Dizziness Depot

Aug. 28, 2013

Malaria Drug and Vestibular Disorders

Alan Desmond
Mefloquine is a drug used for the prevention of malaria. It has come under some scrutiny lately as it has been mentioned as a possible contributor in the Sergeant Robert Bales incident. He is the soldier recently convicted of killing 16 Afghan civilians. Mefloquine has been suspected of causing numerous psychiatric or neurologic type symptoms, including permanent vestibular injury. According
Aug. 21, 2013

How to Save One Billion Dollars a Year

Alan Desmond
Last week, we reviewed a recent story published by Johns Hopkins. The story summarizes an article that recently appeared in the July issue of Emergency Academic Medicine. This week, I want to discuss some new (at least to me) demographic information that was obtained as part of that article. Here Comes the Wave The first issue is the sheer number
Aug. 13, 2013

Acute Dizziness in the ER: Expensive and Ineffective Practices

Alan Desmond
Can I get an “Amen?” A recent article published by Johns Hopkins (www.hopkinsmedicine.org) nicely summarizes and adds some interesting facts to the argument (okay, soapbox) that I have been trying to make over the past year or two: the practice of ordering CT scans, and not doing a brief vestibular function screening when a patient arrives at the Emergency Room
Jul. 31, 2013

Sensory Conflict -Priorities

Alan Desmond
This week’s post is an excerpt from my book: Vestibular Function: Clinical and Practice Management (Thieme 2011). “The primary role of the balance system is to allow humans to interact and maintain contact with their surroundings in a safe, efficient manner. As humans move through their environment, information is gathered through their visual, somatosensory, and vestibular senses and sent to
Jul. 02, 2013

The Caloric Test: By the Numbers

Alan Desmond
Caloric irrigation is performed by irrigating the ear canal with either water or air for a period of 30 to 60 seconds. In order for the test to provide sensitive, accurate information, several minimum standards must be met. 1. The temperature of the air or water must be precisely 7 degrees Celsius over or under body temperature to compare to
Jun. 25, 2013

The Bow and Lean Test

Alan Desmond
A brief word of caution – this week’s blog is not for general consumption. It will be confusing to those not very familiar with Benign Paroxysmal Positional Vertigo (BPPV). Last week, I blogged about some recent courses I had taught, and promised to post about a new trick I learned in the process. I was about halfway through a 90-minute
Jun. 18, 2013

Vestibular Disorders: Teaching and Learning

Alan Desmond
I had a different kind of week last week. I took the week off from seeing vestibular patients to teach a couple of courses. On Tuesday, I spoke to a small group of Otolaryngologists and Audiologists about the differences between primary care and specialty clinic management of the dizzy patient. On Friday and Saturday, I spent all day (and I
Jun. 12, 2013

Physical Therapy and Fall Risk Assessment

Alan Desmond
This week, I just want to review some aspects of what a Physical Therapist can contribute to a Falls Risk Assessment Team (FRAT). The role of the Physical Therapist might change dramatically depending on setting, training and the skills of other FRAT members. What is listed below is a summary provided by Kim Slemp, PT, a good therapist and friend, when asked
Jun. 04, 2013

Frat Boys and Fall Risk

Alan Desmond
When I was in college (and I assume it’s not changed too much) there was typically a point in time where you needed to decide if you wanted to join a fraternity or not. There were a lot of discussions about this in the first few weeks of each school year, with underclassmen asking the older students what they thought
May. 29, 2013

Visual Deficits and Fall Risk

Alan Desmond
Vision and vestibular function are closely linked, particularly as they relate to gait and postural stability. Visual acuity is independent of vestibular function only when the head is perfectly still. With any movement of the head, we rely on the vestibular ocular reflex (VOR) to provide visual stability. Any significant deficiency of the VOR can result in visual blurring (oscillopsia)