Dizziness Depot

Editorial (Rant) In an ideal healthcare world, clinical practice should drive reimbursement, not the other way around. By saying that, I mean that the powers that be should think about paying for tests and treatments that work, and not paying for those that demonstrate little value. Particularly when it comes to vestibular patients, and I am sure true of many

Last week, I reviewed a recent study from the journal Frontiers in Neurology demonstrating that nearly all (about 90%) of patients with complaints of dizziness or vertigo seen at a specialty vestibular clinic receive a firm diagnosis. This is much higher than any other diagnostic approach. This week, let’s take a look at some of the specific diagnosis, and some of

This five-part series continues as follows: Part II   Part III   Part IV   Part V This is the first of a five part series on how to differentiate stroke from inner ear disease in acute vertigo. The main symptoms of cerebellar stroke (CS) are dizziness, nausea, vomiting, gait instability (unsteadiness while walking) , and headaches. This presents some difficulty because

  A recent study out of Switzerland essentially posed the question “How much impact does a specialty vestibular clinic have on the correct diagnosis and effective management of patients complaining of dizziness or vertigo?” They attempted to answer this question by looking at the suspected diagnosis made by the referring Primary Care Physician (PCP), and comparing it to the final

  It is good and standard practice to always check with your patients before performing the Dix-Hallpike and ask them if they have any neck or back issues. I usually phrase it “Do you have any issue with your neck or back that would make laying you down and moving your neck around a problem?”  Most just say “NO,” but

  “Twenty dollars income with nineteen dollars expense equals happiness; nineteen dollars income with twenty dollars expense equals misery.” This is a paraphrase of a quote from the Charles Dickens novel, David Copperfield. It is really that simple. The marketing and financial aspects of managing a successful balance clinic can be broken down into two general areas: 1. getting people

Audiologists have historically taken the lead role as the provider for vestibular evaluation. Since this blog is written primarily for an Audiology audience, we will focus on what the Audiologist can and should do. There are critical aspects of evaluation and management of the dizzy patient that are not/may not be within our scope of practice and training, and require the input

This series on staffing was co-authored by Shanna Thompson, M.S. When a patient is diagnosed with cancer, all related physicians meet at what is known as “tumor board.” The radiation oncologist, medical oncologist, surgeon and attending physician discuss all aspects of the patients’s care. A treatment plan is devised based on the best clinical evidence. This type of multidisciplinary cooperation reduces the

        All audiologists have an audiometer. So what can you do with an audiometer that might be of value to the dizzy patient? A comprehensive audiometric evaluation will not allow a firm diagnosis, but history combined with certain audiometric patterns can point you in the right direction. A patient with a conductive hearing loss and flat tympanogram may

                    Part II: When the test results                     and the history don’t match   Of course, sometimes the history is anything but clear. Another basic rule (again, not always true) is that, if after ten to fifteen minutes of questions you have no idea what is wrong with the patient, there is a very good chance that there is some