vestibular physiotherapy patients mayrequire medical assessment: results of vertigo audit in hutt hospital

Introduction: to identify the type of referrals received by vestibular physiotherapists forvertigo and assess whether medical review for these patients would be appropriate.materials and methods: we performed a retrospective review of referral forms, vestibularassessment forms, and vertigo clinic letters of patients referred for vertigo or vestibularphysiotherapy input between july 1, 2013, to december 31, 2013.results: we studied 29 patients with a median age of 63 years. a diagnosis was providedin 65.5% of the referrals. of 14 patients with possible benign paroxysmal positional vertigo(bppv), dix-hallpike had been performed only for 4 patients. almost half were seen for themedical review in the vertigo clinic due to the concerns of possible alternative non-vestibulardiagnosis, medication issues, or syncope. alternative diagnoses identified medically includedorthostatic hypotension, stroke, vestibular migraine, medication-induced bradycardia, andphobic postural vertigo. medication changes in vertigo clinic included treatment for heartfailure, migraine, and medication optimization.conclusion: medical review is appropriate for some patients referred for vestibularphysiotherapy. a medical opinion should be sought by vestibular physiotherapists if thereis uncertainty or concerns that the referred patients did not have straightforward vestibularproblems, or there were possible alternative diagnoses, concerns with medications, or syncope.