• Episode 39 - Dizziness

  • Mar 29 2021
  • Length: 32 mins
  • Podcast

  • Summary

  • Dizziness

    Dizziness can come in different forms: vertigo, lightheadedness, disequilibrium.

    Vertigo:  False movement, room spinning.  Feels as if you are moving when you are not.  

    Benign Paroxysmal Positional Vertigo:  acute, occurs with certain movements, lasts seconds to minutes

    Dix-Hallpike to diagnose 

    Vestibular rehab/physical therapy to treat - Epley Maneuver

    Meniere’s Disease: vertigo, with hearing loss and ringing in ears

    Labyrinthitis

    Central vertigo: can be more worrisome, exam looks for signs of stroke or other pathology. May need brain imaging. 

    Lightheadedness: feeling like one could pass out, pre-syncope

    Cardiac causes: arrhythmias, valve disease

    Orthostatic hypotension

    Disequilibrium: sense of imbalance

    Changes in nerve sensation can contribute: peripheral neuropathy, knee replacements

    Vision and auditory impairment can also contribute

    Diagnosis: monofilament testing, vibration sensory testing, gait speed, get up and go test, Romberg test all help evaluate

    Treatable causes: B12 deficiency, thyroid disease, uncontrolled diabetes, medications that can be stopped (older anti-histamines)

    Treatment: Adaptations (change in glasses, hearing aids), practice balance - physical therapy, strengthening

    Persistent Postural Perceptual Dizziness (PPPD): persistent dizziness that worsens with motion or upright position, present > 3 months

    Often follows BPPV or labyrinthitis

    Anxiety, depression often present concomitantly

    Treatment: Evaluate medications, consider medication to help with anxiety, depression

    Health Pearl: For people who have been fully vaccinated for COVID-19, we discuss CDC guidelines and ways to safely expand activities. 

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