Dizziness Depot

Featured image for “Academy of Emergency Medicine Releases Guideline for Acute Vertigo”
Jul. 06, 2023

Academy of Emergency Medicine Releases Guideline for Acute Vertigo

Alan Desmond
The Society for Academic Emergency Medicine, in May of 2023, published GRACE-3. Grace is an acronym for Guideline for Reasonable and Appropriate Care in the Emergency Department. GRACE 1 and 2 offer guidelines for chest pain and abdominal pain. GRACE-3 addresses “acute vertigo and dizziness in the emergency department”. This is a welcome, much needed, and frankly overdue development as
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Jun. 23, 2023

Motion Sickness – Result of Sensory Conflict

Alan Desmond
Last week I discussed motion sickness, pointing out that it often has nothing to do with any inner ear disorder. However, occasionally it is directly related to an inner ear disorder. I will try to explain… Seasickness Seasickness represents an extended sensory conflict, whereas brief sensory conflicts typically do not induce nausea despite causing momentary disorientation. A familiar example of
Featured image for “The Masseter VEMP (mVEMP) and Potential Clinical Applications”
Jun. 13, 2023

The Masseter VEMP (mVEMP) and Potential Clinical Applications

Brady Workman
A vestibular evoked myogenic potential, or VEMP, is a measure of vestibular function that only recently is seeing widespread clinical use. A VEMP is a measurement of a change in muscle activity in response to stimulating the vestibular system. These measures allows us to intuit the function of specific end organs of the inner ear, predominantly reflecting the function of
Featured image for “Vestibular Ocular Reflex (VOR) Exercises”
Jun. 09, 2023

Vestibular Ocular Reflex (VOR) Exercises

Alan Desmond
If the results of the rotary chair examination indicate a deficit of the VOR, particularly decreased gain or a significant asymmetry, we may start the patient on a series of exercises known to enhance the function of the VOR. Like most exercises, the goal is to push the limit of your performance to gradually increase your limit. Below, you will
Featured image for “CT Scans for Dizziness: Good or Bad Idea?”
Jun. 04, 2023

CT Scans for Dizziness: Good or Bad Idea?

Alan Desmond
Approximately one year ago, I embarked on an exploration of the most efficient and cost-effective methods for assessing patients experiencing acute dizziness. This investigation took the form of a comprehensive five-part blog series titled “Acute Vertigo: Could It Be A Stroke?” Within this series, I underscored a crucial point: the prevalent imaging techniques often employed in the Emergency Room setting
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May. 29, 2023

Flicker Vertigo – What is it?

Alan Desmond
After more than 25 years of working with vestibular patients and hearing various unusual descriptions, I recently came across a term that caught my attention: “Flicker Vertigo.” Although it may be familiar to pilots, I had never encountered it before, despite spending my childhood Saturdays in the back seat of my father’s airplane during aerobatic stunts. Hmmmmm. Maybe that explains
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May. 25, 2023

Let’s Talk About Meclizine

Alan Desmond
Let’s spend a few weeks talking about meclizine. Most patients complaining of dizziness or vertigo have been given a prescription for meclizine at some point. For a medication that is so widely used, there is very little solid information or recent research to back this up. Meclizine goes by a few names; meclizine is the generic term, but it is
Featured image for “BPPV: Canalithiasis or Cupulolithiasis?”
May. 14, 2023

BPPV: Canalithiasis or Cupulolithiasis?

Alan Desmond
The most common peripheral vestibular disorder is the condition of Benign Paroxysmal Positional Vertigo (BPPV), accounting for anywhere from 17-42% of all patients seen with symptoms of vertigo.1 The condition of BPPV causes brief episodes of vertigo provoked by a head movement or position change. Benign Paroxysmal Positional Vertigo (BPPV) is typically described by location and type. For example, the
Featured image for “Meclizine – Does it help?”
May. 01, 2023

Meclizine – Does it help?

Alan Desmond
Treating Dizziness with Antivert: Research indicates that long-term use may not be the best solution By Alan L. Desmond, Au.D., CCC-A and R.Brian Collie, D.O., RPh Considering how frequently Antivert (Meclizine) is prescribed for dizziness, its effectiveness has been measured in remarkably few studies. While there is general agreement among specialists that vestibular compensation is inhibited by the use of
Featured image for “Meclizine – Does it Hurt?”
May. 01, 2023

Meclizine – Does it Hurt?

Alan Desmond
Editor’s note: This is Part 2 of an update of an article on the use of Meclizine for vertigo that first appeared in print in Advance for Audiologists in 2000. The Physicians Desk Reference lists adverse reactions for meclizine, noting that “Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.” But what about functional impact? Could meclizine