الفهرس 
Aims of the workOnly 14 pages are availabe for public view
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Abstract
Dizziness is one of the most common complaints, it has considerable impact on quality of life of dizzy patients. When patients complain of lightheadedness, fractional or poorly described symptoms of vertigo, faintness or disequilibrium must first be looked for evidence of hyperventilation symptoms, as well as symptoms pointing to a Psychiatric disorder. Hyperventilation is a complex disorder that can result in an array of symptoms including breathlessness, chest tightness, dizziness, tremor and paraesthesia due to decreased arterial partial pressure of carbon dioxide (PaCO2) and respiratory alkalosis. Diagnosis of HVS is based on clinical picture, analysis of arterial blood gases and pH, hyperventilation provocation test (HVPT), thermograms or thermal images and Nijmegen questionnaire. Nijmegen questionnaire is a short, self-administered patient reported outcome measure consisting 16 HVS related complaints. It was developed by a group of researchers at the Nijmegen University in the Netherlands as a screening tool for the hyperventilation syndrome in the 1980s. It is particularly important to diagnose hyperventilation in vestibular patients as hyperventilation has been shown to unmask vestibular disease, disrupts vestibular compensation and increases postural sway Hyperventilation syndrome has long been thought of as an etiologic agent for dizziness. It has been implicated as the cause of dizziness in 23% of published series of dizzy patients. It is important to recognize hyperventilation, because once diagnoses are confirmed, patients can be referred for breathing control exercises as part of a vestibular rehabilitation programme. So, in the current study to develop and adapt the Arabic version of Nijmegen questionnaire, the NQ was translated following cross-cultural adaptation guidelines. The study sample consisted of 100 normal controls (control group), 50 patients complaining of hyperventilation symptoms (hyperventilation group) confirmed by measurement of Partial pressure of carbon dioxide (PCO2) level and 100 patients complaining of dizziness (dizzy group). Patients with disturbed consciousness and severe mental health disorders were excluded. The patients completed the NQ then, retest was done after one hour. Reliability including internal consistency and test retest reliability and Validity including content and construct validity were examined. Receiver operating characteristic (ROC) curve was used to determine the possible cut off points. The prevalence of hyperventilation in dizzy patients was determined.
The Arabic NQ showed good internal consistency (Cronbach’s alpha=0.819 for controls and =0.920 for hyperventilation group). Test-retest correlation for repeatability was high (r = 0.987 among controls, and = 0.927 among cases). Construct validity showed high negative correlations between the total score of the questionnaire and the PCO2 outcome (r = -0.916, p <0.001). The prevalence of hyperventilation in dizzy patients was 28%. Conclusion: This study showed that the adapted Arabic version of NQ is a valid and reliable questionnaire for the assessment of hyperventilation in Egyptian adults and the most sensitive cut off point for diagnosing of hyperventilation was (26.5). The prevalence of hyperventilation in dizzy patients was 28%.