Dizziness Depot

This week we have a contribution from Ken Stallons, a Meniere’s patient who also just happens to be an audiologist. I would describe this as an anecdotal report of treatment efficacy, specifically related to salt restrictions as a conservative treatment option for Meniere’s disease. A couple of years ago, I did a multi-part series on the evidence available for the

In an attempt to answer some of the questions posed last week about the dramatic decrease in the number of vestibular tests performed, let’s review several recent articles related to management of patients who complain of dizziness. Click on the highlighted links for additional information. This information pertains only to patients presenting to the Emergency Room. They represent only a

Over the past few years on this blog I have discussed on several occasions the reductions in reimbursement for vestibular testing. I have also made the statement that clinical practice is often driven by reimbursement, and that changes in reimbursement eventually affect the way people practice. While this is a frightening yet logical conclusion, it is a difficult statement to

vHIT equipment is now available from all the leading manufacturers of vestibular testing equipment, and courses are being offered around the country by equipment sales representatives. There is currently no approved billing code for vHIT testing, but that does not diminish the test’s utility. As described last week, the vHIT apparatus records head movement and eye movement simultaneously, which allows

vHIT refers to relatively new technology to assess the high-frequency Vestibular Ocular Reflex (VOR). vHIT stands for video head impulse test, and theoretically allows the examiner to find VOR deficits that would not be visible under standard examination techniques. This may allow less experienced examiners to detect obvious deficits, and allow more experienced examiners to detect milder deficits. The basis

Dizziness is a vague term that is used to describe a variety of sensations, including vertigo (a sensation of spinning), lightheadedness (a pre-faint feeling), disequilibrium (instability standing or walking), Oscillopsia (visual blurring with head movement) or disorientation (something just ain’t right). I did a whole series on this a couple of years ago. I have found that there are three

All audiologists and ENT specialists are aware that asymmetrical hearing loss should be considered as potential auditory nerve pathology until proven otherwise. In fact, the American Academy of Otolaryngology-Head and Neck Surgery lists it as a position statement on their website as “Red Flags-Warnings of Ear Disease.” The standard of care for asymmetrical hearing loss is either to perform an

1. Vestibular (inner ear) Disorders –Vestibular disorders can cause dizziness, vertigo, or loss of balance with certain movements and in certain environments. 2. The use of multiple prescription medications – When a patient is taking four or more prescription medications, the chance of an adverse reaction increases, and the ability to predict interactions between medications decreases. 3. The use of anti-depressant

Poor balance and instability in the elderly has been described as a “geriatric syndrome” because the specific cause of these complaints is often not obvious on initial examination. This is primarily because poor balance in the elderly is most often multi-factorial, with no single clinical abnormality responsible. The balance system is complex, with contributions from the ears, the eyes, the

I Respectfully Disagree with the Abstract (but I agree and am impressed by the article) A recent article titled Causes of Persistent Dizziness in Elderly Patients in Primary Care (Maarsingh et al. 2010) is a welcome addition to the literature. Dizziness and vertigo are bothersome and common complaints, particularly in the elderly population. There has been much written and discussed