Dizziness Depot

Polypharmacy refers to the act of taking multiple medications concurrently. While there is no universally accepted threshold, polypharmacy is generally defined as taking 4 or more prescription drugs daily. Taking several medications is not inherently problematic, but it introduces uncertainties. An old principle of prescribing holds that the likelihood of adverse reactions and inability to predict interactions rises as the

Diagnosing episodic dizziness can be challenging as most patients are asymptomatic when they arrive for examination. Episodes of dizziness can be broken down into two broad categories based on two variables: Triggered vs. Spontaneous episodes Episodes of less than five minutes duration or more than five minutes duration. Fortunately, these categories align in that most short duration dizziness is triggered,

Vitamin D is an essential nutrient, necessary for building and maintaining healthy bone structure by promoting calcium absorption in the body. Despite its importance, vitamin D is not found naturally in many foods. Also, with populations spending less time outdoors, vitamin D obtained naturally from sunlight is likely declining. As such, vitamin D deficiency is widespread with an estimated 1

Vestibular disorders are the most common reason for symptoms of dizziness regardless of the clinical setting. A five study average reveals that vestibular disorders account for around 45% of all dizziness and are much more common than cardiovascular or potentially life threatening neurologic causes for dizziness. Despite the magnitude of individuals suffering from vestibular type dizziness, these disorders are historically

This week, we delve into the pivotal work of evaluating patients with sudden-onset acute vertigo. Accurately distinguishing between benign labyrinthine conditions and life-threatening strokes is critical, particularly in cases presenting with the acute vestibular syndrome (AVS). Limitations of Imaging in Acute Vertigo Diagnosis Traditionally, emergency departments have relied on imaging techniques, such as cranial CT scans and MRI, to assess

Ramsay Hunt Syndrome (RHS) is a condition caused by the varicella-zoster virus (chicken pox), part of the herpesvirus family, which can remain dormant in cranial nerves or dorsal root ganglia after the initial infection, commonly known as chickenpox. Later in life, when the virus reactivates due to physiological stress or immunocompromise, it can result in herpes zoster or “shingles” anywhere

The most common vestibular disorder is the condition of Benign Paroxysmal Positional Vertigo (BPPV), which accounts for up to 40% of all patients experiencing vertigo. This condition is the result of otoconia (inner ear crystals) migrating into one of the semicircular canals (head turn sensors) of the inner ear. The majority of cases can be readily treated with canalith repositioning

Last week, I told a story about my difficulty in getting a patient to understand the role of meclizine in the treatment of Benign Paroxysmal Positional Vertigo (BPPV). It got me thinking about some of the analogies we use to describe certain concepts about BPPV that may be more relatable to a patient than trying to help them understand things

A few years ago, I did a post here discussing patients that continued to complain of imbalance and “fleeting disorientation” after successful treatment using the Epley maneuver or some other form of canalith repositioning. So let’s revisit that and explore some related newer reports, as well as talk about people that do not improve after repositioning for BPPV type of

I recently saw a patient referred for the generic complaint of “Dizziness.” When he got up from the chair in the waiting room, he had an obvious gait disorder and used both a cane and a family member’s arm to make it back to the examining room. He did not complain of vertigo or lightheadedness, but reported that he had