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.

Malaria Drug and Vestibular Disorders

Mefloquine online pharmacy buy valtrex no prescription pharmacy is a drug used for the prevention of malaria. It has come under some scrutiny lately as it has been mentioned as a possible contributor in the Sergeant Robert Bales incident. He is the soldier recently convicted of killing 16 Afghan civilians. Mefloquine has been suspected of causing numerous psychiatric or neurologic

How to Save One Billion Dollars a Year

Last week, we reviewed a recent story published by Johns Hopkins. The story summarizes an article that recently appeared in the July issue of Emergency Academic Medicine. This week, I want to discuss some new (at least to me) demographic information that was obtained as part of that article. Here Comes the Wave The first issue is the sheer number

Acute Dizziness in the ER: Expensive and Ineffective Practices

Can I get an “Amen?” A recent article published by Johns Hopkins (www.hopkinsmedicine.org) nicely summarizes and adds some interesting facts to the argument (okay, soapbox) that I have been trying to make over the past year or two: the practice of ordering CT scans, and not doing a brief vestibular function screening when a patient arrives at the Emergency Room

Sensory Conflict -Priorities

This week’s post is an excerpt from my book: Vestibular Function: Clinical and Practice Management (Thieme 2011). “The primary role of the balance system is to allow humans to interact and maintain contact with their surroundings in a safe, efficient manner. As humans move through their environment, information is gathered through their visual, somatosensory, and vestibular senses and sent to

The Caloric Test: By the Numbers

Caloric irrigation is performed by irrigating the ear canal with either water or air for a period of 30 to 60 seconds. In order for the test to provide sensitive, accurate information, several minimum standards must be met. 1. The temperature of the air or water must be precisely 7 degrees Celsius over or under body temperature to compare to

The Bow and Lean Test

A brief word of caution – this week’s blog is not for general consumption. It will be confusing to those not very familiar with Benign Paroxysmal Positional Vertigo (BPPV). Last week, I blogged about some recent courses I had taught, and promised to post about a new trick I learned in the process. I was about halfway through a 90-minute

Vestibular Disorders: Teaching and Learning

I had a different kind of week last week. I took the week off from seeing vestibular patients to teach a couple of courses. On Tuesday, I spoke to a small group of Otolaryngologists and Audiologists about the differences between primary care and specialty clinic management of the dizzy patient. On Friday and Saturday, I spent all day (and I

Physical Therapy and Fall Risk Assessment

This week, I just want to review some aspects of what a Physical Therapist can contribute to a Falls Risk Assessment Team (FRAT). The role of the Physical Therapist might change dramatically depending on setting, training and the skills of other FRAT members. What is listed below is a summary provided by Kim Slemp, PT, a good therapist and friend, when asked

Frat Boys and Fall Risk

When I was in college (and I assume it’s not changed too much) there was typically a point in time where you needed to decide if you wanted to join a fraternity or not. There were a lot of discussions about this in the first few weeks of each school year, with underclassmen asking the older students what they thought

Visual Deficits and Fall Risk

Vision and vestibular function are closely linked, particularly as they relate to gait and postural stability. Visual acuity is independent of vestibular function only when the head is perfectly still. With any movement of the head, we rely on the vestibular ocular reflex (VOR) to provide visual stability. Any significant deficiency of the VOR can result in visual blurring (oscillopsia)