The Causes of Dizziness in Parkinson’s Disease

Abstract

Patients with Parkinson’s disease complain dizziness frequently. Postural hypotension and postural instablity are suggested to be the reasons of dizziness in elderly people with Parkinson’s disease. The aim of this prospective surveillance study was to characterize the etiology of the dizziness in patients with PD. A total of 47 consecutive patients with idiopathic Parkinson’s disease were enrolled in the prospective surveillance study. Of the 47 patients, 32 (68.1%) had dizziness. All patients underwent neurological and otologic examination. Complete blood count, serum electrolytes, glucose, liver function tests, renal function tests and thyroid function tests, cranial computerized tomography, direct cervical region radiography and vertebral artery doppler ultrasonography were obtained from all patients. Patients were screened for blood pressure changes, drug use, cardiovascular diseases, hypertension and diabetes mellitus. The findings of loss of disk height, with subsequent loss of cervical lordosis were higher in patients with dizziness (p = 0.01). The results of this study show that cervical-vertebral degeneration may be a common cause of dizziness in Parkinson’s disease patients.

Share and Cite:

Yilmaz, L. , Tunç, T. and İnan, L. (2014) The Causes of Dizziness in Parkinson’s Disease. International Journal of Clinical Medicine, 5, 667-673. doi: 10.4236/ijcm.2014.512092.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Gelby, D.J., Oliver, E. and Gilman, S. (1999) Diagnostic Criteria for Parkinson Disease. Archives of Neurology, 56, 33-39.
http://dx.doi.org/10.1001/archneur.56.1.33
[2] de Rijk, M.C., Trourio, C., Breteler, M.M., Dortiques, J.F., Amaducci, L., Lopez-Pouse, S., Manubens-Bertran, J.M., Alperovitch, A. and Rocca, W.A. (1997) Prevalence of Parkinsonism and Parkinson’s Disease in Europe: The Euro-park¡nson Collaborative Study. European Community Concerted Action on the Epidemiology of Parkinson’s Disease. Journal of Neurology, Neurosurgery & Psychiatry, 62, 10-15.
http://dx.doi.org/10.1136/jnnp.62.1.10
[3] Colledge, N., Lewis, S., Mead, G., Sellar, R., Wardlaw, J. and Wilson, J. (2002) Magnetic Resonance Brain Imaging in People with Dizziness: A Comparison with Nondizzy People. Journal of Neurology, Neurosurgery & Psychiatry, 72, 587-589.
http://dx.doi.org/10.1136/jnnp.72.5.587
[4] Luxon, L.M. (2004) Evaluation and Management of the Dizzy Patient. Journal of Neurology, Neurosurgery & Psychiatry, 75, 45-52.
http://dx.doi.org/10.1136/jnnp.2004.055285
[5] Barone, P., Antonini, A., Colosimo, C., et al. (2009) The PRIAMO Study: A Multicenter Assessment of Nonmotor Symptoms and Their Impact on Quality of Life in Parkinson’s Disease. Movement Disorders, 24, 1641-1649.
http://dx.doi.org/10.1002/mds.22643
[6] International Committee of Medical Journal Editors (1991) Statements from the Vancouver Group. British Medical Journal, 302, 1194.
[7] Gibb, W.R. and Lees, A.J. (1988) The Relevance of the Lewy Body to the Pathogenesis of Idiopathic Parkinson’s Disease. Journal of Neurology, Neurosurgery & Psychiatry, 51, 745-752.
http://dx.doi.org/10.1136/jnnp.51.6.745
[8] Siderowf, A., McDermott, M., Kieburtz, K., Blindauer, K., Plumb, S., Shoulsa, I., Parkinson Study Group (2002) Test-Retest Reliability of the Unified Parkinson’s Disease Rating Scale in Patients with Early Parkinson’s Disease: Results from a Multicenter Clinical Trial. Movement Disorders, 17, 758-763.
