Alan Desmond

Alan Desmond, AuD, is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. He has written several books and book chapters on balance disorders and vestibular function. He is the co-author of the Clinical Practice Guideline for Benign Paroxysmal Positional Vertigo (BPPV). In 2015, he was the recipient of the President's Award from the American Academy of Audiology.

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Motion Sickness – Result of Sensory Conflict

Last week I discussed motion sickness online pharmacy champix no prescription , pointing out that it often has nothing to do with any inner ear disorder. However, occasionally it is directly related to an inner ear disorder. I will try to explain… Seasickness online pharmacy strattera for sale no prescription pharmacy Seasickness represents an extended sensory conflict, whereas brief sensory

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Vestibular Ocular Reflex (VOR) Exercises

If the results of the rotary chair examination indicate a deficit of the VOR, particularly decreased gain or a significant asymmetry, we may start the patient on a series of exercises known to enhance the function of the VOR. Like most exercises, the goal is to push the limit of your performance to gradually increase your limit. Below, you will

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CT Scans for Dizziness: Good or Bad Idea?

Approximately one year ago, I embarked on an exploration of the most efficient and cost-effective methods for assessing patients experiencing acute dizziness. This investigation took the form of a comprehensive five-part blog series titled “Acute Vertigo: Could It Be A Stroke?” Within this series, I underscored a crucial point: the prevalent imaging techniques often employed in the Emergency Room setting

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Flicker Vertigo – What is it?

After more than 25 years of working with vestibular patients and hearing various unusual descriptions, I recently came across a term that caught my attention: “Flicker Vertigo.” Although it may be familiar to pilots, I had never encountered it before, despite spending my childhood Saturdays in the back seat of my father’s airplane during aerobatic stunts. Hmmmmm. Maybe that explains

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Let’s Talk About Meclizine

Let’s spend a few weeks talking about meclizine. Most patients complaining of dizziness or vertigo have been given a prescription for meclizine at some point. For a medication that is so widely used, there is very little solid information or recent research to back this up. Meclizine goes by a few names; meclizine is the generic term, but it is

Featured image for “BPPV: Canalithiasis or Cupulolithiasis?”

BPPV: Canalithiasis or Cupulolithiasis?

The most common peripheral vestibular disorder is the condition of Benign Paroxysmal Positional Vertigo (BPPV), accounting for anywhere from 17-42% of all patients seen with symptoms of vertigo.1 The condition of BPPV causes brief episodes of vertigo provoked by a head movement or position change. Benign Paroxysmal Positional Vertigo (BPPV) is typically described by location and type. For example, the

Featured image for “Meclizine – Does it help?”

Meclizine – Does it help?

Treating Dizziness with Antivert: Research indicates that long-term use may not be the best solution By Alan L. Desmond, Au.D., CCC-A and R.Brian Collie, D.O., RPh Considering how frequently Antivert (Meclizine) is prescribed for dizziness, its effectiveness has been measured in remarkably few studies. While there is general agreement among specialists that vestibular compensation is inhibited by the use of

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Meclizine – Does it Hurt?

Editor’s note: This is Part 2 of an update of an article on the use of Meclizine for vertigo that first appeared in print in Advance for Audiologists in 2000. The Physicians Desk Reference lists adverse reactions for meclizine, noting that “Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.” But what about functional impact? Could meclizine

Featured image for “Polypharmacy and Dizziness: More Medications, More Problems?”

Polypharmacy and Dizziness: More Medications, More Problems?

Polypharmacy refers to the act of taking multiple medications concurrently. While there is no universally accepted threshold, polypharmacy is generally defined as taking 4 or more prescription drugs daily. Taking several medications is not inherently problematic, but it introduces uncertainties. An old principle of prescribing holds that the likelihood of adverse reactions and inability to predict interactions rises as the

Featured image for “Unwinding Episodic Dizziness: A Checklist for Front Line Practitioners”

Unwinding Episodic Dizziness: A Checklist for Front Line Practitioners

Diagnosing episodic dizziness can be challenging as most patients are asymptomatic when they arrive for examination. Episodes of dizziness can be broken down into two broad categories based on two variables: Triggered vs. Spontaneous episodes Episodes of less than five minutes duration or more than five minutes duration. Fortunately, these categories align in that most short duration dizziness is triggered,