Phantom earthquake sensation, post-earthquake dizziness symptoms, and balance performance after the 6 February 2023 Kahramanmaraş Earthquakes: An item-level analysis using the PEDS questionnaire

This study examined the prevalence and characteristics of phantom earthquake sensation and other post-earthquake dizziness–related symptoms measured using the Post-Earthquake Dizziness Syndrome (PEDS) questionnaire, and explored their associations with balance performance among individuals affected by the 6 February 2023 Kahramanmaraş earthquakes. In this cross-sectional observational study, 121 individuals from central Kahramanmaraş were assessed. Participants completed a demographic and earthquake-exposure form and the 10-item PEDS questionnaire. Balance was evaluated using the Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Functional Reach Test (FRT). Nonparametric between-group comparisons were performed, and Holm–Bonferroni correction was applied to control for multiple comparisons. Phantom earthquake sensation was reported by 75.2% of participants. The most common symptoms were anxiety (80.2%), motion sickness (52.9%), tinnitus/aural fullness (41.3%), and vertigo/dizziness (25.6%). Dizziness was most frequently described as a ground-shaking sensation (63.6%) and resolved within approximately one month in 54.5% of respondents. After adjustment for multiple comparisons, only autonomic symptoms remained significantly associated with balance performance. Participants reporting autonomic symptoms demonstrated significantly different BBS scores and greater FRT distances compared to those without autonomic symptoms (Holm-adjusted p=0.024 for both). No significant associations were observed for TUG or other PEDS items. Post-earthquake dizziness–related symptoms and phantom earthquake sensation were common in this sample and showed limited item-specific associations with balance performance. These findings suggest that integrating vestibular-related symptom screening and balance assessment may be clinically relevant in post-disaster care.