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.

Readers’ Choice 2012: Acute vertigo–Could it be a stroke? Part I

This five-part series continues as follows: Part II Part III Part IV Part V This is the first of a five part series on how to differentiate stroke from inner ear disease in acute vertigo. The main symptoms of cerebellar stroke (CS) are dizziness, nausea, vomiting, gait instability (unsteadiness while walking) , and headaches. This presents some difficulty because

New Study Supports Vestibular Clinics

A recent study out of Switzerland essentially posed the question “How much impact does a specialty vestibular clinic have on the correct diagnosis and effective management of patients complaining of dizziness or vertigo?” They attempted to answer this question by looking at the suspected diagnosis made by the referring Primary Care Physician (PCP), and comparing it to the final

BPPV and the unstable cervical spine

It is good and standard practice to always check with your patients before performing the Dix-Hallpike and ask them if they have any neck or back issues. I usually phrase it “Do you have any issue with your neck or back that would make laying you down and moving your neck around a problem?” Most just say “NO,” but

Balance Clinic Marketing and Financial Aspects

online pharmacy zetia no prescription “Twenty dollars income with nineteen dollars expense equals happiness; nineteen dollars income with twenty dollars expense equals misery.” This is a paraphrase of a quote from the Charles Dickens novel, David Copperfield. It is really that simple. The marketing and financial aspects of managing a successful balance clinic can be broken down into two

Balance Clinic Staffing-Part II

Audiologists have historically taken the lead role as the provider for vestibular evaluation. Since this blog is written primarily for an Audiology audience, we will focus on what the Audiologist can and should do. There are critical aspects of evaluation and management of the dizzy patient that are not/may not be within our scope of practice and training, and require the input

Balance Clinic Staffing – Part I

This series on staffing was co-authored by Shanna Thompson, M.S. When a patient is diagnosed with cancer, all related physicians meet at what is known as “tumor board.” The radiation oncologist, medical oncologist, surgeon and attending physician discuss all aspects of the patients’s care. A treatment plan is devised based on the best clinical evidence. This type of multidisciplinary cooperation reduces the

Audiometric Patterns in Vestibular Disease

All audiologists have an audiometer. So what can you do with an audiometer that might be of value to the dizzy patient? A comprehensive audiometric evaluation will not allow a firm diagnosis, but history combined with certain audiometric patterns can point you in the right direction. A patient with a conductive hearing loss and flat tympanogram may

Vestibular Brain Droppings, Part II

Part II: When the test results and the history don’t match buy flagyl online https://www.vitalysthealth.org/wp-content/uploads/2010/02/flagyl.html no prescription Of course, sometimes the history is anything but clear. Another basic rule (again, not always true) is that, if after ten to fifteen minutes of questions you have no idea what is wrong with the patient, there is a very

Brain Droppings: Vestibular Screening Exams

Brain Droppings Regarding Vestibular Screening Exams In 1997, George Carlin published his book, Brain Droppings. According to the cover, the book contains page after page of “”jokes, notions, doubts, opinions, questions, thoughts, beliefs, assertions, assumptions, and disturbing references” and “comedy, nonsense, satire, mockery, merriment, sarcasm, ridicule, silliness, bluster, and toxic alienation.” Any fan of George Carlin will know that this is

Vestibular Smackdown

Wrestling and Dizziness -Say What? online pharmacy cipro no prescription pharmacy Pharmacie-Marseille.com We have the ability to diagnose and effectively treat most causes of dizziness. It is not a matter of “Can we help?”, but more a matter of getting the right patients to the right specialists. The vast majority of dizzy patients never make it as far as a