Dizziness Depot

Jun. 29, 2011

Dizziness in the Emergency Department –Part II

Alan Desmond
  What typically happens when a patient goes to the Emergency Room for the complaint of dizziness? When a patient presents with the complaint of vertigo or dizziness in the Emergency Room,  the most common diagnostic procedures performed are blood tests (including CBC, ECG, Glucose, BUN and Creatinine), Pulse Oximetry, Chest X-Ray, Urinalysis, Cardiac monitoring and CT/MRI (Kerber et al.,
Jun. 15, 2011

Dizziness in the Emergency Department –Part I

Alan Desmond
Last week, we explored various techniques to view nystagmus, and I made the suggestion that every Emergency Room in the country should have a pair of video goggles available. To better understand why I made this suggestion, let’s take a look at what happens most often when a patients goes to the Emergency Room with the complaint of “dizziness.” Dizziness
Jun. 12, 2011

Why in the world is there not a set of infra-red videonystagmography goggles in every emergency room in the country?

Alan Desmond
Nystagmus are best viewed using infrared videonystagmography, however, other techniques can partially reduce visual fixation known to suppress vestibular nystagmus. Alternative viewing techniques include Frenzel’s glasses or direct observation assisted by a penlight, otoscope, or ophthalmoscope. Observation Techniques Compared Guidetti, Monzani, and Rovatti (2006) compared three observation techniques (direct visual observation, Frenzel’s glasses and infra-red assisted videonystagmography) used in the examination
May. 21, 2011

Acute Vertigo – Could it be a Stroke, Part III

Alan Desmond
Is there a better way to manage patients with suspected stroke causing dizziness ? Part III Because of the low incidence of dizziness caused by Cerebellar Stroke (CS), as well as the increased cost and reduced availability of MRI scanners, screening protocols to determine which patients require MRI scanning should be developed and followed in both Emergency Departments and primary
May. 13, 2011

Acute Vertigo – Could it be a Stroke? -Part II

Alan Desmond
Could a stroke causing dizziness be missed? Part II Retrospective studies of misdiagnosis of Cerebellar Stroke (CS) reveal that the most common medical errors include failure to perform appropriate screening exams, choosing a diagnosis that does not explain all the presenting symptoms, failure to consider CS as a differential diagnosis based on the patient’s age, and the ordering of the
Apr. 20, 2011

Treating Dizziness Related to Blood Pressure Issues – Part III

Alan Desmond
The treatment of dizziness related to blood pressure abnormalities is not within the scope of Audiology practice, and is best managed by an Internist or Primary Care physician. None of the suggestions listed below should be attempted without first consulting with your physician. As noted in the previous blogs, dizziness on rising from the sitting or supine position is frequently
Apr. 12, 2011

Blood Pressure and Dizziness –Part II

Alan Desmond
Last week we talked about blood pressure and dizziness, and a condition known as orthostatic hypotension. This week we dig a bit deeper, and talk about proper measurement techniques as well as problems with diagnosing this condition. Orthostatic hypotension is a clinical sign, not a disease. The most common symptom associated with OH is postural pre-syncope (a lightheaded or near
Apr. 06, 2011

Welcome to the Vestibular Corner…

Alan Desmond
…at Hearing Health & Technology Matters! This site is primarily devoted to issues relating to hearing loss, but let’s not forget the ears do much more than just hear.  The inner ear is critical to balance, orientation and visual clarity when you are moving. When something goes wrong with the inner ear, life (as you knew it) stops. It is
Apr. 06, 2011

Blood Pressure and Dizziness

Alan Desmond
Many patients complain of dizziness or light headedness on rising from the sitting or supine position. Postural dizziness has been loosely correlated with postural or orthostatic hypotension (OH). The American Academy of Neurology (1996) has issued a consensus statement defining orthostatic hypotension which can be found here in a later post. There is some inconsistency in both education and practice