Episode 39 - Dizziness

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. Follow us on Facebook and Twitter