Dizziness Depot

Featured image for “BPPV: Canalithiasis or Cupulolithiasis?”
May. 14, 2023

BPPV: Canalithiasis or Cupulolithiasis?

Alan Desmond
The most common peripheral vestibular disorder is the condition of Benign Paroxysmal Positional Vertigo (BPPV), accounting for anywhere from 17-42% of all patients seen with symptoms of vertigo.1 The condition of BPPV causes brief episodes of vertigo provoked by a head movement or position change. Benign Paroxysmal Positional Vertigo (BPPV) is typically described by location and type. For example, the
Featured image for “Meclizine – Does it help?”
May. 01, 2023

Meclizine – Does it help?

Alan Desmond
Treating Dizziness with Antivert: Research indicates that long-term use may not be the best solution By Alan L. Desmond, Au.D., CCC-A and R.Brian Collie, D.O., RPh Considering how frequently Antivert (Meclizine) is prescribed for dizziness, its effectiveness has been measured in remarkably few studies. While there is general agreement among specialists that vestibular compensation is inhibited by the use of
Featured image for “Meclizine – Does it Hurt?”
May. 01, 2023

Meclizine – Does it Hurt?

Alan Desmond
Editor’s note: This is Part 2 of an update of an article on the use of Meclizine for vertigo that first appeared in print in Advance for Audiologists in 2000. The Physicians Desk Reference lists adverse reactions for meclizine, noting that “Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.” But what about functional impact? Could meclizine
Featured image for “Polypharmacy and Dizziness: More Medications, More Problems?”
Apr. 21, 2023

Polypharmacy and Dizziness: More Medications, More Problems?

Alan Desmond
Polypharmacy refers to the act of taking multiple medications concurrently. While there is no universally accepted threshold, polypharmacy is generally defined as taking 4 or more prescription drugs daily. Taking several medications is not inherently problematic, but it introduces uncertainties. An old principle of prescribing holds that the likelihood of adverse reactions and inability to predict interactions rises as the
Featured image for “Unwinding Episodic Dizziness: A Checklist for Front Line Practitioners”
Apr. 13, 2023

Unwinding Episodic Dizziness: A Checklist for Front Line Practitioners

Alan Desmond
Diagnosing episodic dizziness can be challenging as most patients are asymptomatic when they arrive for examination. Episodes of dizziness can be broken down into two broad categories based on two variables: Triggered vs. Spontaneous episodes Episodes of less than five minutes duration or more than five minutes duration. Fortunately, these categories align in that most short duration dizziness is triggered,
Featured image for “Vitamin D Deficiency: Can it Cause Vertigo and Hearing Loss?”
Mar. 22, 2023

Vitamin D Deficiency: Can it Cause Vertigo and Hearing Loss?

Brady Workman
Vitamin D is an essential nutrient, necessary for building and maintaining healthy bone structure by promoting calcium absorption in the body. Despite its importance, vitamin D is not found naturally in many foods. Also, with populations spending less time outdoors, vitamin D obtained naturally from sunlight is likely declining. As such, vitamin D deficiency is widespread with an estimated 1
Featured image for “VNG: An Incomplete Picture”
Feb. 22, 2023

VNG: An Incomplete Picture

Brady Workman
Vestibular disorders are the most common reason for symptoms of dizziness regardless of the clinical setting. A five study average reveals that vestibular disorders account for around 45% of all dizziness and are much more common than cardiovascular or potentially life threatening neurologic causes for dizziness. Despite the magnitude of individuals suffering from vestibular type dizziness, these disorders are historically
Featured image for “Ramsay Hunt Syndrome – Symptoms, Evaluation, Diagnosis and Treatment”
Feb. 02, 2023

Ramsay Hunt Syndrome – Symptoms, Evaluation, Diagnosis and Treatment

Alan Desmond
Ramsay Hunt Syndrome (RHS) is a condition caused by the varicella-zoster virus (chicken pox), part of the herpesvirus family, which can remain dormant in cranial nerves or dorsal root ganglia after the initial infection, commonly known as chickenpox. Later in life, when the virus reactivates due to physiological stress or immunocompromise, it can result in herpes zoster or “shingles” anywhere
Featured image for “Modified Epley Maneuver Update”
Jan. 31, 2023

Modified Epley Maneuver Update

Brady Workman
The most common vestibular disorder is the condition of Benign Paroxysmal Positional Vertigo (BPPV), which accounts for up to 40% of all patients experiencing vertigo. This condition is the result of otoconia (inner ear crystals) migrating into one of the semicircular canals (head turn sensors) of the inner ear. The majority of cases can be readily treated with canalith repositioning
Featured image for “Positional Vertigo: Hula Hoops and Other BPPV Analogies”
Jan. 29, 2023

Positional Vertigo: Hula Hoops and Other BPPV Analogies

Alan Desmond
Last week, I told a story about my difficulty in getting a patient to understand the role of meclizine in the treatment of Benign Paroxysmal Positional Vertigo (BPPV). It got me thinking about some of the analogies we use to describe certain concepts about BPPV that may be more relatable to a patient than trying to help them understand things