Dizziness Depot

When performing an exam for Superior Canal Dehiscence (SCDS), you may have two different goals.  In a patient with many of the symptoms described in last week’s post, but no diagnosis, you are trying to establish the likely source of those symptoms. This might lead to the referring physician ordering a high resolution CT scan to investigate the possibility of

Last week we discussed the physiology behind symptoms associated with Superior Canal Dehiscence Syndrome (SCDS). This week, we look at some of the symptoms associated with this condition. While many patients with SCDS complain of chronic dyequilibrium and disorientation, there are some symptoms that are more specific to SCDS. Mass Eye and Ear describes the symptoms as: patients with SCDS

Superior Canal Dehiscence Syndrome (SCDS) is a relatively recently discovered syndrome involving an abnormality of the inner ear that can be responsible for a number of bothersome symptoms. It was first described by Dr. Lloyd Minor at Johns Hopkins University.  SCDS is a developmental condition where the bone that separates the inner ear from the brain basically “gives way”, and

Let Me Introduce You This week’s blog required little writing, but it does require some reading. Today, I am going to play information matchmaker.   Sometimes it’s who you know, not what you know. I wrote a blog here several months ago about the options available to people if they are diagnosed with an Acoustic Neuroma or Vestibular Schwannoma. A few weeks

This is the final installment of this series regarding my “faux” Clinical Practice Guideline (CPG) for Acute Vertigo.   Clinicians should use the HINTS protocol for increased efficiency in evaluating patients presenting with acute vertigo.   The HINTS protocol is a series of tests that have been developed, researched and is in the gradual process of being applied as a

We are back with a few more “Action Statements” to continue with my “faux” Clinical Practice Guideline (CPG) for Acute Vertigo.  Patients complaining of vertigo-dizziness should undergo screening for acute and positional nystagmus before more expensive, lower yield tests are ordered. A 2009 study out of the Veterans Administration retrospectively reviewed the medical records of 193 adult patients over a

We continue this week with our “faux” Clinical Practice Guideline for Acute Vertigo. There are several benefits in having a CPG that is developed through cooperation between medical specialty societies. The process includes in depth examination, discussion and summary of the existing research. Based on that, the panel makes a recommendation as to the most logical action to take given

There is no current Clinical Practice Guideline (CPG) for acute vertigo, but I think there should be. Based on published research, there are several things that should be done, and some current practices that need to be reconsidered. Disclaimer: A true CPG involves many specialists from a variety of specialties, researching hundreds of applicable peer reviewed journal articles. My “faux”

The American Physical Therapy Association (APTA) has released a draft version of a new Clinical Practice Guideline (GPG) for Vestibular Rehabilitation (VR). The CPG Panel considered the benefits to various groups seeking VR. They addressed patients presenting with acute, sub-acute and chronic unilateral vestibular hypofunction, as well as those with bilateral hypofunction. They considered which types of exercises were most helpful

The American Physical Therapy Association (APTA) has released a draft version of a new Clinical Practice Guideline (GPG) for Vestibular Rehabilitation (VR). The panel includes some of the best in the business, representing Physical Therapy, Neurology, Otolaryngology and Audiology, among others. I had the privilege of representing Audiology on the CPG panel for BPPV several years ago, so I appreciate