chronic dizziness and imbalance are amongst the commonest causes for post-traumatic morbidity (up to half of patients at 5 years). These symptoms significantly impair quality of life and are also an independent predictor of failure to return to work post-TBI. The reasons underlying chronic dizziness post TBI, however, remain unexplained. 20 consecutive TBI patients (12M, mean=44.7 yrs range 19–69) with persisting dizziness (>6 months post-TBI, range 6–18 months) underwent comprehensive clinical and vestibular laboratory testing (full electronystagmography, vestibular-evoked myogenic potentials, smooth pursuit (0.1–0.4 Hz), VOR (vestibulo-ocular reflex) suppression (0.25 Hz, 40 o/sec); and optokinetic stimulation (40 o/s) at a tertiary neuro-otology centre. The two commonest causes of post-TBI dizziness were benign positional paroxysmal vertigo (n=8) and vestibular migraine (n=4) and 40% of our sample had both diagnoses (n=8). Central vestibular dysfunction as evidenced by impaired VOR suppression and broken pursuit (gain <0.40) was found in 30%. TBI results in multiple, albeit treatable, vestibular diagnoses, with a combination of central and peripheral dysfunction, hence a thorough evaluation is required to detect all potential diagnoses. The disruption of central vestibular pathways post TBI may lead to impairment of brain plasticity repair mechanisms.