Dizziness Depot

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

Just imagine, you wake up one morning and the entire room is spinning around you. You have no idea why this is happening or how to make it stop. You notice that if you remain still the spinning will stop, but whenever you move again, the spinning sensation starts again. Because the world appears to be spinning around, you become

After a unilateral peripheral injury, such as would occur with vestibular neuritis, there is a predictable set of clinical signs and symptoms that occur. In addition to an initial period of acute vertigo, there is often a period of motion intolerance that follows. The acute vertigo usually lasts for several hours, but gradually decreases over a period of three to

Multiple sources agree that the most common causes of the complaints of dizziness and vertigo include benign paroxysmal positional vertigo, vestibular migraine, orthostatic hypotension, vestibular neuritis, and Ménière’s disease.  There are subtle differences in the symptom presentation, duration, provoking or exacerbating factors that guide the examiner to the diagnosis. Vestibular neuritis almost always presents as an isolated episode of vertigo

As we and many others have discussed in previous blogs and articles, the word “dizzy” is a broad and ineffective descriptor of symptoms that might bring someone to a vestibular clinic. I did an eight part series on this topic about ten years ago. It is important to get additional information to venture any guess as to the possible cause of the

Recently, I was reading an article discussing the differences in symptoms among adults with canal versus otolith vestibular dysfunction, which raises some important questions for the future of vestibular assessment. As most clinicians know, a detailed case history is essential in establishing a diagnosis of peripheral vestibular dysfunction, with the qualitative nature of the symptoms being important in reaching a