Dizziness Depot

When a patient presents with acute vestibular syndrome (AVS), the primary responsibility of the examiner is to determine, as best as possible, whether this represents a worrisome pathology such as a posterior fossa stroke. While the vast majority of patients presenting with AVS will ultimately be found to have peripheral vestibular disorders, this does not undermine the importance of performing

Last month, we discussed the acute medical management of vestibular neuritis. This month, we will review potential outcomes and expand on the long-term management of vestibular neuritis. Recovery and Long-Term Outcomes There are two general outcomes after vestibular neuritis: a person may recover completely, or they may be left with some degree of permanent dysfunction at the level of the

Vestibular neuritis is one of the most common causes of dizziness and vertigo, with an estimated incidence of 3.5–15.5 per 100,000 persons. It is presumed to result from either a viral or vascular insult to the vestibulocochlear nerve or inner ear structures, leading to symptoms of intense vertigo. The initial vertigo can last for hours to days. While many individuals

Let me first start by disclosing that I am not a neurologist. As such, much of what will be discussed here is an overly simplistic explanation of complex neurological processes. The aim is simply to increase awareness of white matter lesions and their associations with dizziness, imbalance, and falls. The most appropriate specialist to address white matter abnormalities is a

Vestibular disorders are one of the most common causes of dizziness regardless of clinical setting. The dizziness is most often due to an involuntary eye movement called nystagmus. Nystagmus occurs due to disagreement between the inner ear balance organs or centrally in the brain/brainstem. In most cases, this nystagmus is temporary or may recur sporadically, depending on the condition. The

Simple answer, “Yes.” In addition to typical focal headaches, many migraineurs also experience  photophobia, phonophobia, and/or osmophobia, both during and between headache episodes. Many migraineurs describe sensory hypersensitivity which results in common everyday situations being intolerable. Lights are too bright, sounds are too loud, smells are too strong. Most of us can relate the discomfort of having a bright light

We have previously discussed the association between hearing loss and falls but it seems new data is emerging regularly on this topic, likely given the magnitude of this societal problem. Hearing loss is prevalent, with an estimated 15% of American adults reporting some difficulty hearing. The prevalence of hearing loss also increases significantly with advanced aged. Sensorineural hearing loss is

Benign Paroxysmal Positional Vertigo (BPPV) has a recurrence rate estimated between 15% and 40% within one to two years after an initial episode. While many patients respond well to canalith repositioning procedures (CRPs), a smaller subset experiences more frequent recurrences. Understandably, these individuals often ask what they can do to prevent future episodes. This post explores several actions patients can

Falls are a burgeoning societal problem, and much effort is being made to reduce falls. The risk for falling increases with advanced age, with nearly 1 in 4 individuals in the US over the age of 65 reporting a fall every year. Falls can lead to injury, activity limitation, economic burden and even death. Falls are the leading cause of

Symptomatically, Vestibular Neuritis (VN) typically presents as sudden onset spontaneous acute vertigo, often associated with nausea and vomiting.  The vertigo typically lasts for a minimum of several hours to sometimes days.  While the intensity of the symptoms can be exacerbated by movement, they are not resolved by lying or sitting still in the first 24 hours, which differentiates VN from