What is Dizziness and Vertigo?

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It is difficult to discuss dizziness because it means different things to different people.  There are three main terms in use by physicians which describe what we all refer to as “dizziness” Disequilibrium Disequilibrium is the sensation of being off balance, much like when getting off a boat, and is sometimes characterized by falls in a specific direction. This condition is not often associated with nausea or vomiting or vertigo. Pre-syncope Pre-syncope (literally near fainting) or lightheadedness, like when standing up too … Read More

Vertigo has me at my wits’ end…I need more help!

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Vertigo and dizziness are very distressing problems.  Some say that nausea is worse than pain.  At least pain makes some physiologic sense. Vestibular diseases are problematic in that they are so poorly understood. Many patients  end up vague diagnosis such as recurrent vestibulopathy.  Medical science has just not reached a point where we can diagnose every kind of problem.  Further, even those conditions which we can diagnose may not have effective treatments.  Tinnitus is a good example of a difficult … Read More

Superior and Horizontal Canal BPPV – what are those?

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Someone recently asked about the treatment for the other 2 canals in the inner ear and if the Epley maneuver work for those types of BPPV. The quick answer is no the Epley maneuver does not work for horizontal or superior canal BPPV but only for the more common posterior canal form of BPPV. The good news about that, however, is that those other two types are easier to treat. First – superior canal BPPV is theoretical and may not … Read More

Mal de debarquement? Is that like BPPV?

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We recently were asked: “I think that I have Mal de Debarquement syndrome. I believe this because I tend to get it after train travel. In the past it took 6 weeks for it to go away. Now, it seems to be taking longer. Does the Epley maneuver work for this?” Until recently very few people knew about Mal de Debarquement syndrome. This syndrome can occur after any type of travel. The best analogy is sea sickness. When you first step … Read More

How long does BPPV last? Why does it go and come back?

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We were recently asked, “Why does BPPV go away and come back?”.  To understand the treatment and natural history of BPPV it helps to understand how it happens in the first place. Lets imagine that the inner ear is akin to a tiny snow globe inside the head.  In a healthy person the snow inside this globe is actually stuck down but with age the snow comes loose and begins to fly around when disturbed.  Now lets imagine there is a … Read More

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