Dizziness Depot

I am recycling a portion of a post I did a couple of years ago. This post discusses a particular observation that occurs periodically when performing canalith repositioning, namely a short burst of downbeat vertical nystagmus when bringing the patient back up to the seating position (position #4). We are revisiting this because I saw a patient last week with

Balance is not one thing, it is several things. Balance involves several parts of the body generating and responding efficiently to movement. There are two primary pathways involved. The first is described in scientific terms as the afferent pathway. This pathway includes sensory information that is gathered by the eyes, the inner ears and the sense of touch (tactile system)

A healthy inner ear supplies the brain with constant information about movement. That information changes with movement. The inner ears could be described as generators producing electrical current. When the head is still, the “power” supplied by the two generators (the two inner ears) is equal. Whenever the brain receives a signal from the inner ears, the eyes reflexively respond

Good, But Not Sliced Bread Yet This week’s post would fall under the heading of “unsolicited opinion.” I received my copy of the March/April edition of AudiologyToday, which is produced by the American Academy of Audiology.  I spotted a Letter to the Editor by Gary Jacobson and Devin McCaslin, both on the faculty at Vanderbilt University. Jacobson and McCaslin are

One Veterinarian’s Account   This week, my good friend Jenny Langford has agreed to give a veterinarian’s perspective on canine vestibular disease. Jenny also happens to be my dog’s vet as well as a periodic BPPV sufferer herself. I asked her if she has ever seen a dog that she suspected may have BPPV. Here’s Jenny:   “He has had

  Last week’s blog discussed that “Dogs Get Dizzy Too!” I mentioned that I was unaware of any specific case reports of doggy BPPV. Well, the next day, I got an email from my friend Erin Miller AuD, who just happens to be one of the top audiologists in the country and past president of the American Academy of Audiology. Erin’s

Dogs and Vestibular Disorders We get to know our dogs pretty well. We know when they are happy, scared, lonely or hungry. We also know when they suffer from a vestibular (inner ear) disorder. Dogs rely on their ears for hearing and balance just like we do. And, they can suffer from the same inner ear disorders. There are many

  Explained by an Astronaut: I ran across an interesting article in Forbes Magazine by Dr. Garret Reisman, former NASA astronaut. He was asked what it is like to return to earth after being in a gravity free environment on the international space station. I have a vague memory of this topic being discussed at one of the first vestibular

A couple of weeks back, I did a short post discussing that many patients diagnosed with Meniere’s disease may be misdiagnosed. I received a comment from a reader asking, “is there now a definitive way to diagnose Meniere’s?”  Well, sort of. Meniere’s disease is diagnosed by recognizing a pattern of symptoms and a constellation of clinical signs. There is no

The Epley maneuver (or canalith repositioning) has historically been described as involving four positions, with the Dix-Hallpike test being position #1. Position #2 involves having the patient roll their head away from the affected side. Position #3 continues in the same direction to the nose down position, and position #4 involves bringing the patient back up into the sitting position.