A new guideline was published in the May 27 issue of Neurology, stating that the “Best Treatment for Vertigo Is Easiest One”.  The Guideline urges immediate therapy with a simple series of head, body movements to clear the inner ear of otoconial debris on the affected side.  The guideline published by the American Academy of Neurology, goes on to describe several maneuvers which can be performed efficaciously to treat the alleged benign, Paroxismal Positional Vertigo, aka BPPV, an extremely common cause of vertigo.

“The good news is that this type of vertigo is easily treated. Instead of telling patients to ‘wait it out’ or having them take drugs, we can perform a safe and quick treatment that is immediate and effective,” guideline author Dr. Terry D. Fife, of the University of Arizona College of Medicine and Barrow Neurological Institute, said in a prepared statement.  This is a statement which I happen to agree with as too many people suffering with vertigo are simply told to “learn to live with it”.  In light of the simplicity of this diagnosis and treatment, being told to learn to live with it is not only a ridiculous thing to say, but also a clue as to the competency of the individual making the assessment.

Benign paroxysmal positional vertigo is caused by loose calcium carbonate crystals, (otoconia), that become dislodged in the vestibular labyrinthine canals. The maneuvers recommended in the guideline move the crystals out of the canals and into another part of the labyrinth, where they can be destroyed by your bodies natural immune system.

My office has been successfully treating this disorder probably longer than anyone in the area, and with great success.  It remains unfortunate however that the general population goes to their PCP, (primary care provider), first, and is typically treated with inappropriate drug therapies, which often times cause profound dizziness as a side affect.  Additionally, referrals for a myriad of completely unnecessary and expensive diagnostic testing are also typical.  This is unfortunate in light of the fact that better than 97% of these tests will not yield any useful information at all, and most will cost around $1000.  It just seems to make a lot more sense to treat the disorder quickly and appropriately and be done with it, at a fraction of the cost.



A recent study suggests that after age 40, dizziness makes you 12 times more likely to suffer serious injury from a fall.  About 69 million Americans over age 40 have some form of inner-ear dysfunction or another, that predisposes dizziness and makes them up to 12 times more likely to suffer a serious fall.

“More than 22 million of those people are unaware of their risk, mostly because they’ve had no previous incidents of dizziness or sudden falls”, said Johns Hopkins researchers who surveyed more than 5,000 men and women over age 40.  In this study the authors find that compared to those with a healthy sense of balance, those with an inner-ear dysfunction who had experienced no symptoms as of yet, were actually three times more likely to suffer a potentially fatal fall than other people, while those who actually have experienced symptoms had a 12-fold greater risk of a fatal fall.

The survey additionally noted that 85 percent of those over age 80 already had a balance problem and people with diabetes were 70 percent more likely to suffer imbalance than those without diabetes.  The findings were so significant they were published in the Archives of Internal Medicine.

So why is all this important?  Because vestibular imbalances need to be taken extremely seriously, because they can unwittingly lead to a fatal fall, or leave you disabled from an unintentional injury, possibly associated with long hospital stays and significant loss in quality of life.

The CDC, (Centers for Disease), reports that accidental falls are a leading cause of death and injury among the elderly. Each year in the United States, falls kill about 13,000 seniors and result in more than 1.5 million visits to hospital emergency rooms.

“Our survey shows that balance testing needs to be part of basic primary care, and that all physicians need to be monitoring and screening their patients for vestibular dysfunction so that we can take preventive measures to guard against falling,” was the conclusion drawn by the researchers.  Our office is compliant in this regard, offering computerized dynamic posturography, which assesses stability and thus risk of fall in seconds.  We offer this service free as a community service, which according to this study, is invaluable no matter your age or your perceived sense of balance.