Dizziness Depot

The Epley maneuver (or canalith repositioning) has historically been described as involving four positions, with the Dix-Hallpike test being position #1. Position #2 involves having the patient roll their head away from the affected side. Position #3 continues in the same direction to the nose down position, and position #4 involves bringing the patient back up into the sitting position.

It’s time again for some disorganized thoughts that surface periodically. Hopefully, one of them will be helpful. In Which Ear Do You Have Meniere’s? There is nothing simple about Meniere’s disease. It is the least understood, most debilitating, and least responsive to treatment of all inner ear disorders. It is also over-diagnosed. I have seen hundreds of people over the

Has the Pendulum Swung Too Far? Back in 2013, I did a several part series on BPPV (Benign Paroxysmal Positional Vertigo). My concern was that BPPV was being overlooked, under diagnosed, and not treated often enough in the general medical community. The vast majority of patients complaining of positional vertigo never got a positional test. A reader commented that things seemed

  I am a bit behind the times posting this information two weeks into 2016, but it just seems sort of anticlimactic. We have been working to change the incorrect valuation of the caloric irrigation codes for about five years. Well, we got a change, but it isn’t what we hoped for. It also isn’t correct, or the result of

We started last week’s post discussing screen time, or time spent looking at a TV or computer. But, consider all the other screens you deal without throughout the day. The most obvious is your smart phone, but we also deal with 3D movies, IMAX movies, and back up cameras in your cars,   Think about the additional complexity of these

Christmas and New Year’s Day are over and it is back to the grind of daily life which, in 2016, is quite a bit different than it was just ten years ago. We spend more and more time looking at screens such as TV and computers. A recent survey found American adults spend 5 ½ hours a day engaged in

In my new position as Director of the Balance Disorders Programs at Wake Forest University Baptist Hospital, I am seeing a whole range of patients that were not part of my private practice. I have been on the job just 6 months (the first two months were dedicated to building the clinic). During that short 4 months time, I have

I am off on holidays this week, but hope you will enjoy this top post from 2015. Meclizine – Condensed Back in 2013, I did a three part series reviewing the literature regarding the use of meclizine for complaints of “dizziness.” Today’s post updates and condenses those three posts into one, with some additional new information, hoping that this shorter

Vestibular specialists use caloric irrigation as a test of labyrinthine (particularly horizontal semicircular canal) sensitivity. The results have historically been used to make judgments about the functional status of an entire labyrinth. More recent test modalities have shown that many of those assumptions were incorrect. Rotational chair and vHIT testing have taught us that an ear with an abnormal caloric

  Last week, I posted a short blurb about the FDA approval of the application by GN Otometrics for their EP Charter system with VEMP capability and EMG monitoring.  A few days later, Jill Craig, audiologist and product manager at Otometrics, contacted me with additional information and a slightly different perspective on the FDA approval.  Here is what Jill had