Saturday, October 29, 2016

To Diagnose and Cure Dizziness Sooner Than Later

After focusing my medical practice on vestibular system disorders over a decade ago and seeing over a thousand new dizzy patients per year for many years, I have noticed that patients ask me one particular question more than any other. The question is:
why couldn't I have found you sooner?
Fortunately, with technologic and diagnostic advances in vestibular medicine, we are now much better able to recognize the cause of dizziness or vertigo and to therefore provide the most appropriate and effective treatment.  As with any symptom in medicine, the correct diagnosis is necessary in order to apply the most effective and appropriate treatment.  Vestibular function testing, when combined with the patient's clinical symptoms and physical examination findings, enhances our ability to arrive at the most likely diagnosis.  We are now able to differentiate brain from inner ear disorders causing dizziness/vertigo and thus know whether a CT or MRI is needed (usually not).  We can quickly identify and instantly cure patients with benign paroxysmal positional vertigo (BPPV), aka the 'crystal' problem.  Based on the diagnosis, we know whether medication or a physical therapy intervention would be most useful.
Unfortunately, many patients go months or years without a correct diagnosis, undergoing unnecessary (and sometimes multiple) MRI or CT scans and/or carotid doppler studies. They are prescribed medications, such as meclizine, which are often ineffective.  They are sent to a physical therapist when the underlying cause of their dizziness or vertigo is something that physical therapy cannot help.  
For the specific case of BPPV, patients are amazed to learn that their vertigo can be cured with a simple head maneuver - they leave our office after their first visit cured of the vertigo they had been suffering with for months or years.  One particular patient who had been suffering with BPPV for many months actually fell and broke her hip as a result of vertigo and certainly wished she had received a diagnosis and treatment sooner.
In neurology, we have a saying:  "time is brain".  Indeed, in vestibular system disorders, timely diagnosis and appropriate treatment can save needless suffering, prevent painful and sometimes deadly falls, and save our healthcare system unnecessary expense.  
For further information or to schedule an appointment, click here to go to our website,, or call toll free 888-888-DIZZY (3499).

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