http://dx.doi.org/10.1002/mds.10011
[9] Davies, R. (2004) Bedside Neuro-Otological Examination and Interpretation of Commonly Used Investigations. Journal of Neurology, Neurosurgery & Psychiatry, 75, 32-44.
http://dx.doi.org/10.1136/jnnp.2004.054478
[10] Bronstein, A.M. (2003) Vestibular Reflexes and Positional Manoeuvres. Journal of Neurology, Neurosurgery & Psychiatry, 74, 289-293.
http://dx.doi.org/10.1136/jnnp.74.3.289
[11] Low, P.A. and Engstrom, J.W. (2005) Disorders of the Autonomic Nervous System. In: Kasper, D.L., Braunwald, E., Fauci, A.S., Hauser, S.L., Longo, D.L. and Jameson, J.L., Eds., Harrison’s Principles of Internal Medicine, 16th Edition, Mc-Graw-Hill, New York, 2428-2434.
[12] Kelsey, J.L., Githens, P.B., Walter, S.D., Southwick, W.O., Weil, U., Holford, T.R., Ostfeld, A.M., Calogere, J.A., O’Connor, T. and White, A.A. (1984) An Epidemiological Study of Acute Prolapsed Cervical Intervertebral Disc. The Journal of Bone and Joint Surgery (American Volume), 66, 907-914.
[13] Brandt, T. and Bronstein, A.M. (2001) Cervical Vertigo. Journal of Neurology, Neurosurgery & Psychiatry, 71, 8-12.
http://dx.doi.org/10.1136/jnnp.71.1.8
[14] Richmond, F.J.R. and Bakker, D.A. (1982) Anatomical Organization and Sensory Receptor Content of Soft Tissues Surrounding Upper Cervical Vertebrae in the Cat. Journal of Neurophysiology, 48, 49-61.
[15] Colledge, N.R., Barr-Hamilton, R.M., Lewis, S.J., Sellar, R.J. and Wilson, J.A. (1996) Evaluation of Investigations to Diagnose the Course of Dizziness in Elderly People: A Community Based Controlled Study. British Medical Journal, 313, 788-792.
http://dx.doi.org/10.1136/bmj.313.7060.788
[16] Cushnaghan, J. and Dieppe, P. (1991) Study of 500 Patients with Limb Joint Osteoarthritis. Analysis by Age Symptomatic Joint Sites. Annals of the Rheumatic Diseases, 50, 8-13.
http://dx.doi.org/10.1136/ard.50.1.8
[17] Hilen, M.E., Wagner, M.L., Pharm, D. and Sage, J.I. (1996) Subclinical Orthostatic Hypotension Is Associated with Dizziness in Elderly Patients with Parkinson Disease. Archives of Physical Medicine and Rehabilitation, 77, 710-712.
http://dx.doi.org/10.1136/ard.50.1.8
[18] Senard, J.M., Rai, S., Lapeyre-Mestre, M., Brefel, C., Rascol, O. and Montastruc, J.L. (1997) Prevalence of Orthostatic Hypotension in Parkinson’s Disease. Journal of Neurology, Neurosurgery & Psychiatry, 63, 584-589.
http://dx.doi.org/10.1136/jnnp.63.5.584
[19] Sandroni, P., Ahlskog, J.E., Fealey, R.D. and Low, P.A. (1991) Autonomic Involvement in Extrapyramidal and Cerebellar Disorders. Clinical Autonomic Research, 1, 147-155.
http://dx.doi.org/10.1007/BF01826212
[20] Martinez-Martin, P., Schapira, A.H.V., Stocchi, F., et al. (2007) Prevalence of Nonmotor Symptoms in Parkinson’s Disease in an International Setting; Study Using Nonmotor Symptoms Questionnaire in 545 Patients. Movement Disorders, 22, 1623-1629.
http://dx.doi.org/10.1002/mds.21586
[21] Leonetti, J.P. and Srinivas, M. (1997) Advances in the Diagnosis and Management of Vertebrobasilar Insufficiency. Otolaryngology & Head and Neck Surgery, 5, 272-275.
[22] van Wensen, E., van Leeuwen, R.B., van der Zaag-Loonen, H.J., Masius-Olthof, S. and Bloem, B.R. (2013) Benign Paroxysmal Positional Vertigo in Parkinson’s Disease. Parkinsonism & Related Disorders, 19, 1110-1112.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.