Dizziness Symptom Profile: Development and Applications

By Richard A. Roberts, Gary P. Jacobson, and Daniel J. Romero

This article is a part of the May/June 2022, Volume 34, Number 3, Audiology Today issue. 

Obtaining a case history from a patient presenting with dizziness can be an arduous process; yet, it is regarded by many to be the most important “test” in a vast selection of vestibular exams. The purpose is to gather the most salient information (e.g., the duration and character of the spells) and to provide patients with an opportunity to tell their story, sometimes including less relevant details. 

To improve the synergy between the process of gathering essential information by the clinician and the presentation of helpful information by the patient and to ensure that this process is effective and effortless, we developed the Dizziness Symptom Profile (DSP). This article describes the process underlying the development of the DSP and our experiences using this device in a multispecialty tertiary care clinic.

The first step in developing the DSP was to identify symptoms that differentiate common types of dizziness diseases or disorders.

Development of the DSP

PHASE 1: Identification of Initial DSP Statements

The first step in developing the DSP was to identify symptoms that differentiate common types of dizziness diseases or disorders. For example, the duration of a dizziness spell might be seconds in benign paroxysmal positional vertigo (BPPV), minutes in vestibular migraine, hours in Meniere’s disease, and days in vestibular neuritis. Consider the following example. In a common structured case history, the examiner would ask the patient to explain how long dizzy spells last, which might provoke a five-minute anecdote about specific instances where the patient felt symptomatic. 

To obtain the greatest amount of useful information in the shortest amount of time, we created a self-report measure that requires the patient to respond to a series of statements (not questions as normally occurs during a case history interview) using a five-point Likert scale. Initially, we developed a group of 64 case history statements while considering the diagnoses we hoped might be identified by patterns of responses to the statements.