Dizziness Depot

Temporal Course (Timing)   Temporal course includes information regarding the onset, duration, and frequency of symptoms. In general, dizziness lasting for less than 1 minute when the patient is lying down is associated with benign paroxysmal positional vertigo (BPPV), whereas dizziness lasting less than 1 minute when the patient stands up is associated with orthostatic hypotension (OH). Note: Dizziness from

Quality of Vestibular Symptoms Traditional medical education stresses that most complaints of dizziness fall within one of four broad categories: Vertigo(described as a sensation or illusion of spinning or rotation which is traditionally associated with peripheral vestibular etiology, )Presyncope (technically describes a sensation of imminent loss of consciousness, but it is frequently used to categorize the sensation of lightheadedness), Dysequilibrium

Structure of the Case History Interview   The case history interview should be initially unstructured and open ended. Patients should be allowed to tell their story with minimal interruption. One approach is to ask the patient, “Tell me, what brings you here?” It is helpful to ask patients to start at the beginning and present their story chronologically. Patients should

Role of the Case History Interview   A thorough history is critical for three main reasons: 1. Many patients have difficulty articulating their symptoms beyond simply describing themselves as being “dizzy.” 2. Additional evaluation and treatment will differ depending on the suspected site of the lesion. Patients with BPPV may not require caloric testing to achieve diagnosis and successful treatment.

“Good morning Mrs. Butterworth, Tell me what you brings you here today?” Mrs. Butterworth: “I’m dizzy.” What have I learned? Nothing. The term “dizziness” serves as a catch-all phrase for a wide range of sensations, making it an inadequate descriptor. It encompasses experiences such as vertigo, lightheadedness, faintness, disorientation, and gait instability. These diverse complaints can arise from various underlying

Fraud and abuse in vestibular function testing   Last week we discussed some of the factors that have led to such dramatic and unsustainable reductions in reimbursement for vestibular function tests. These include professional turf battles, federal deficits and Medicare’s reaction to past fraud and abuse. This week we take a closer look at the fraud and abuse issue. For

Last week we reviewed the structure of CPT codes, developed and valued by the American Medical Association, as a primer to discuss the reasons behind recent reductions in valuation and reimburseent for vestibular procedures. Let’s start with the new “bundled” code.  The CPT code 92540 (Basic Vestibular Exam) was created to combine four of the CPT codes that make up

Last week I proposed that dispensing audiologists should consider adding vestibular services to their practice. I have to say, I thought it was a pretty convincing argument.  And I still think that overall, there is great benefit to all involved, and I have been encouraging audiologists regarding this for years. The problem is, in the second to last paragraph of

 Adding vestibular services to your practice provides benefits to all involved    Most of you are familiar with the frequently quoted statistics regarding hearing loss and hearing aid use.  This quote comes directly from the Better Hearing Institute website:  “The last MarkeTrak survey (2004) estimated that 31.5 million people report a hearing difficulty; that is around 10% of the U.S. population.”

We have another post this week from Dr. Phillip Griffin, Audiologist and Vestibular Specialist in the Greensboro/High Point, NC area. Perhaps you’ve heard of a new type of exercise that is popping up everywhere at local YMCA’s, senior centers, and retirement communities. It comes from a far away land and has an exotic sounding name. Its slow graceful movements make it