Dizziness Depot

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)

A few years ago, we took a family trip to New York City for Christmas. Part of that weekend included taking in the Broadway production of Wicked. We missed seeing Kristin Chenoweth in her starring role, but we went out and bought the soundtrack as soon as we got home. For the next two years, my girls ran around the

The Epley Maneuver, initially described by John Epley in 1992, has been widely used for the treatment of Benign Paroxysmal Positional Vertigo (BPPV). However, based on personal observations from an experienced practitioner who has performed thousands of Canalith Repositioning Procedures (CRP) over the past two decades, it appears that the maneuver may be more complex than necessary. Despite this, the

Despite the well established safety and effectiveness of Canalith Repositioning, patients with BPPV rarely receive this treatment.  A 2002 German study reviewed the prior medical history via questionnaire in a group of patients with confirmed BPPV. They report that 51% admitted to recurrent symptoms over a mean duration of 3.2 years. Prior to correct diagnosis, eight percent were hospitalized, Cerebral

Last week, I reviewed some studies that found that patients with BPPV have historically been managed quite ineffectively. I am pasting a reader (Audiologist) comment I received shortly after the blog was posted: “Sadly, I’m not shocked at all by these stats. However, I will say there seems to be more awareness amongst physicians the past few years. “Inevitably, though,

This week, we are going to take a quick look at some (at least to me) startling and depressing statistics related to Benign Paroxysmal Positional Vertigo. Each will be linked to the abstract if you want further detail. I will be exploring current management of BPPV over the next few weeks. 1. Two recent studies explored the time period from

After three weeks of dissecting the Optokinetic Tracking test, let’s take a light diversion. It is Final Four weekend, and the country is basketball crazy right now. I am a bit of a basketball junkie myself, so anytime I can combine basketball and dizziness, I am on it. The first item involves a game we used to play back in

Last week, I went on a bit of a “poor me” rant. This week, I am back with a little cheese to go along with my whining. This week’s blog plugs in some others’ thoughts on the Optokinetic tracking test, and the purpose of screening tests in general. Forgive the liberal use of cutting and pasting this week, but this

I am feeling a little vulnerable this week. I am not a lawyer thank goodness, but the quote, “Never ask a question if you don’t already know the answer” can also apply to someone who writes blogs, or books, or teaches courses, or simply wants to understand why we do what we do. That leads to the second part of

Optokinetic tracking is the part of the VNG battery where the patient is simply asked to “follow the lights” as they sail by, first in one direction, then the other. In real life, the optokinetic system kicks in when the vestibular system fails to ‘‘keep up’’ during sustained head rotation. Optokinetic tracking is similar to smooth pursuit tracking in its mechanism of