Many people with balance disorders confuse the symptoms that they are experiencing, which can have harmful consequences when presenting to your doctor, who will often medicate you based upon your complaint.  First off, vertigo is a symptom, not a diagnosis.  It is a symptom of spinning, or feeling as though you, or the environment is going around and around.  The most common form of this is when you get into or out of bed, and suddenly you are holding on as the room begins to spin violently.  This is the most common form seen in my office, which is also the easiest to treat with close to 100% success in a single office visit.  Dizziness, also a symptom, not a diagnosis, is a sense of lightheadedness, or almost a feeling as though you are going to pass out.  Dizziness does not include the rotary spinning sensation of vertigo.  Dysequilibrium, again, a symptom, not a diagnosis, is quite simply a loss of balance.  You may feel as though you lean to one side or fall to one side on walking, or just feel as though you may fall at any instant.  Often, dizziness and dysequilibrium are the direct result of untreated vertigo.  Left untreated, each attack of vertigo changes the brains monitoring and regulation of the postural systems, which over time, causes less than desirable changes, which include poor stability and thus increased risk of fall.  This is actually an endemic problem currently, with falls being the leading cause of death in the elderly, and the leading cause of nonfatal injuries in all-remaining age groups.  To appropriately treat any of these symptoms however, the key remains in being able to accurately diagnose what is wrong.  This is the focus of my office, fit with a complete vestibular laboratory and balance center.  Drug therapies such as frequently prescribed vestibular suppressant medication such as Meclizine, (Antivert), will often magnify symptoms of dysequilibrium due to the slowing of nerve conduction and thus slowed reaction times, comparable to that of alcohol use.  Worse still, they have no benefit as a treatment.  They merely reduce ones perception of symptoms temporarily.

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  1. I have vertigo, and I’m fairly convinced its bbpv. almost every morning getting out of bed makes me so dizzy and nauseous that I vomit excessive amounts of bile, which is quite worrying. I can already feel the back of my throat is raw. I’ve read that bbpv usually overcomes itself in about 6 months, is that right? and is the epley maneuver enough to treat bbpv, can I do that at home?? I’m a med student and this is really interfering with my sleep and study 🙁

    • I am very sorry to hear that you are suffering as badly as you are with vertigo, which can be difficult to endure. It sounds as though you may have BPPV by your description, but without examining you it is difficult to be certain and I would be merely guessing. Having said that, if it is BPPV I can treat that very easily and have you better in a few treatments. I have seen (many) patients go 6 months and longer, sometimes years, when they are treated inappropriately by those inadequately trained. I do not recommend the “home” Epley maneuver as I have had many patients attempt that finding that they are developing reciprocal dysequilibirum from doing a maneuver that is inappropriate to their labyrinthine canal affliction. If the maneuver is not done with a high degree of specificity, it will just make you worse each time you perform it. I am not sure where you live but I would be happy to see you. There are not a lot of specialists who can treat this disorder properly which is why my office sees so many individuals from other states. Lastly, if you are coming to see us from out of state my office manager is familiar with making all of the arrangements. We would ask that you spend a week.

      Thanks for contacting me, best with your medical studies, and hope to meet and help you.

      Dr. S.

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