Alan Desmond

In an effort to quickly identify potential risk factors, I developed a fall risk questionnaire several years ago that I use routinely in my practice.( A copy of the questionnaire and accompanying “Physician’s Guide will be posted next week). The Fall Risk Questionnaire is a 15 item checklist to be filled out by the patient prior to examination. This allows

Why is there so much disagreement regarding the best way to minimize the risk of falling?                                                    A review of several recent studies regarding the cause of falling reveals different assessments, different treatments, and different health care specialists involved. This makes it very difficult to effectively compare or reproduce findings. For example, in one study vestibular function was evaluated through

          What are the most common risk factors for falling? Lists of risk factors for falling often differ depending on the type of specialist performing the evaluation or the type of evaluation performed.  One thing that nearly everyone agrees on, the more risk factors present, the higher the chance of falling.  This is more eloquently stated by Tinetti  et al

Over the next few weeks, we will take a look at the subject of “Fall Prevention.” This should more accurately be described as “Fall Reduction”, or “Minimization of Fall Related Injury.” It is impossible to prevent falls entirely. Accidents happen. Nonetheless, falling in the elderly is a huge health care problem. So even if we don’t have the answer, it

A new web based educational site is currently being developed through the American Institute of Balance Education Foundation (AIB). The URL is  www.CME2go.com   According to Dr Richard Gans, founder and director of AIB: “We here at AIB also have a new global educational platform you may be interested in, The American Institute of Continuing Medical Education.   “It is perhaps the

  What typically happens when a patient goes to the Emergency Room for the complaint of dizziness? When a patient presents with the complaint of vertigo or dizziness in the Emergency Room,  the most common diagnostic procedures performed are blood tests (including CBC, ECG, Glucose, BUN and Creatinine), Pulse Oximetry, Chest X-Ray, Urinalysis, Cardiac monitoring and CT/MRI (Kerber et al.,

Last week, we explored various techniques to view nystagmus, and I made the suggestion that every Emergency Room in the country should have a pair of video goggles available. To better understand why I made this suggestion, let’s take a look at what happens most often when a patients goes to the Emergency Room with the complaint of “dizziness.” Dizziness

Nystagmus are best viewed using infrared videonystagmography, however, other techniques can partially reduce visual fixation known to suppress vestibular nystagmus. Alternative viewing techniques include Frenzel’s glasses or direct observation assisted by a penlight, otoscope, or ophthalmoscope. Observation Techniques Compared Guidetti, Monzani, and Rovatti (2006) compared three observation techniques (direct visual observation, Frenzel’s glasses and infra-red assisted videonystagmography) used in the examination

Is there a better way to manage patients with suspected stroke causing dizziness ? Part III Because of the low incidence of dizziness caused by Cerebellar Stroke (CS), as well as the increased cost and reduced availability of MRI scanners, screening protocols to determine which patients require MRI scanning should be developed and followed in both Emergency Departments and primary

Could a stroke causing dizziness be missed? Part II Retrospective studies of misdiagnosis of Cerebellar Stroke (CS) reveal that the most common medical errors include failure to perform appropriate screening exams, choosing a diagnosis that does not explain all the presenting symptoms, failure to consider CS as a differential diagnosis based on the patient’s age, and the ordering of the