Dizziness Depot

  Benign Paroxysmal Positional Vertigo (BPPV) got its 15 minutes of fame this past weekend. During the nationally televised U.S. Open Golf Tournament, a contender for the title reportedly battled with recurrent vertigo throughout the tournament. From this point on in this blog, it will become increasingly apparent that I do not golf, do not watch golf, and never heard

In the several years after Brandt and Daroff published their classic article, Physical therapy for benign paroxysmal positional vertigo, France became a hotbed of activity in developing techniques that would eventually become known as Canalith Repositioning. Several researchers began experimenting with movements (not exercises) intended to promote loosening and redistribution of otoliths from the semi-circular canals. That description, paraphrasing Brandt

I wasn’t always a vestibular geekazoid. In the first several years of practice I “did ENGs” like many others, but soon decided my time was more effectively spent helping those with hearing problems. While the ENG test often found abnormalities, there were no solid treatments to help these people. I backed away and did not see vestibular patients for several

  Caloric testing has been a standard part of the test battery for dizziness and vertigo for more than fifty years. Although newer technology and techniques are gradually making us less dependent on the information produced by caloric testing, it still remains a commonly performed procedure. Here is a simple explanation of the test: the ear canal is irrigated with

I have mixed feelings about the following post. For the practitioner, I think it is helpful to understand the history behind some of the techniques we use today. For the patient, I hope they realize that modern rotational chair testing is very well controlled, rarely producing any nausea or distress. One of the first reports of using a rotational chair

  I am constantly looking for ways to make the path a little easier for the patient complaining of dizziness, and for the health care practitioners trying to help them. I have discussed on this blog in the past that it is imperative that the description go beyond simply describing the sensation as dizziness. The word “dizzy” can be used

As you may noticed in the last few blog posts, I am going back to some earlier topics and seeing if the evidence, or general consensus, has changed over the two or three years since the posts were written. I did a series on Blood Pressure and Dizziness about three years ago. The gist of that series was that many patients

This week, let’s discuss the rotational chair exam. Rotational chairs are not commonly found in many private offices performing vestibular tests, simply because they are so expensive. There is little discussion of the effectiveness and sensitivity of the rotational chair in helping diagnose patients with vestibular disorders. Many Veterans Administration and Military Hospitals use them routinely (at taxpayers expense), but

Random Thoughts and Observations Migraine is a common cause of vertigo, yet the symptoms and temporal pattern differ enough from classic migraine that the International Headache Society has established criteria for “Vestibular Migraine” listed at the end of this blog. Similar to classic migraine, there is no specific test that confirms the diagnosis. Rather, diagnosis is made on the basis

“Time will tell.” This is a quote from my mom, Marge Desmond. She likes to say this to point out that the truth usually prevails. A recent study out of China supports my informal research, and years-long soap-boxing about the inadequate diagnostic process for patients suffering from Benign Paroxysmal Positional Vertigo (BPPV). I have pointed out on this blog that