Dizziness Depot

Last month’s post focused on atypical causes of positional vertigo. This month’s post will be a change of pace and will consist of some general tips and tricks that we have found helpful in treating patients with BPPV. Some of the items covered may seem rudimentary to experienced practitioners but hopefully it will be informative to others. Correct positioning during

The majority of cases of positional vertigo are attributed to the condition of benign paroxysmal positional vertigo (BPPV). BPPV occurs when otoconia migrate into the semicircular canals of the inner ear, resulting in nystagmus and a sense of vertigo that occurs with head movement or position change. Most cases of BPPV impact the posterior semicircular and are readily treated with

In my last blog post, I reviewed the new GRACE 3 guideline for acute dizziness and vertigo in the emergency department. The first recommendation from that guideline was that Emergency Department (ED) physicians need training in bedside tests such as the HINTS protocol, the Dix-Hallpike test, and performing the Epley maneuver when applicable. I also suggested that those of us

There have been symptom reports consistent with Meniere’s disease for many years yet it still remains poorly understood. There is some suspicion that historical figures such as Julius Caesar, Martin Luther, and even Vincent Van Gogh may have had the condition.4 The condition was first theorized to be an inner ear condition by French physician Dr. Prosper Meniere in 1861.3

As audiologists providing both vestibular and hearing assessment, we evaluate individuals with a variety of hearing and/or dizziness related symptoms. We frequently encounter the same common diagnoses. For instance, a symmetric high frequency sensorineural (inner ear/auditory nerve) hearing loss is commonly encountered in a hearing evaluation and may be observed in older adult patients and/or those who have been exposed

I have been told that it is rude to ask people what they do for a living in Italy. I know that seems like a strange way to start a blog about vestibular disorders, but hang in here with me for a minute. I just got back from a week-long vacation visiting friends at their lake house in Michigan. I

The Society for Academic Emergency Medicine, in May of 2023, published GRACE-3. Grace is an acronym for Guideline for Reasonable and Appropriate Care in the Emergency Department. GRACE 1 and 2 offer guidelines for chest pain and abdominal pain. GRACE-3 addresses “acute vertigo and dizziness in the emergency department”. This is a welcome, much needed, and frankly overdue development as

Last week I discussed motion sickness, pointing out that it often has nothing to do with any inner ear disorder. However, occasionally it is directly related to an inner ear disorder. I will try to explain… Seasickness Seasickness represents an extended sensory conflict, whereas brief sensory conflicts typically do not induce nausea despite causing momentary disorientation. A familiar example of

A vestibular evoked myogenic potential, or VEMP, is a measure of vestibular function that only recently is seeing widespread clinical use. A VEMP is a measurement of a change in muscle activity in response to stimulating the vestibular system. These measures allows us to intuit the function of specific end organs of the inner ear, predominantly reflecting the function of

If the results of the rotary chair examination indicate a deficit of the VOR, particularly decreased gain or a significant asymmetry, we may start the patient on a series of exercises known to enhance the function of the VOR. Like most exercises, the goal is to push the limit of your performance to gradually increase your limit. Below, you will