[Assessment of betahistine dihydrochloride effectiveness in the treatment of disturbance of balance system, based on analysis of doctors and patients questionnaires results].Pol Merkur Lekarski. 2006; 21 Suppl 1:3-12.PM
In balance system assessment there is no single set of tests applicable for all patients. A comprehensive medical history plays a main role in balance assessment. Patients often describe the same disorders in different ways. The aim of our work was to analyze effectiveness of betahistine hydrochloride (Betaserc) treatment on vertigo, nausea, vomiting, tinnitus and progressive hearing loss basing on the medical assessment (interview) performed by doctors and patient's personal questionnaires as well as to collect and accumulate data about balance system disorders. We prepared questionnaires for both doctors and patients. The doctor's questionnaire was divided into three sections. In the first section we included questions about direct cause of visit at the doctor's office. Questions were covering problems regarding balance system disorders (difficulty to keep erect position), vertigo, tinnitus, hearing impairment and other problems. The second section of the questionnaire included assessment of treatment effectiveness through the first 14 days and on the 28th day (a control visit). A third section of the questionnaire was focused on estimation of intensity of balance system disturbances. Patient's questionnaire included everyday self observations of intensity of disturbances within the 14 days observation period. We analyzed data of 980 patients, of the age between 16 and 96 years (mean age--54.1). There were 57.8% females and 42.2% males. From the group of 980 patients we separated a group of patients under 40 and over 60 years of age for additional analysis. Having analyzed doctors questionnaires we noted that the most frequent cause of patients' visits were: vertigo--in 770 people (78.57%), tinnitus--in 708 people (72.24%), disturbance of balance system--in 612 people (62.45%), hearing loss--in 607 people (61.94%) and other problems--in 72 people (7.35%). Patients over 60 years of age described vertigo as rolling and falling (38.92%). Patients under 40 years of age described vertigo as a body rotation and they were able to indicate direction of rotating movement (53.78%) in this group balance disturbances were intensified by moving of the head (56.49%). Both doctors and patients noticed higher percentage of answers "none" and "minimal difficulty in everyday life" on 14th and 28th day of observation in all analyzed groups, especially in people under 40 years of age. Properly prepared questionnaire for doctors and patients is very helpful not only at initial interview but also at reviewing the current condition of patient as well as at monitoring effects of treatment. Aliments and symptoms self noticed by patients are more serious and troublesome than those noticed by doctors. Ailments linked to disturbances of balance system noticed by group of patients under 40 years of age are usually sudden and shorter in duration and more intensive than in group of patients over 60 years of age. Betaserc used in treatment of balance system disorders lessens the insensitivity of vertigo, gait disturbances and nausea/vomiting. It does not affect hearing loss or tinnitus. The first therapeutic goals are achieved (especially in patients under 40 years of age) after 14 days of treatment.