Dizziness Depot

  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

  BPPV (Benign Paroxysmal Positional Vertigo) is the most common cause of vertigo and dizziness complaints. It is generally easily treated once identified, as long as it happens to affect the posterior canal. In fact, it seems that many people are self diagnosing and going to the internet for home treatment instructions. Many physicians are sending people home with exercises

Holiday greetings to all. I will be on a beach in Mexico with the women in my life, my lovely wife and daughter. I won’t be thinking about vestibular issues, but I will leave you with one thought regarding the post below. I have tried the headshake technique on a handful of patients with history strongly suggestive of active BPPV,

Wrapping up our Meniere’s Update series, we have a contribution from Philippa Thomson. Below, I have pasted her biography from the Amazon webpage. I have read her book A Hole in My Life, and we have become email buddies over the past few months. She is smart, passionate, and has a heck of a story to tell. This article “

  A Shotgun Approach to Treatment As we have reviewed Meniere’s disease treatments over the last several weeks, it is clear that there is not consensus on the proper, most effective treatment. There is also no consensus on the cause of Meniere’s type symptoms. Various theories on etiology include:     Overproduction of endolymph by the stria vascularis Blockage of

  Over the past several weeks, we have been reviewing the various treatments for Meniere’s disease. Conservative treatments covered previously in this series do not have strong evidence of effectiveness. As we move towards more invasive treatments, the likelihood of a positive change is more likely, but they come with some risk. These invasive treatments are performed by ear surgeons,

Middle Ear Muscles and Meniere’s Last week, I mentioned that a study advocated severing the tendons to the tensor tympani and stapedius muscles as a treatment for Meniere’s disease. I admitted that I was not familiar with this treatment and decided to look into it. Here is what I found: For this to make any sense, we must do a

Endolymphatic Sac Surgery   This week, I had intended to provide the fourth post in the Meniere’s update series with some clarity on the role of surgical procedures intended to reduce endolymphatic pressure in patients with Meniere’s disease. My initial 2012 post on this topic discussed the lack of definitive information surrounding the benefit of these procedures. My hope was

 In 2012, I reported here that meta-analysis demonstrated no benefit in reducing the frequency or severity of Meniere’s episodes when compared to placebo. Since that time, one particularly high quality clinical trial and one updated meta-analysis have been published. First, the updated meta-analysis: A group out of China reviewed multiple studies and did not state that there was no benefit,