Dizziness Depot

 A few weeks ago, I gave an example of a young lady that seemed to have a prolonged reaction to simple posterior canal BPPV that I suspected was the result of her history of migraine. I have been suspicious for years that migrainuers experience vestibular disorders with more extreme symptoms and recover with more difficulty than non-migrainuers. A recent study

A couple of years ago, I did a four part series here discussing the potential benefits of developing a Clinical Practice Guideline for Acute Vertigo. This would be most applicable to Emergency Department (ED) and Primary Care Physicians (PCP), as very few patients are still in the acute phase by the time they make it to a vestibular lab. There

BPPV is a common disorder, typically easily treated once identified.  The vast majority (over 90%) of cases of BPPV involve free floating debris in the posterior canal on one side. These types of BPPV responds well to the Epley maneuver. There are other, less common and less easily-treated variants of BPPV. Occasionally, the debris will settle in the horizontal canal.

Both Migraine and Vestibular Dysfunction affect a large percentage of the population, so it stands to reason that there is a subgroup of people that have both. I am not talking about vestibular migraine here. I am thinking about people with a long, established history of classic migraine headaches, that coincidentally suffer for a vestibular event such as BPPV or

Last week, I attended a conference at Johns Hopkins in Baltimore, MD. It was described as a ‘Vestibular Master Class”, and I agree that the information and faculty were as good as it gets. There was a fairly international attendance, and many of the top people in the United States and Canada were present. These types of conferences are very helpful,

Meniere’s disease was first described by Prosper Meniere in the 1800s. Up until that time, vertigo was thought to be the result of epileptic type seizures. Meniere was the first to publicly suggest that the inner ear was the cause of the collection of symptoms including hearing loss and vertigo, but he thought that they were the result of a

It seems like a high percentage of my posts here relate to Meniere’s disease.  So many questions, with very few definite answers. There are many theories as to what causes the triad of symptoms (vertigo, tinnitus, hearing loss) associated with a Meniere’s episode, and many treatment options available. If you think about it, if any one theory explained all aspects

 This week, we will review an article by Dr. David Newman-Toker. Dr. Newman-Toker has been a leader in the movement to change the way patients with sudden onset acute vertigo are evaluated. The primary concern of the physician evaluating these patients is to determine, as best possible, “Is this a stroke versus a benign labyrinthine condition?” Historically, patients presenting to

  In my relatively new position running a Balance Disorders program at a large teaching hospital, I am exposed to a very different patient population than what I encountered in my private practice. One example of this is being exposed to patients that have recently undergone cochlear implantation.  One recent case triggered my curiosity about how often a patient might

A summary of “An Abbreviated Diagnostic Maneuver for Posterior Benign Paroxysmal Positional Vertigo”, Michael, P.,  et al (2016).     The authors of this article report that canalothiasis (free floating otoconia) of the posterior canal is the most common single cause of vertigo.  Treatments are easy, inexpensive, safe and effective, yet people wait months to years without proper diagnosis and